Had CVA, hemipleic and ventilator dependent. Had seizures, use depakine, TDS and midazolam. Has hypotesion and eczema
Patient: Hi , How are you? My father is 88 years old , 9 months ago he had CVA , hemiplegic and ventilator dependent. He had tracheostomy PEG CVLINE FULY CATETER , He has had seazure from 2 months ago. We use depakine 500 mg TDS to remove his seazure but he has seazure still now and for removing his seazure attack we use midazolam and diazepam iv and by this he has hypotention and for removing hypotention we use dopamin infution.We used digoxin (anti arrytmy) 2 months ago but now he has generalize edema , alb (seruma) :3/7 What should we do for removing his generalize edema? Doctor: Hi,Thank you for posting your query.It is unfortunate that your father has had recurrent seizures along with multiple other comorbid illnesses, including generalized edema, hypotension, etc.The cause of generalized edema is likely to be low serum albumin and poor nutritional status. His dietary protein intake can be increased through the Ryle's tube feeds. For short term improvement, albumin infusions may be given.For nursing, his legs can be elevated while he is sleeping or lying down. This would also help reduce his edema in the legs.If his seizures are not adequately controlled with depakine, then, other anti-seizure medications such as tegrital (carbamepine) or levetiracetam (keppra) may be added.I hope it helps. Please get back if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumarMy BLOG: http://bestneurodoctor.blogspot.in