The regulation of chloride-bromide intake in epilepsy

Summary

In summing up we may state that 34 patients have been treated with Sedobrol from four to nine months; 31 with Sedobrol alone and three with a combination of Sedobrol and Luminal. Two patients died during the course of treatment, one of aortic insufficiency, the other of general physical debility. All of the patients showed a very good response to the treatment, the majority remaining free from seizures for as long as seven months. They also improved mentally and physically. In regard to the technique of bromide medication our experience with it taught us that the administration of larger doses of bromide is unnecessary and dangerous. It is sufficient to start with one cube of Sedobrol per day (17 grains of sodium bromide) and increase the number of cubes after short intervals until the maximum optimal dose is reached, that is, the dose which gives the best response without producing any signs of bromine poisoning. Except for the elimination of salty food such as cheese, sardines, etc., we did not diminish the usual amount of table salt in the daily food (about 15.0 grams per day). In the two cases of severe bromism we reduced the amount of Sedobrol, but did not eliminate it entirely. We added table salt to the food up to 5 grams per day. The dermal manifestations were successfully treated by this addition of table salt and with the application of wet dressings of a saturated solution of sodium chloride. Along with it, sodium cacodylate, 0.5 grain to one dram solution was given once or twice daily. In cases of severe bromine poisoning where the oral administration of table salt is impossible an enema of normal saline solution is very effective. In aggravated cases of epilepsy with frequent daily seizures a combination of Luminal and Sedobrol has proven very effective.