Hi everyone.

i have a question.

my friend's mom has just been dx'd with absence szs and has been scripted phenytoin as her only AED. she was also hospitalized for a few days and kept on phenobarbital temporarily.

the situation is not simple. my friend's mom is elderly and has had existing neurological issues often not fully lucid for a few years now. i do not know exactly what because my friend doesn't either, but she has been in the care of a neurologist for some time. if she was taking meds, i don't know what. no history of seizures. about 6 months ago she had two strokes, the most severe of which left her paralyzed neck down, even after rehabilitation.

the absence seizures just emerged ... or were just noticed... as the sx are especially subtle in this lady's conditions. my friend was told, at the hospital, that scar tissue from the stroke is causing her szs, which would seem consistent to me with the timing of her stroke, so hopefully the docs are somewhat decent.

but regarding the phenytoin.... i've read conflicting information: some of my sources specify it is useful for grand mal and various partial sz types except of absence sz. other sources give no exceptions and do say it is indicated for seizures [type unspecified] "arising from brain damage".

i've read that ethosuximide (Zarontin) is first line treatment for absence seizures, and that valproic acid/valproate (Depakote) is also effective. These meds also list an indication for seizures arising from brain damage.

so why not one of these two?

i suppose there could be a problem of interactions with her other meds, but phenytoin does not exactly have a pristine profile as far as drug-drug interactions, does it. my friend seems certain her mother has not had other seizures; i suggested to her that the docs may suspect other types of szs. But they confirm absences seizures! So... those need treatment...

is phenytoin appropriate for absence szs? i just don't understand this choice of medication, and i'm a bit concerned. have any of you had absence szs treated with phenytoin alone?

what do you think? i would really appreciate any input on this! my friend will be talking to the doctors on and off.

thanks very much in advance

~ waves ~ waffling in the dark