Still confused after seizure

[notime]

Hello,

I was wondering if anybody is experiencing the same problem that I am at the moment. I was put on keppra in June of 2013, and started on a low dosage and the seizures continued about one month on average and my neurologist increased it, until September when I was already at full dosage he finally put me on lamical. He slowly increased my dosage, until I was at 200mg and since September I've been seizure free.

Until recently, I've been reducing it throughout the year until July I was finally taken off completely. I am trying to figure out, was that the right combination for me? I heard polytherapy rarely works, but perhaps I'm the exception? Besides, I skipped one pill the night I had the seizure. What are the chances of it being just because I skipped the one pill? I mean, it is very close after going off of keppra and I've been seizure free for one year and I only skipped one 100mg pill, that caused me to have a seizure? I don't get it.

Sorry, I can't ask my neurologist all of these questions because he won't talk directly to me through the phone (only his nurse) ... my father doesn't have time right now to take off to take me over there just for questions. Any idea though?

 

[bRyan1981]

Hi there, I can tell you without a doubt that you most certainly can have a seizure if you skip a dose. this has happened to me plenty of times in the past when I would forget to take my meds. To put it simply, the meds probably left your system by the time you had the seizure, which only proves that your meds were in fact keeping you from having seizures. If I were you I would just continue to take you meds as prescribed, but definitely talk to your neurologist as soon as you can.

 

[Dolores]

I agree with bRyan and know by personal experience unfortunately that missing a dose can result in a seizure. It all has to do with the half-life of the drug and how long it is in your system. So if I had been seizure free for an entire year on a particular drug/combo I would not be so quick to blame the drug for not performing as expected. I would look for extenuating circumstances (like missing a dose). If there were any as there are in your case, I'd stay on the drug but closely monitor and record my blood levels & dosage changes. This way you have a log of how much of the drugs are in your system and then you and your doctor can make an decision educated by your particular situation.

I use excel to chart my drugs and the dosage I am on (my seizures are controlled but I tend to overdose every few years so we just change the dosage). I then color code everything as to high and normal and low. My doctor was amazed when I showed it to him and actually uses it since it provides a simple clear picture of what has happened to me at what dosages rather than wading through all the lab reports.

Wishing you the best - Dolores

 

[Kgartner]

I'm going to agree with what both bRyan and Dolores said- skipping one dose can definitely cause a seizure, and in fact it is the most common reason for breakthrough seizures. This happened with my daughter recently: she skipped her morning dose of Onfi and had a seizure 2 hours later. We are now completely rigorous about making sure that she takes her medication on time each and every day.

I would continue on the path your doctor recommends for now; if you have a seizure recurrence without missing any doses then you may want to discuss reintroducing the Keppra. But if you can have seizure freedom on just one medication that is much better for many reasons!

 

[Cint]

Hello,

I was wondering if anybody is experiencing the same problem that I am at the moment. I was put on keppra in June of 2013, and started on a low dosage and the seizures continued about one month on average and my neurologist increased it, until September when I was already at full dosage he finally put me on lamical. He slowly increased my dosage, until I was at 200mg and since September I've been seizure free.

What do you consider full dosage? I've been on the max dosage of Keppra (3000 mgs a day) for 15 years along with several other meds off and on to control my (or trying to control) seizures.

Until recently, I've been reducing it throughout the year until July I was finally taken off completely. I am trying to figure out, was that the right combination for me?

Only you can make that decision. What may work for one, won't necessarily work for another. I've tried 15 meds + the VNS and none have worked.
Plus, I have forgotten to take meds at one time or another. Sometimes I have seized, others, I haven't. It all depends on the timing.

I heard polytherapy rarely works, but perhaps I'm the exception? Besides, I skipped one pill the night I had the seizure. What are the chances of it being just because I skipped the one pill? I mean, it is very close after going off of keppra and I've been seizure free for one year and I only skipped one 100mg pill, that caused me to have a seizure? I don't get it.

You are no exception. I've been on polytherapy for over 20 years. Like I said,
the seizure could have been due to you skipping your med. I've accidently skipped my meds at bedtime or other times. Sometimes I have a seizure, others I don't. It depends on the timing and the medication. One should be seeing an epileptologist because of this reason.

Read more:
http://www.ncbi.nlm.nih.gov/pubmed/19949564
Monotherapy to polytherapy: antiepileptic drug conversions through the spectrum of epilepsy care.
St Louis EK.

 

[notime]

@Cint

It was 3000mg of keppra xr, and I think that's the max dose. My memory was a lot worse, like I wondered if what I had was absence seizures or myclonic seizures, and after being taken off it has improved a lot.

If I have another I'll ask him to increase lamictal, and if they still continue instead of upping it more I may ask him just to put me back on keppra, it's better using that I suppose at a low dosage then hunting all over again.

 

[bighealey]

I missed one dose and had a seizure. This was after getting my dose reduced.