How I schedule my seizures for early mornings

[Zolt]

Hi Everyone,

New here, my background is having seizures after a brain tumor was removed from my head few yrs back. After being on a few medications, i'm now on Gabapentin, i take 3 x a day, 600mg each time.

Well i've noticed something very interesting with this new drug, i'm having seizures early in the mornings.

11 of my 12 seizures last yr were all like 40 min after i woke. I seem to have on average 1 seizure per month. So roughly it takes 30 days for the electricity to build up to the point where the electricity overloads causing my seizures. Well the reason I think why the seizures are happening in the morning is because of Gabapentin, the medicine i’m on. I take it 3 times a day, 600mg each time, morning noon and night, 7am, 1pm, 7pm. This medicine only seems to work for 6 hrs, so in the mornings the medicine is not covering me anymore when I wake at 6am. I normally get up at 6am and do my wake up routine. So basically since the med only works for 6 hrs, between 6-7am i'm not being covered. Since i am not covered in that 1st hour between 6-7am I have my seizures during that time. I take my medicine normally around 7am. I could take the medicine as soon as i wake up, but i think it's great to have the seizures in the mornings, then going through the day worrying if one will happen.

Schedule my seizures for the morning please. Is this a new concept? Would you like to schedule your seizures for early morning?

Has anyone had any similar happenings? Or any studies been done on this type of scenario? Maybe it's just me and the way my seizures are, but i thought i'd pass this info on to others. And no, i do not work for a drug company or any ties to the medical field.

 

[Nakamova]

Hi Zolt --

How about asking your neuro about adding one more dose before bedtime? That might give you enough coverage to protect you against the morning seizures, especially since our metabolisms slow at night.

The half-life of gabapentin is 5 to 7 hours (as you've deduced), and the extended -release version was denied approval in the U.S. So you could also consider trying a med with a longer half-life, and/or one with an extended release version available.

lThe transitional moments from waking to sleep or sleep to waking are popular times for seizing. The brain can be more vulnerable then because of the kinds of brainwaves (Delta) being produced at that time. In addition to the sleep/wake state, day/night or circadian rhythms can play a role. And things like low blood sugar or dehydration may also be factors depending on your individual metabolism.

Different seizure types/origins seem to have patterns as well, although not every one matches up 100%. One study showed a correlation between the area of the brain where Partial Seizures originate, and the time of day that they occur:

-- Occipital seizure occurrence peak between 4:00PM and 7:00PM
-- Parietal seizures peak between 4:00AM and 7:00AM
-- Frontal lobe seizures peak between 4:00AM and 7:00AM
-- Mesial temporal lobe seizures have a primary peak in the late afternoon between 4:00PM and 7:00PM and secondary peak in the morning between 7:00AM and 10:00AM.

These are just averages, but there's a definite statistical link. It's not entirely clear why this correlation exists -- most likely some combination of circadian rhythms (24-hour body clock) and external rhythms (like meals and sunlight).

 

[ROBERT45]

Good to hear from you Zolt. For me this is Not a new or different scenario. I would have seizures during the early morning---4--6am. Sometimes they would occur during the day. Do your seizures occur at a similar usual time of the month? The reason for my question is that over time I saw the pattern that my seizures occurred. There was a pattern of the last several days of one month over-lapping the first several days of the next month as when I had Most of my seizures. Sort of like a woman's periods when hormonal levels change and the body's metabolization of everything is affected---that especially includes medicines. Yes, men have similar hormonal fluctuations like women that affect how their body functions. So, consider these ideas to see if that may be a factor in how, why and when you have seizures. These influences may or may not be an influence; their are many, many others. Buttttttt>>>>>>>>>>Robert45

 

[Zolt]

Hi Nakamova and Robert,

My seizures do occur in the parietal lobe and so far the meds i have been on do not seem to stop them completely from happening. On average i have the seizures once a month, yes similar to woman periods. Before starting on Gabapentin, may seizures would happen randomly without any specific time. I started Gabapentin beginning of last year, and since then my seizures have happened early in the morning, like clock work. I'm grateful for this, i would not want to change a thing with the meds right now, especially if it schedules them at a known time and in the safety of my home. I'll call in sick that day and just rest. I've been having seizures for 5-6 yrs now.

Robert, what medicine are you on? Do you think it's the meds you take that makes yours happen in the mornings? For me, the days will fluctuate, so it's not always at the end of the month or beginning, it may be in the middle of the month. On average it's about 1 a month, but i have went with with longer periods in between seizures.

This year, i didn't have a seizure for 2 months. I attribute it to starting to learn how to play the piano. I'm 2/3s of the way through learning Beethoven's Fur Elise song. I think there is a few reasons why i went so long without a seizure, learning to play the piano is quite complicate, lots of brain activity involved and Memory space and allocations need to be made as well as new connections to the memory. Hopefully i'm not writing over preexisting memory. It could also be the type of music, the classics is a beautiful songs that as they say, "Soothes the savage beast".


So right now i'm not complaining about the scheduled time, instead i'm grateful they have happened before leaving the safety of my home.

 

[mzollinger]

Hi Zolt --

How about asking your neuro about adding one more dose before bedtime? That might give you enough coverage to protect you against the morning seizures, especially since our metabolisms slow at night.

