1) Ms. ABC experienced brief episodes of seizures and loss of consciousness. Testing found abnormal brain activity in her left temporal lobe, leading to a diagnosis of epilepsy. 2) Epilepsy is caused by excessive electrical discharges in the brain that cause seizures. The patient was prescribed phenytoin to prevent further seizures. 3) The patient was counseled to take her medication as prescribed, avoid high risk activities, seek medical help for prolonged or repeated seizures, and make lifestyle changes to manage her condition.

1. Patient counseling on epilepsy
Presented by- Jagruti G. Mahajan (D.Pharm)
Pranita V. Mitkari (D.Pharm)
KYDSCT’S College of Pharmacy, Sakegaon, Bhusawal
Guide: Miss. A.B.Chavhan

2. Scenario
• Ms. ABC, a 25 years old female, had to visit to the hospital, reports brief episode of
seizure and temporary loss of consciousness for about 1-2 min. she works at marketing
company and drive occasionally. Her work collogues accompanied her while episode and
they reported recovery in consciousness after the seizure activity with dizziness
afterwards.
• Ms. ABC stated that she had feel very strong sensation of déjà vu, a rising sensation in the
abdomen and unusual taste. Her colleagues witnessed the event, they said she collapsed
and jerking and not responding to their comment and it last for 1-2min. Also she reports
the afterwards symptoms like extreme sleepiness, Inability to recall what occurred during
the seizure, and Unawareness of having had a seizure.
• She had no vomiting, palpitation, fever, urinary incontinence. She had no head injury or
neurological illness or use of recreation drug. She reported no any allergies or current
medication. His family history revealed that her grandfather died of heart attack. She
experienced the similar event a couple of month’s ago.

3. Diagnosis
Neurological exam: motor abilities and mental function of brain were found to be normal
Blood tests: No abnormalities were found
Magnetic resonance imaging (MRI): brain MRI scan was found to be normal.
Electroencephalogram (EEG): abnormal EEG due to the presence of potential epileptiform
activity from the left temporal lobe.
Impression: Spikes and sharp waves
on the EEG in a left temporal lobe

4. Electrical signal
Excitatory
neuron
Inhibitory
neuron
Epilepsy: recurrent episodes
of seizure
Seizures: transient episodes associated
with abnormal excessive electrical
discharges from neurons.

5. Sudden excitatory
signals ‘over & over’
in localized area of
the brain
Seizure appears on the
body part like
intentional or
unintentional arm
movement
Perception of weird
smell or taste

6. (Symptoms)
Blank
expression;
Deja Vu
Unusual
odor/taste
Dizziness
A rising sensation
in the abdomen
Repetitive
motions
Loss of
awareness of
surrounding

7. After a temporal lobe seizure, you may have
Inability to recall what occurred
during the seizure
Unawareness of having
had a seizure
Extreme
sleepiness

8. Treatment
The goal of treatment is to prevent further seizures, avoid
adverse effects, and enable patients to lead active lives.
Anti-epileptic drugs (AED)
1. Carbamazepine, phenytoin or Valproic acid (sodium valproate) are often
rated as first-line drugs for treatment of focal seizure
2. Starting treatment with 100-mg extended phenytoin capsule three times daily.

9. SIDE EFFECTS ASSOCIATED WITH USING PHENYTOIN
Headache Numbness
Drowsiness
Nausea &
vomiting
fatigue
Loss of balance

10. CONTRAINDICATIONS
× Hypoglycemic seizure patient
× Sinus bradycardia
× Heart block
× Pregnancy or lactation
× Blood disorders
DRUG-INTERACTION
× There are numerous drug
interaction
× While having another
treatment consult it before
starting the treatment

11. 1. Avoid high risk-activities like swimming, driving, roof tops
etc. For at least 6 months after the last seizure
2. Take medications on right time to avoid the side effects
3. Put the hospital emergency card in your pocket
4. Inform when you are on oral contraceptives or taking anti
tubercular drugs
5. Report immediately if seizure frequency increases or
develops any intermittent illness especially fever &
behavioral problem
6. Should maintain a seizure diary & have regular follow up
to ensure that prescribed medication is taken as advised to
detect any ADR.
7. Subsequent follow up at every 3-6 months
1. Avoid alone traveling
2. Drinking alcohol while on
medication
3. Not getting proper sleep
4. Heavy work
5. Negative thoughts & attitudes

12. Seek immediate medical help if any of the following occurs:
 The seizure lasts more than five minutes.
 Breathing or consciousness doesn't return after the
seizure stops.
 A second seizure follows immediately.
 Recovery isn't complete after the seizure is over.
 Recovery is slower than usual after the seizure is over.
 You have a high fever.
 You're experiencing heat exhaustion.
 You're pregnant.
 You have diabetes.
 You've injured yourself during the seizure.
When to see a doctor