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How Can Slurred Speech, Tilted Mouth And Weak Grip In The Hands Be Treated?
Question: Hi Doctor my father 63 years of age is diabetic and suffering from cystic problem in head since last 2 years . He is taking levitracetam tablets ... after every few months problem reoccurs I.e slurring voice , tilted mouth and low grip in right hand . It has occurred now again . I am enclosing doctor prescription and MRI report. please advise of treatment is ok .
Brief Answer:
Get brain MRI as advised
Detailed Answer:
Hello,
I have gone through your question and report and understand your concern.
The MRI brain is showing lesion in brain reported to be neurocysticercosis but at this age other lesion may be possible.
Contrast MRI and mrs should be done.
Drugs for seizures control can be changed to carbamazepine or oxcarbazepine.
Other options may be lacosamide or valproate. Recurrent seizures can be a problem during the initial 2-3 months. Regular follow up and timely drugs are necessary.
Hope I have answered your query. Let me know if I can assist you further.
Get brain MRI as advised
Detailed Answer:
Hello,
I have gone through your question and report and understand your concern.
The MRI brain is showing lesion in brain reported to be neurocysticercosis but at this age other lesion may be possible.
Contrast MRI and mrs should be done.
Drugs for seizures control can be changed to carbamazepine or oxcarbazepine.
Other options may be lacosamide or valproate. Recurrent seizures can be a problem during the initial 2-3 months. Regular follow up and timely drugs are necessary.
Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
recurrent problem is there after even 1.5 years.is it ok . also attaching latest prescription which doctor has added. now since yesterday he is having lot of vertigo
Brief Answer:
Get drugs changed
Detailed Answer:
Hello,
Comparison of previous MRI with recent MRI is required regarding nature of lesion.
The location of lesion is very superficial near to cortex and such a lesion may lead to recurring seizures for long time.
The location is also near to motor cortex and hence causing weakness.
Drugs may be changed to oxcarbazepine and lacosamide/ valproate.
Vertigo may be a result of eptoin or clonazepam.
Hope I have answered your query. Let me know if I can assist you further.
Get drugs changed
Detailed Answer:
Hello,
Comparison of previous MRI with recent MRI is required regarding nature of lesion.
The location of lesion is very superficial near to cortex and such a lesion may lead to recurring seizures for long time.
The location is also near to motor cortex and hence causing weakness.
Drugs may be changed to oxcarbazepine and lacosamide/ valproate.
Vertigo may be a result of eptoin or clonazepam.
Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
our doctor has just now started eptoin along with lavetricatem. should we have lacosamide along with this medicine. also will this vertigo be normal within few days with eptoin usage.
Brief Answer:
Continue eptoin for now
Detailed Answer:
Hello,
Vertigo may get better with eptoin if it has been started recently. If no improvement in 4-5 days then get serum phenytoin levels and decrease dose or change.
No need to add lacosamide if a new antiepileptic has been added.
Hope I have answered your query.
Take care
Regards,
Dr Neeraj Kumar , Neurologist
Continue eptoin for now
Detailed Answer:
Hello,
Vertigo may get better with eptoin if it has been started recently. If no improvement in 4-5 days then get serum phenytoin levels and decrease dose or change.
No need to add lacosamide if a new antiepileptic has been added.
Hope I have answered your query.
Take care
Regards,
Dr Neeraj Kumar , Neurologist
Above answer was peer-reviewed by :
Dr. Nagamani Ng
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