A "fail" for Phenytoin

Haya and me walking in the kitchen seven days
after we stopped the Phenytoin

One week after starting her on 100mg/day of Phenytoin [background here], Haya had a couple of horrific days, seizing terribly and for hours on end. Nothing I gave her stopped them.

On the second horrific day, after five hours of that hell I wrote her new neurologist about it. But even before her response, I just stopped administering it.

 
She emailed us, agreeing that in rare cases this drug can exacerbate instead of improving the situation. 

I pointed out to her that on the day of five hours worth of convulsing, Haya also had a bloody nose and her menstrual period. Now, she never gets the former, and hasn't had the latter in about a decade. The neurologist attributed the bloody nose to our dry weaather. I doubt that; we often have dry weather but, as I noted, never a bloody nose. The menstruation stumped her. 

Well, the nose dried up quickly. The period, though light, is still ongoing. All very strange.

 
So we're back to square one with medications. 

The neurologist hasn't suggested any others to experiment with. I hope she won't jump to the second option she mentioned after medications: the Ketogenic Diet. I haven't got the stamina for that anymore. 

I was some twenty years younger the last time we attempted it. We persevered then for 10 months and only ditched it when Haya began vomitting several times a day from the high fat content. 

The neurologist was pretty eager for us to try it when we visited her two months ago. But she seemed even more eager about the Vagal Nerve Stimulator surgery. The idea of surgery leaves me positively cold particularly since a surgeon warned us a couple of years ago that it would be "complicated" in Haya's case. She has had an old, non-functional VNS stuck in her neck since 1999. It is undoubtedly coated with all sorts of tissue by now.

So Haya is back to seizing quite a lot and functioning poorly. It is a bleak situation and her new diagnosis of Epileptic Encephalopathy Early Onset 11 due to an SCN2A de novo mutation only bleakens it more.

The academic articles about her syndrome which we receive thanks to Google Alert make it clear that there is currently no salvation our there for Haya.

This last one, for instance, taught me that her current seizure situation qualifies as Status Epilepticus.