5 year old girl, has recently been diagnosed with epilepsy by her neurologist. About six years ago she suffered a slight

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5 year old girl, has recently been diagnosed with epilepsy by
her neurologist. About six years ago she suffered a slight
concussion as the result of a fall when skiing. There were no
further neurological problems until two weeks ago, when she
reported experiencing a strange sensation. This was followed by a
tonic-clonic seizure.
The neurologist commences the patient on anticonvulsant
medication. She is commenced on 300mg phenytoin PO daily.
Question One
What patient education could you offer the
patient and her parents immediately following her
diagnosis?
(Note: Your answer should take into consider medical
history and all medication received. Remember to
incorporate latest evidence based practice in your answer)
After several weeks of therapy, patient has another
tonic-clonic seizure and phenobarbital (phenobarbitone) 150mg PO
daily is added to her treatment program. This brings the seizures
under control.
Given your knowledge of these drugs and their use in
seizure management, what is the likely rationale behind adding a
second anticonvulsant?
About six months after starting the treatment program,
patient tells her mother that her gums seem to be increasing
in size and are covering more of her teeth. Her mother believes
this could be related to the medication and calls to schedule an
appointment with the neurologist.
Given your knowledge of her medication, what might be
the cause of gingival hyperplasia? What advice should you give to
the patient and her mother?