The half-life of gabapentin is 5 to 7 hours (as you've deduced), and the extended -release version was denied approval in the U.S. So you could also consider trying a med with a longer half-life, and/or one with an extended release version available.

lThe transitional moments from waking to sleep or sleep to waking are popular times for seizing. The brain can be more vulnerable then because of the kinds of brainwaves (Delta) being produced at that time. In addition to the sleep/wake state, day/night or circadian rhythms can play a role. And things like low blood sugar or dehydration may also be factors depending on your individual metabolism.

Different seizure types/origins seem to have patterns as well, although not every one matches up 100%. One study showed a correlation between the area of the brain where Partial Seizures originate, and the time of day that they occur:

-- Occipital seizure occurrence peak between 4:00PM and 7:00PM
-- Parietal seizures peak between 4:00AM and 7:00AM
-- Frontal lobe seizures peak between 4:00AM and 7:00AM
-- Mesial temporal lobe seizures have a primary peak in the late afternoon between 4:00PM and 7:00PM and secondary peak in the morning between 7:00AM and 10:00AM.

These are just averages, but there's a definite statistical link. It's not entirely clear why this correlation exists -- most likely some combination of circadian rhythms (24-hour body clock) and external rhythms (like meals and sunlight).

My son has recently been diagnosed with epilepsy. He has ONLY had a routine EEG done and MRI. The EEG suggested seizures in the left front temporal lobe. If what you are saying is true, why is my son experiencing grand mal seizures at 9:30 am every 12 to 14 days on Fridays (only one has been on a different day)?

I'm still learning about all of this. But, it would seem to me considering the MANY different types of seizures I've seen in him over the last month, should I consider another EEG that is sleep deprived to get a better idea? I was surprised a routine one was ordered, and so was a Dr. friend that we know.

 

[elis]

I can't remember what my seizures are called but they are the kind where the grand mal ones generally take place in the the morning when my brain waves are -or have just moved - from one pattern to another. Maybe that is what you have going on?

 

[mzollinger]

That's a really good thought!

 

[Nakamova]

Keep in mind:
1. The time patterns listed above are just averages -- that means there will be seizures that fall outside of those time ranges, and some that are nowhere near it.
2. The data is merely statistically significant -- enough to indicate that the pattern isn't random. Not enough to say that everyone with x seizures will have them at b time.

As mentioned above, there many other external factor including age, triggers, kinds of seizures, etc. that play a role, and patterns can change over time.

 

[Cint]

Keep in mind:
1. The time patterns listed above are just averages -- that means there will be seizures that fall outside of those time ranges, and some that are nowhere near it.
2. The data is merely statistically significant -- enough to indicate that the pattern isn't random. Not enough to say that everyone with x seizures will have them at b time.

As mentioned above, there many other external factor including age, triggers, kinds of seizures, etc. that play a role, and patterns can change over time.

:agree: I've had Epilepsy for over 30 years and experienced CP's and TC's in the morning, afternoon, evening and even in my sleep. My very first TC happened at 7:00 in the morning years ago and they gradually changed over the years. After my brain surgery is when the TC's became more intense and random. Plus hormones such as thyroid and blood sugar can change over time and effect seizure control.

 

[BadMoonRising!]

This is an especially fascinating thread for me. My Seizures are Tonic/Clonic and generalized (not isolated to or originating primarily from one area of the brain). And they also happen almost exclusively in the morning. I am currently taking 50mg of topiramate in the morning and again before bed, and about to change over to lamotrigine after suffering from far too many side effects on levetiracetam (when the cure becomes worse than the sickness....). As for the 30 day electrical buildup, i noticed it myself as a correlation with the phases of the moon, which sounds like sheer....well, 'lunacy' but since the moon is powerful enough to affect the ocean tides and humans are primarily made of water, i figured i'd look into it a bit further and found out it's really not that uncommon. (At least it gave me a user name for this site) Of course, it's not the kind of thing that's researched by doctors, but i can now predict within a day or 2 when my seizures will happen, thankfully always when i'm in bed.

 

[Zolt]

Hey Bad Moon Rising,

Interesting the sun, moon and stars, what alien forces are working against us? I'll have to take a look at my seizure diary and see if the dates match up with the Moon phase.

I've never had a night time seizure, all mine have happened while awake. Or at least the ones i'm aware of. I can't predict mine, (yet), but i'm sure happy it happens in the mornings. Before i was on this particular med, the seizures would happen at all times of the day and of course at the most inopportune moment.

Zolt

 

[ROBERT45]

Hi Zolt. If you are still having seizures---and I Hope---you aren't I hope they are in the early morning hours when you are still asleep. Like you said, didn't like having seizures period; but if I had to it was great they occurred at that time of day. I didn't have to worry about being out somewhere, scarring people, having to pay for an ambulance I probably didn't need, etc. I remember your seizures became more consistent and dependable when you started taking gabapentin ( sorry if the spelling is not right ). Are you still taking that. I started having seizures when I was 12. Most were when in the early morning when I was asleep. I was unintentionally---as confirmed by neurologists---conditioned by my mother when she took care of me to have some seizures to get attention. If you want to know more about this let me know and I'll be glad to explain.
Keep in touch>>>>>>>ROBERT45