Trileptal

Reggie has been on Trileptal for 4 weeks, and seizures have improved from baseline. The patterns seems to be 2-3 Grandmal seizures in a 2 day cluster with generalized seizures, every 7 days.

Depakote toxicity

Reggie came to MCH ER Thursday for progressive lethargy, and diarrhea. Diagnosis depakote toxicity and depakote induced thrombocytopenia. His ammonia level was 65, elevated liver enzymes, platelets 103 (383 before depakote).
Unfortunately depakote is the only thing that has ever stopped his seizures, and now we have to come off. Thrombocytopenia is not dose dependent