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Dr. Andrew Rynne

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Cerebral Palsy, Epilepsy, Got Hypothermia, Sedation, Vomiting On Starting Sodium Valporate. Bloods Show Toxic Phenobarb Levels. Common?

34yrs. Cerebral palsy . Epilepsy . 24hr care required. Been on tegretol cr and phenobarbitone for years to help control seizures. Neurologist prescribed keppra for 2yrs. No side effects but experienced 1-3 seizures daily. Weened off keppra and started sodium valproate . Within the first week she had experienced sedation, vomitting. Then bloods showed valpro levels low, dose increased. She experienced hypothermia , sedation, vomitting. She lost the ability to swallow food and drink. Bloods showed her phenobarb levels were toxic. Is this common or unheard of for these medications to interacte this way?
Fri, 14 Dec 2012
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Neurologist,  's  Response
Hi,

Thank you for posting your query.

The side effects as experienced by the patient are known with the medications she has been given, however, they are fortunately uncommon.

The only method of treatment would be to titrate the dose of medications till the desired efficacy is reached, as per the tolerance by the patient, and the drug levels in the blood.

I am sure she would recover from the side effects of medicines with proper care and there is no need to worry.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Senior Consultant Neurologist
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Cerebral Palsy, Epilepsy, Got Hypothermia, Sedation, Vomiting On Starting Sodium Valporate. Bloods Show Toxic Phenobarb Levels. Common?

Hi, Thank you for posting your query. The side effects as experienced by the patient are known with the medications she has been given, however, they are fortunately uncommon. The only method of treatment would be to titrate the dose of medications till the desired efficacy is reached, as per the tolerance by the patient, and the drug levels in the blood. I am sure she would recover from the side effects of medicines with proper care and there is no need to worry. Best wishes, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist