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Is It Normal To Have Recurring Seizures Despite Taking Medicines?
Question: Hi, my brother who is 22 years, had been diagnosed with Epilepsy. The doctor has prescribed Levipi 1000mg BD. However yesterday he had a seizure again, despite having taken the medicine. The seizure occurred just before the evening doze. He is also taking Frisium 5mg. What I wanted to know is if this is normal to have a seizure despite taking the medicine.
Also in October 2011 was his first seizure, after which he was on Eptoin 100mg once a day for 3 years. We stopped in 2014 on doctors advice and the seizure started again in July 2015, which is when he started levipill.
History of Seziure:
October 2011 - once
2nd July, 2015 5pm - once
3rd July , 2015 9pm - once
11 July, 2015 8pm - once
What I wanted to know was 1) is it normal to have recurring on medicines and 2) are we having the right medicine?
Also in October 2011 was his first seizure, after which he was on Eptoin 100mg once a day for 3 years. We stopped in 2014 on doctors advice and the seizure started again in July 2015, which is when he started levipill.
History of Seziure:
October 2011 - once
2nd July, 2015 5pm - once
3rd July , 2015 9pm - once
11 July, 2015 8pm - once
What I wanted to know was 1) is it normal to have recurring on medicines and 2) are we having the right medicine?
Brief Answer:
Continue and consult your neurologist
Detailed Answer:
Hello dear,
I have gone through your question and understand your concerns.
Seizures have many causes and unidentified idiopathic group is termed as epilepsy.
You need to provide some more details as whether his seizures are of generalized tonic clonic type with onset in whole body simultaneously or has some partial onset starting from one limb or one side of body.
Other type of seizure like myoclonic brief jerking of body with or without impairment of consciousness, absence seizure.
What was his MRI and eeg reports.
His dosing of eptoin doesn't seems to be adequate.
Sometimes at drug initiation some patients may have repeated seizures.
The dose of levipil is at upper limit of his age and doesn't require any escalation.
Frisium can be increased but with side effects of increased sedation.
You can consult your treating neurologist for advice regarding uncontrolled seizure.
Is there any drugs other than epilepsy been taken simultaneously.
Please provide above details.
Hope you found the answer helpful.
Regards
Dr Neeraj Kumar
Neurologist
Continue and consult your neurologist
Detailed Answer:
Hello dear,
I have gone through your question and understand your concerns.
Seizures have many causes and unidentified idiopathic group is termed as epilepsy.
You need to provide some more details as whether his seizures are of generalized tonic clonic type with onset in whole body simultaneously or has some partial onset starting from one limb or one side of body.
Other type of seizure like myoclonic brief jerking of body with or without impairment of consciousness, absence seizure.
What was his MRI and eeg reports.
His dosing of eptoin doesn't seems to be adequate.
Sometimes at drug initiation some patients may have repeated seizures.
The dose of levipil is at upper limit of his age and doesn't require any escalation.
Frisium can be increased but with side effects of increased sedation.
You can consult your treating neurologist for advice regarding uncontrolled seizure.
Is there any drugs other than epilepsy been taken simultaneously.
Please provide above details.
Hope you found the answer helpful.
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Yogesh D
thanks for the promt response doctor. attached is the EEG and MRI summary.
Brief Answer:
Drugs can be changed to other group if not improving
Detailed Answer:
Hello dear,
Eeg report is normal which has lesser positivity.
Mri is showing abnormal focus in insular region and involvement of head of caudate also.
Does your brother suffered any vascular events or encephalitis like presentation in past.
Has he been investigated 3 years back when he started having these symptoms.
Is he mentally normal with no birth asphyxia.
Are his milestones normal.
Oxcarbamazepine or lacosamide may be preferred drugs for localisation related epilepsy.
You can consult your treating neurologist with reports for adding drugs or changing to this group.
If possible upload the Mri images in pdf form.
Hope you found the answer helpful.
Regards
Dr Neeraj Kumar
Neurologist
Drugs can be changed to other group if not improving
Detailed Answer:
Hello dear,
Eeg report is normal which has lesser positivity.
Mri is showing abnormal focus in insular region and involvement of head of caudate also.
Does your brother suffered any vascular events or encephalitis like presentation in past.
Has he been investigated 3 years back when he started having these symptoms.
Is he mentally normal with no birth asphyxia.
Are his milestones normal.
Oxcarbamazepine or lacosamide may be preferred drugs for localisation related epilepsy.
You can consult your treating neurologist with reports for adding drugs or changing to this group.
If possible upload the Mri images in pdf form.
Hope you found the answer helpful.
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Yogesh D
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