Is Lamotrigine The Right Medication For Seizures?
An Anti-Seizure medication is the safest option
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Hi, Thanks for coming to HealthCareMagic. I am so sorry to hear about your Sub Arachnoid from last September. I trust you are on the mend and that your are getting the Physical and Occupational therapy that will help you recover from the nerve damage that might have caused.
Now. depending on the force of the trauma and where you got hit, there are a few different resulting types of SAHs(Sub Arachnoid Hemmorhages). I won't traumatize you further with a full accounting of the different types, but I want to boil it down to this... the part of th brain the bled means alot in the long term management of seizure complications. An SAH into the 'Ventricle' (the liquid filled center of the brain) is pretty risky business and I would recommend that you be on antiseizure meds (like Lamictal, Lamotrigine, though there are others) for more than a year. On the other hand, a small bleed into the parietal cortex wouldn't warrant that much caution.
So all in all, if you could tell e a bit more about the position and extent of the bleed that happened in Sept, I can go into a good amount of detail with you on the anti seizure precautions that need to be taken.
From a more general point of view though.. yes, people who suffer from traumatic Hemorrhages do benefit from anti-siezure prophylaxis, but not forever. if there are no seizures for a certain period after the insult.. then we taper and stop them, but since you have had a few seizures, it's probably a smart idea to carry them on for awhile longer.
I hope I didn't make things worse. I look forward to your reply and remember, the more information you can give me, the more useful I will be to you. Take Care
Vinay
Thankyou very much for your help and look forward to your reply. Yours XXXXXXX
Yup, sylvian fissure bleeds need long term meds
Detailed Answer:
Hey there, thanks for following up. Based on the scan impression here.. I'm thinking that these are real seizures and you need to be covered on antiepileptics for awhile.
The Sylvian fissure is a deep furrow in the brain. When you bleed into it the total area of cortex that is exposed to blood is pretty huge. That really increases the risk of seizure.
The gliosis is to be expected... instead of gliosis ... you can use the word scarring... The brain was injured.. neurons died.. and now there is some scarring.. I wouldn't worry to much about that.
As to the aneurysm issue. I wish the scan had been better. but i wouldn't bother rescanning... there is a risk to that as well from the contrast that they have to give you.
Make sense? let me know what you are thinking. Look forward to answer you.
Take care
Dr Vin
Risky!!! Meds or not
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Look, seizures are a problem where there is basically an electrical short circuit in the brain. The short circuiting is due to a problem with 2 major elements in the neurons... Sodium Channels and Calcium Channels. I don't want to bore you to death with theory.. But the basic thing is that alcohol makes it more likely that those channels would get leaky and cause the short circuit.. Kids who binge drink in a single night can give themselves a seizure without any underlying disorder.
In your case. Every time you drink ANYTHING with alcohol in it... you are increasing your chances of having a seizure.. It's that simple. You have to weight that risk against the need for that drink. I wish I could give you numbers... but there's never been a quantitative study showing the risks.. we just know that it can happen.
Make any sense?
Vin
I can only hope it helps!
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Hey there. I hope the advice becomes useful for you. If you get a chance. Drop me a line to let me know how things are going.
Vin
the site is my only way
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i know its annoying. but the site is my only way of keeping in touch with patients. Company policy and all
Take Care
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All the best.