TY - CHAP M1 - Book, Section TI - Antiseizure Drugs A1 - Jobst, Erin E. A1 - Panus, Peter C. A1 - Kruidering-Hall, Marieke Y1 - 2020 N1 - T2 - Pharmacology for the Physical Therapist, 2e AB - CASE STUDYC.M. is a 60-year-old man that experienced a right cerebrovascular accident 15 months ago, with resultant left hemiplegia. He initially received rehabilitation in an acute inpatient facility for 4 weeks and was transferred to a long-term cognitive rehabilitation facility for approximately 8 weeks. C.M. made significant improvements in his cognitive and speech abilities, but he was still nonambulatory when he was discharged to home. Home health providers felt he had potential for additional functional return and referred him for outpatient physical therapy. C.M. is medically stable living at home with his wife. His medications include escitalopram (antidepressant), pantoprazole (proton pump inhibitor), amlodipine (calcium channel blocker), warfarin (anticoagulant), valproic acid (antiseizure drug), and lamotrigine (antiseizure drug). C.M. told the outpatient physical therapist that he developed a seizure disorder poststroke and was initially treated only with valproic acid. However, he had breakthrough seizures and lamotrigine was added. C.M. reported that he had his blood levels of warfarin and valproic acid checked every 3 months. After 2 months of outpatient therapy, the physical therapist observed that C.M. was much more lethargic on several consecutive sessions. He began to require multiple rest periods during treatment sessions. Communication with the patient was difficult as his speech was soft and muffled. Notably, there were no new sensory or motor neurologic signs that might suggest another stroke. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accessphysiotherapy.mhmedical.com/content.aspx?aid=1192815347 ER -