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What Causes Severe Headache While On Eptoin For Epilepsy?

Posted on Mon, 2 Jun 2014

Question: Hi,

My wife is 26yrs old and she is having epilepsy from the age of 17. Currently she is taking eptoin 100mg 3 tab (night), Levipil 250gm tab (morning 1, night -1). Lately she is getting severe headache for the past couple of weeks and we checked with the neurologist, he suggested to take Paracetomol tablets. Her medication was changed during pregnancy when her weight was around 67kgs, now she is 60kgs and still takes same tablets. Can overdose cause headaches? Please advise.

Answered by Dr. Sudhir Kumar (9 hours later)

Brief Answer:
Headache is not due to overdose.

Detailed Answer:
Hi,

Thank you for posting your query.

I have noted your wife's symptoms and her current medications.

I am of the opinion that her headache is not due to medication overdosage.

The correct dose for eptoin (phenytoin) for a 60-kg person is 300 mg per day (5 mg/kg body weight) and levipil (levetiracetam) is 1000-2000 mg per day.

So, she is on appropriate dose of eptoin and lower dose of levipil. Therefore, her headache is not due to these medications.

Headache is most likely related to migraines. Please follow the advice of her neurologist.

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, Hyderabad, India
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. Raju A.T

Follow up: Dr. Sudhir Kumar (14 hours later)

Thanks for replying my question Dr,

we are following our Neuro's suggestion but still her headache is not going away after taking paracetamol.

If this is migrane, will it be caused due to medication or side effects of seizures?

how do we identify migrane from ordinary headache? Wats its symptoms?

Thanks

Answered by Dr. Sudhir Kumar (39 minutes later)

Brief Answer:
Symptoms would help in diagnosis.

Detailed Answer:
Thank you for getting back and providing more information.

Paracetamol is a weak pain-killer and severe forms of headache would not go away with that.

Migraine is not caused by these medications or her seizures. However, in many people, both seizures and migraine can occur together, a condition known as migralepsy.

Migraine can be diagnosed on the basis of symptoms. A neurologist (not a neurosurgeon) can help in accurate diagnosis and treatment.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Sudhir Kumar (3 hours later)

Symptoms
Headache is severe on fore head and once she takes rest, its getting reduced without tablets. But its there for quite some time, say 5hrs.

On some times its become so severe that she cannot manage without tablets. Once she takes tablet & rest, its gone.

she is also getting it when she gets tensed.

If migrane, can tablet cure it?
how long should we be under medication?

Answered by Dr. Sudhir Kumar (6 hours later)

Brief Answer:
Migraine can be cured with tablets.

Detailed Answer:
Thank you for getting back.

Her symptoms do sound like migraine.

There are several good medications that can reduce the severity and frequency of headaches, such as flunarizine, propranolol, topiramate, etc.

These medications are required for 3-6 months.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

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