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Chapter: Diseases of The Brain and Nervous System(A Health Education Guide): Neurological Medicines to be used for longer duration

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Epilepsy (Fit / Seizure) Diphenyl Hydantoin

In rare cases this medicine can cause a serious allergic reaction, known as Steven’s Johnson syndrome which starts with erythema on skin and fever endangering life.

Epilepsy (Fit / Seizure)

Diphenyl Hydantoin

In rare cases this medicine can cause a serious allergic reaction, known as Steven’s Johnson syndrome which starts with erythema on skin and fever endangering life. The common side-effects of this drug are inflammation of the gums, regression of the beauty and softness of the face, unwanted hair growth, decline in memory, enlarged lymphnodes in the neck, damage to the small brain (cerebellum), or minor problems of the nerves. If the dose is high, the patient experiences double vision and vertigo. Therefore, it is important to monitor the levels of the drug in the blood regularly. This is known as “ Phenytoin Blood Level”. Blood for this test has to be taken on a fixed time just before dose or else it is useless,. If possible pregnant patients are shifted to some other drug, because 0.7% children are born with deformities due to this drug.

 

(i) Carbamazepine :

This medicine can also cause the earlier mentioned rare Steven’s Johnson syndrome, which is a life-threatening allergy of skin and mucous membrane. In addition to that, white blood corpuscles particularly neutrophils can decrease causing ulcers in the tongue and throat and infections canoccur. Therefore, the patients using this drug should regularly get their blood tested for various blood cell levels every three to four months. This medicine is harmless during pregnancy and there is no evidence of side effects to the child.

(ii)  ValproicAcid :

This medicine is used in many types of epilepsy. It commonly causes weight gain and hair loss, but it can also damage the liver and so if this medicine is being taken, regular blood test called S.G.P.T. should be done every 3 to 4 months, though there are a few disparities in this advice, e.g. the S.G.P.T may have been normal a week ago and suddenly the liver starts malfunctioning. If the symptoms point out to this the drug may have to be stopped after conducting the blood test again and confirming the clinical findings. If a pregnant woman takes this drug there are reports of damage to the spinal cord of the baby, though the proportion is in 10 babies out of every 1000. The presence of this defect can be ascertained by sonography, blood test called alpha-fetoprotein, or amniocentesis and if a problem is detected the pregnancy should be terminated.

(iii) Phenobarbitone :

This medicine is old yet very effective but medical reports show that if it is given to small children for a long period, they may become stubborn and mischievous and in some cases there can be memory defects. It also causes drowsiness and so this drug is used very infrequently these days. Instead of this drug, another slightly different drug called eterobarb is used in Europe, which has fewer side - effects.

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