Suggest Treatment For Vertigo

Posted on Fri, 27 Oct 2017

Question: Id like another opinion about possible simple partial seuzures i might be having, they are similiar to a vertigo sensation, last a few seconds, happen several times a day and are more frequent during ovulation and my period. How well does medication usually control sps and will an eeg detect them? Im currently on Gabapenton and have a 3 day eeg scheduled for next week, i have history of complex partial seizures that was surgically corrected 6 years ago, any insight would be appreciated, thanks :)

Answered by Dr. Sudhir Kumar (1 hour later)

Brief Answer:
Yes, these symptoms could be simple partial seizures.

Detailed Answer:
Thank you for posting your query.

I am Dr Sudhir Kumar, Neurologist, and I would try my best to help you.

I have noted your clinical details. Based on this, your symptoms could be suggestive of simple partial seizures (SPS). A 3-day EEG would be able to pick up epileptiform activity in more than 50% of patients with simple partial seizures.

SPS can be controlled by medications. However, s compared to gabapentin, oxcarbazepine may be preferred.

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 (43 hours later)

I was just taken off the gabapentin for increased anxiety and depression. I was on the trileptal in the past but adverse reactions also led to a medication change, but so far no med has stopped the SPS as they happen several times a day with or without meds.

Answered by Dr. Sudhir Kumar (6 hours later)

Brief Answer:
Epilepsy surgery could be considered.

Detailed Answer:
Thank you for getting back with more information.

About 30% of patients with seizures do not respond to anti-epileptic medications. This category is referred to as medically-refractory epilepsy. This group of patients should be evaluated in a specialised epilepsy center for a possible epilepsy surgery. Evaluation would include long term EEG (upto 7 days), 3 Tesla MRI brain, PET CT scan of brain and neuro-psychological testing. After this, the decision regarding surgery, and the type of surgery can be taken.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)

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

Follow up: Dr. Sudhir Kumar (19 hours later)

Yes i had a temporal lobectomy 6 years ago when my complex partial seizures did not respond to medications, so i amfamiliar with the process. I still have the same sps i used to have and this vertigo sensation began 4 years ago and coinside with other sps symptoms hence my concern, thanks for the information so far.

Answered by Dr. Sudhir Kumar (3 minutes later)

Brief Answer:
You have had the correct treatment so far.

Detailed Answer:
Thank you for getting back with more information.

I agree that after epilepsy surgery too, about 50% people become seizure free and the rest continue to have seizures (usually at a lower frequency), requiring anti-epileptic medications.

In this scenario, you need to try out different anti-epileptic drugs (as combination therapy), which provides maximum seizure control with the least side effects. Lamotrigine or topiramate could be tried in your case, if not already tried.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)

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