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What Causes Trouble Breathing And Hair Loss After Having Eptoin For Seizures?

Posted on Mon, 4 May 2015

Question: My wife aged 35 years suffered from right occipital bone un-displaced linear fracture with bi-frontal sub arachnoid haemorrhage involving both frontal lobes due to a road accident. She was released from hospital after conservative treatment and was prescribed to take Eptoin tablets 100mg thrice daily.She developed side effects like trouble with breathing particularly while taking food,hair loss,skin rash,unsteadiness & weakness.Now she has developed sore throat,sores,ulcers & white spots in the mouth with swollen lips along with painful swollen lymph glands in the neck.The irritation in the mouth is so severe that she is unable to take food or talk properly as the tongue is affected too.The doctor has asked her to stop taking Eptoin on 8th April 2015 and prescribed Levera 250mg twice daily instead.I would request you to suggest ways to relieve her from the pain she is suffering from due to the oral infection.

Answered by Dr. Senduran Narayanasamy (1 hour later)

Brief Answer:
Eptoin side effects..

Detailed Answer:
Hello Sir,

Thank you for asking to healthcaremagic..

I have gone through the query carefully and understood your concerns..

Nearly all of her symptoms/sufferings likely related to the drug eptoin(phenytoin),which was prescribed to prevent seizures..

Her treating doctor has done the right thing to change the drug,which is relatively a safe alternative and can also prevent seizures..

Unfortunately there is no proven treatment to treat these adverse effects right away.Most symptoms would resolve gradually over time as the drug gets washed away from the system.

Reassure her,encourage liquid/soft diet(no spicy,no hot,no chilled foods),safe analgesics like paracetomol may be considered for pain relief..

Observe her and also if possible monitor her vitals(Respiratory rate,pulse rate,BP) now and then for the next few days.

If there are constraints in looking after her,i would suggest you to get her admitted in the hospital for observation.

If her symptoms tend to worsen,seek immediate medical care..I would also suggest you to be in touch with her treating doctor to report her status..

Hope i was of some help..If any further questions,don't hesitate..

Wish her a speedy recovery and good health..

Regards

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Senduran Narayanasamy (4 hours later)

Should continuing Roxid 300 with PredMet 8 offer any help? Can you suggest any mouthwash or any other alternative which will give her relief from the burning sensation in her mouth and get rid of bad breath without aggravating her condition?

Answered by Dr. Senduran Narayanasamy (12 hours later)

Brief Answer:
Both drugs are helpful.

Detailed Answer:
Hello there

Sorry for late reply..

Roxid(Roxithromycin) help indirectly by preventing development of infections in the setting of preexisting gingivitis/ulcers etc and thus can be continued..

Predmet helps reduce the inflammation and also decrease the progression of mouth ulcers..

The symptoms like burning sensation,bad breath etc as i said earlier will improve over time..

1) Mouth rinse with antiseptics like chlorhexidine(preferably non alcoholic),betadine 1% solution would be enough.I don't recommend any other mouthwash preparations at present as this may exacerbate the condition.

2)Avoiding local irritants that trigger her symptoms,using soft brush would also help.

Hope this is helpful..If any further concerns,do write back or else please close this discussion..

Wishing her a speedy recovery and good health

Regards

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Senduran Narayanasamy (3 hours later)

Is she suffering from SJS? Because she felt flu like symptoms on 6/04/2015 & 7/04/2015 like heavy sneezing & running nose.There was severe itching in her eyes too.After that red pimple like rashes developed on hands,legs & trunk.After that she developed & suffered from complications as discussed earlier.This is my last query.Hope you will be kind enough to provide me with an answer as I am very much worried about my wife's health. If it is SJS,does she require hospitalisation?

Answered by Dr. Senduran Narayanasamy (2 hours later)

Brief Answer:
May be the start of SJS..

Detailed Answer:
Hello again

Thanks for following up..I have read the additional information carefully..
XXXXXXX XXXXXXX syndrome(SJS) is rare but a serious adverse effect..

In my opinion, this might be either drug related adverse effects or the start of the XXXXXXX XXXXXXX syndrome(SJS)..

Yes.SJS is a medical emergency and she needs immediate hospitalization mainly to prevent any life threatening ?..

Suspect SJS if any of the following occurs despite stopping phenytoin for few days..
1)The skin rash progressively spreads with appearance of bullae/blisters and skin tends to peel off on touch..
2)Facial swelling
3)Increasing breathlessness
4)Generalized skin discoloration and skin pain..
5)Worsening of mucosal ulcers.

Its better however to admit her for early detection and expectant management of SJS if she develops..

Hope this is helpful..

Regards

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Raju A.T