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Suggest Treatment For Fatty Liver And Seizure Attacks

Posted on Tue, 18 Nov 2014

Question: Sir, my wife suffering from seizure attack without any warning and haing medicine continue but not controlled due to use of medicined now my wife also suffer from DM,HTN,SGPT-71,SGOT-83,USG- FATTY LIVER,CHOLELITHIASIS

Sir due to no warning seizure attack my wife got tonge bite and lips got injury every time so please help me at least warning sign or seizure free medicine.

Answered by Dr. Sudhir Kumar (3 hours later)

Brief Answer:
Medications need to be adjusted/modified.

Detailed Answer:
Hi,

Thank you for posting your query.

I have noted the details, test results and medications of your wife.

She is suffering from epilepsy and needs long term medications. Normal MRI means that we need to manage her with medications, and there is no need for surgery.

Valparin chrono (sodium valproate) is a good anti-epileptic drug, however, it can not be used in your wife because of side effects (liver problem and hair loss).

Torleva (levetiracetam) is a good drug too, and the dose may be increased to 1000 mg twice daily. Also, instead of torleva, you may use keppra, the original brand of levetiracetam.

If the seizures do not get controlled despite taking 2000 mg per day of levetiracetam, then, oxcarbazepine (oxetol) may be added.

Unfortunately, most seizures come without any warning.

I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.

Wishing you good health,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (1 hour later)

Sir my wife is using torleva 500mg and lametec 25 sir in your reply you did not mentioned the dose of oxetol and whether i have to continue or not my existing tablet of lametec 25 ,sir i just asked whether taking of 1000 mg is there any danger for liver damage .and 1000 mg is taken as soon as possible or gradually increased the dose.

Answered by Dr. Sudhir Kumar (34 minutes later)

Brief Answer:
Dose should be gradually increased.

Detailed Answer:
Thank you for getting back.

In the list of eight current medications, you had not mentioned Lametec (lamotrigine). If she is taking lamotrigine, it would be wiser to increase the dose of lametec also, very slowly to 100 mg two times daily.

Similarly, levetiracetam (torleva) can be increased to 750 mg two times daily, and if needed, then, 1000 mg two times daily. It would not lead to liver damage.

Oxetol needs to be started only if her seizures do not get controlled with the recommended doses of levetiracetam and lamotrigine.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (20 minutes later)

Thank you very much sir for your valuable suggestion.

Sir my wife got attack only before the festive season after doing lots of cleaning work at home continuously is the reason of getting seizure attack or some thing else what precaution should be taken because my wife is also suffering from high BP and high BLOOD SUGAR.

Answered by Dr. Sudhir Kumar (8 minutes later)

Brief Answer:
She should get adequate sleep.

Detailed Answer:
Thank you for getting back.

One reason for getting attacks during festive season could be lack of sleep and not eating food on time. She should sleep well in nights for at least 7-8 hours. Also, she should eat well on time. Also, she should avoid stress and tension.

Adequate control of BP and sugars is also important.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (15 hours later)

Thank you sir i just want to know that local doctor prescribed during last seizure attack on 20.10.2014 lonazap 0.5 and frisium 10 whether these medicine should be continue or stopped.

Thank you sir i just want to know that local doctor prescribed during last seizure attack on 20.10.2014 lonazap 0.5 and frisium 10 along with torleva 500 and lametec 25 whether these medicine lonazap 0.5 and frisium 10 should be continue or stopped.

Answered by Dr. Sudhir Kumar (11 hours later)

Brief Answer:
Continue only one of them.

Detailed Answer:
Thank you for getting back.

Both clonazepam (lonazep) and clobazam (frisium) are benzodiazepines, and belong to the same class of drugs. Therefore, you need to give your wife only one of them (she can take frisium preferably).

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (12 hours later)

Thank you very much sir i am very happy with your valuable suggestion and it will help us more than i expect.

Sir as i told you after taking torleva 500 and lametec my wife got again seizure attack so doctor examined STVEEG whether this is sufficient for proper diagnosis or want more examine like LTVEEG or something else required to diagnosis,
Sir are you coming to any clinic in XXXXXXX

Answered by Dr. Sudhir Kumar (2 hours later)

Brief Answer:
STVEEG is enough at present.

Detailed Answer:
Thank you for getting back.

It is enough to do STVEEG at present. However, if her seizures recur again, then, LTVEEG may be done.

I am not visiting XXXXXXX at present.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar