DEAR DR. GOTT:
Our son, now 47, was severely brain injured in a bike vs. truck accident 28 years ago. As a result, he also suffered grand mal seizures. He was put on 100 mgs of Dilantin twice a day. It was then increased to three times daily. He has been seizure-free for almost 20 years now. My son is otherwise very healthy. He lives with us but has become quite independent and even drives his own car.

Our family physician retired and our new (young) family physician said the decision was ours, but we should think about stopping the medication. We’re hesitant because we dread the possibility of seizures again. What are your views on this situation?

DEAR READER:
Most neurologists I know often remove patients from Dilantin if they have been seizure-free for several years. This must be done by gradually reducing the dose and must be supervised by a neurologist. Only this type of specialist can tell you if it is appropriate to discontinue the Dilantin.

You and your son need to speak to his neurologist about the possibility of stopping the medication, the possible risks and benefits of stopping versus continuing and whether your son is indeed a good candidate for removal of the Dilantin.

If the specialist believes it is best to stop the medication, he or she may recommend testing before, during and/or after the process. This will provide appropriate monitoring of your son for any adverse effects from stopping the Dilantin, such as return of the seizures or abnormal brain function.

I am not a neurologist and am not familiar with your son’s case. His neurologist is his best source for further information.