Dear Dr. Gott: My wife, 42, had a seizure in 1994 that her doctor attributed to alcohol withdrawal. She was placed on Dilantin, and the Department of Motor Vehicles revoked her driver’s license. She continues to test “sub-therapeutic” and the DMV will not return her license until her doctor says it’s OK for her to drive. She’s had no more seizures and is alcohol-free. She doesn’t want to remain on medication for the rest of her life. What’s the alternative?
Dear Reader: Sudden cessation of heavy drinking can cause seizures; this is the reason that alcohol is considered addictive. The body becomes dependent on it. When the alcoholic stops drinking without medical supervision (and prescription drugs to assist detoxification), seizures can result.
At that point, the doctor placed her on anticonvulsant medication. Subsequent blood tests have shown a suboptimal level of Dilantin in her system, but she has been seizure-free.
Therefore, I conclude that she did, indeed, experience a single convulsive episode, probably related to alcohol. If she doesn’t drink, she won’t have any more seizures.
This is where the picture becomes less clear. Most doctors would have stopped the medication after a few months, obtained a brainwave test (to check for epilepsy, an inherited seizure disorder) and monitored your wife’s health. If she remained seizure-free for a year, the majority of motor vehicle departments would reissue her license provided that she remained abstinent and the doctor confirmed that she was no longer a threat on the road.
I’m confused as to why she is still on medication. I do not understand why, while taking therapy, her Dilantin blood levels were not taken more seriously. It would be customary to increase the dose of the drug until a therapeutic level was obtained. The doctor can’t have it both ways; either he would discontinue treatment or make sure that she receives an appropriate amount. If she doesn’t need the Dilantin, she shouldn’t have to take it for the rest of her life.
In my view, she has two choices:
1. Return to the physician for clarification of the issues I raised and a letter to the state authorities allowing them to re- license her.
2. Seek a consultation with a neurologist — or, if her treating doctor is such a specialist, a second neurologist. The new doctor should be able to sort things out and get your wife’s license back.
To give you related information, I am sending you a copy of my Health Report “Epilepsy: The Falling Sickness.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.
Write Dr. Gott c/o United Media, 200 Madison Ave. 4th floor, New York, NY 10016
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