Thanks so much for your reply... sorry for not getting back sooner. I have been doing things somewhat out of order... sigh...

well, currently i am unable to be in touch with my friend anyway... she is busy.

i suspect they are giving phenytoin to control other "possible" sz types as it really doesn't make sense for absences.

i mean, she is not a kid at school having hundreds of them who cannot concentrate because of them, or someone who might need to drive. she is already bed-bound by full body paralysis, and cognitively compromised. so if she really is just having absence seizures, keeping them would probably better for her than having ANY AED shoved down her gullet, which would just serve to stress out her liver and kidneys and might give her unpleasant side effects.

so it goes back to... i suspect more is afoot here than my friend has been told, or than she understood. (she was quite adamant that there were only absences when i asked about other sz activity and also about the EEG.)

the docs... the cost... insurance payout to the docs?... umm, nope... i am not in the US. state-run medical system and they pay the docs dirt. phenytoin is cheap. docs have many limits placed on them too. there are also plenty of very non-brilliant docs practicing. example. i was prescribed erythromycin while on carbamazepine (Tegretol). in case you aren't familiar, erythromycin can raise Tegretol plasma levels to the point of toxicity and even death. i had told this doc i was on Tegretol, but he did not remember (mind, he didn't ask right then if i took anything else), or did not know of the interaction, i don't know. but that is pretty bad. another patient who didn't know the meds could have ended up DEAD. another time by another doc i was scripted a max dose of an antidepressant that had previously made me manic - doc knew, no titration period. that is just not a good idea. the only reason it didn't happen is that I REFUSED to take that much. i have other experiences of abject incompetence (by 2 neuros at a famous institute, actually) so... so no, i do NOT trust the docs here. i like to stay on top of things as much as i can. i believe in doing my own research, but i think here especially it is necessary. seen and heard too many horror stories. prevention is better than death.

in this case, it is to help someone who may think EEEK epilepsy! quick! medication! when that is absolutely false.... if there are only absence seizures at play anyway.

however my friend has been out of touch... perhaps still "dealing" with this news, surely tired from looking after her mom, and perhaps not ready to talk about things. i tried to reassure her initially but, i doubt it sank in much. it saddens me but i cannot help her / share knowledge / point her to resources until she decides she wants to learn.

meanwhile i just hope her mom tolerates the phenytoin well, and that if she does have other sz, that it controls them.

sigh.

Anyway i appreciate your input. will post if i have news. i will try to call her perhaps in a week to see how her mom is doing, and how she is holding up. it will be interesting to see if the phenytoin does help her... as you mention the fact that perhaps the szs arising from due to lesions might not be typical absences.

~ waves ~