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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Seizures In Sleep With Tongue Bitten

I have a 16 year old son. This morning in his sleep, he had a seizure that lasted over 5 minutes. He bit down on his tongue really hard. I called 911 and when they got here, he was unconscious and unresponsive to general stimuli. A CAT scan was done and lab, nothing came back. He has been put on 100mg Dilantin 3 caps @ hs. I m very concerned, because they don t know where this is coming from. About a year ago, he woke up and told me that his mouth hurt really bad and that he had bitten his tongue in his sleep, which leads me to the assumption that he had a seizure. Can you please give me some advie.
Thu, 4 Dec 2014
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Neurologist,  's  Response
I read your concern and I am sorry about the stressful period you are experiencing.
Seizures can have various causes but often they remain idiopathic meaning no primary cause can be found. The important thing is to rule out causes like brain tumor, infection, stroke or vascular malformation in the brain, metabolic changes. Some of those causes have been ruled out by the CT scan and some metabolic ones by the lab tests which is great since some of those conditions could be life-threatening. So the fact that no cause has been established should not surprise you because as I said often remain idiopathic and not bring you to panic either.
You don't mention an EEG among the tests which is necessary to confirm the diagnosis and also while not necessarily on an emergency basis, a MRI should be scheduled if possible as it could unveil minor lesions the CT could miss.
Regarding the treatment since it could be a long one he should be regularly followed by a neurologist. Dilantin is a valid therapy for now but if he has side effects or the desired effect on seizure control is not achieved there are also many other available alternatives.
I hope to have been of help and that things will work out for the best.
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Suggest Treatment For Seizures In Sleep With Tongue Bitten

I read your concern and I am sorry about the stressful period you are experiencing. Seizures can have various causes but often they remain idiopathic meaning no primary cause can be found. The important thing is to rule out causes like brain tumor, infection, stroke or vascular malformation in the brain, metabolic changes. Some of those causes have been ruled out by the CT scan and some metabolic ones by the lab tests which is great since some of those conditions could be life-threatening. So the fact that no cause has been established should not surprise you because as I said often remain idiopathic and not bring you to panic either. You don t mention an EEG among the tests which is necessary to confirm the diagnosis and also while not necessarily on an emergency basis, a MRI should be scheduled if possible as it could unveil minor lesions the CT could miss. Regarding the treatment since it could be a long one he should be regularly followed by a neurologist. Dilantin is a valid therapy for now but if he has side effects or the desired effect on seizure control is not achieved there are also many other available alternatives. I hope to have been of help and that things will work out for the best.