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Is Abrupt Withdrawal Of Keppra Safe In A 81 Year Old?

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Posted on Tue, 15 Nov 2016
Question: My 81 yo mother had R Parietal Meningioma excision on XXXXXXX 22, 2016. She has been on Kepra 300 mg bid. She is experiencing pretty severe pains in her muscles especially the limbs. Weakness as well. Her neurosurgeon initially told her to continue with the Keppra until she completes the 6 month regimen. He now told her to stop it since she is so uncomfortable.
I am a DDS and she lives with me now but I am worried about a seizure if she stops the med.
Do you normally 'taper' a patient off?
How long do post craniotomy patients stay on Keppra?
Is it a certainty that she will have a seizure?
doctor
Answered by Dr. Dr. Erion Spaho (39 minutes later)
Brief Answer:
Keppra should be tapered.

Detailed Answer:
Hello and thanks for using HCM.

I have read your question and understand your concerns.

Predictors of antiseizure drugs use after surgery for low grade tumors of brain including meningioma, are existence of preoperative seizures, temporal lobe location of tumor, male sex, incomplete resection and tumor recurrence.

So, in your mother's case, ( I guess only preoperative seizures seems to be an indication for AED drugs use ), if Keppra will be stopped, recurrence of seizures possibility is very low.

Generally antiepileptic drugs including Keppra are used for 6 months after the craniotomy.

Before discontinuation EEG is necessary to evaluate better the seizures recurrence.

Of course that a drug like Keppra should be tapered instead of cold turkey.

In conclusion, regarding to side effects, Keppra should be discontinued, the possibility of seizures is low, if they are recurring another antiepileptic drug may be used.

Hope you found the answer helpful.

Let me know if I can assist you further.

Greetings.

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Dr. Erion Spaho (30 minutes later)
She had no preop seizures whatsoever. Surgeon had initially said three months of Keppra but due to intraoperative finding of larger size of tumor, he changed it yo 6 months of Keppra. Does this help predict seizure possibility if stopped?
How would you suvgest tapering?
Thank you. Very helpful
doctor
Answered by Dr. Dr. Erion Spaho (5 hours later)
Brief Answer:
Seizures possibility very unlikely.

Detailed Answer:
Welcome back.

Since there were no preoperative seizures, this decreases the seizures possibility.

Large tumors is a relative predictor of possible seizures.

One way of tapering is decreasing 150 mg of Keppra each week for example.

Hope this helps.

Take care.
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
Answered by
Dr.
Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4502 Questions

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Is Abrupt Withdrawal Of Keppra Safe In A 81 Year Old?

Brief Answer: Keppra should be tapered. Detailed Answer: Hello and thanks for using HCM. I have read your question and understand your concerns. Predictors of antiseizure drugs use after surgery for low grade tumors of brain including meningioma, are existence of preoperative seizures, temporal lobe location of tumor, male sex, incomplete resection and tumor recurrence. So, in your mother's case, ( I guess only preoperative seizures seems to be an indication for AED drugs use ), if Keppra will be stopped, recurrence of seizures possibility is very low. Generally antiepileptic drugs including Keppra are used for 6 months after the craniotomy. Before discontinuation EEG is necessary to evaluate better the seizures recurrence. Of course that a drug like Keppra should be tapered instead of cold turkey. In conclusion, regarding to side effects, Keppra should be discontinued, the possibility of seizures is low, if they are recurring another antiepileptic drug may be used. Hope you found the answer helpful. Let me know if I can assist you further. Greetings.