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Old 09-24-2018, 07:55 AM
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EEG while taking meds


My son was diagnosed with juvenile absence epilepsy nearly 18 months ago at age 12. He was started on Zarontin 250mg once per day, then bumped up to twice per day. He stopped having absence seizures at that dose, even though it was, technically, a slightly sub-therapeutic dosage for his weight. He has since had a huge growth spurt and is now about 20 lbs heavier than he was when he began that dose, but he still hasn't had any more absence seizures. His bloodwork has shown low, but not insignificant, levels of Zarontin. However, due to scheduling, his bloodwork has generally been performed only a few hours after his morning dose. Obviously, the levels would be lower if he were approaching his evening dose.

Given that he's at such a low dose of medication for his weight, his neurologist suggested a repeat EEG. He said that if the EEG appears normal, we could try weaning him off his medication. I asked if the Zarontin, even at a low dose, might effect the EEG such that it showed up as normal, even if he still has JAE. The neurologist said that there would still be epileptic activity even with successful medication treatment, so that a normal EEG would be a good sign.

Doing my own research, I found a couple of articles that seemed to indicate otherwise... that Zarontin would likely negate the spike and wave patterns (not sure if completely remove or just diminish or reduce the frequency) of absence epilepsy. If this is the case, I'm afraid that his EEG might not be an indicator that he might have outgrown his epilepsy. My understanding is that JAE is rarely outgrown (unlike it's similar condition, CAE).

Does anyone know which is true? Whether Zarontin would mask epileptic activity on an EEG, or whether the EEG would still show the spike and wave patterns of JAE even with medication?
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Old 09-25-2018, 06:30 AM
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Hi Elljen,

I started having absence seizures when I was 10 (56 now). Just like your son I was put on zarontin and it didn't show any difference in the e.e.g. testing. Sometimes a person can outgrow the seizures which is great but then there are other people who aren't so lucky.
Your son is at an age where he's growing and hormones are changing a lot this will be the time that body will have the most activity going on both chemically and with neurons firing up in the brain so if your son has stopped having seizures there's a good chance he may outgrow the seizures. I wish you and your son only the best of luck and May God Bless the Both of You!

Sue
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Old 09-25-2018, 07:04 AM
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Thank you so much for replying. I just didn't understand why the doctor would want him to keep taking the Zarontin if it might affect the EEG results. But of course i don't totally understand how it works. I guess we'll just wait and see!
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Old 09-25-2018, 08:21 AM
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Hi Elljen --

I have had several EEGs while on meds where the results have been positive. It can depend on the individual, the dose, and the kind of seizures. It can also help if the EEG is sleep-deprived, since that can help provoke ictal or interictal brainwaves in someone who has a lowered seizure threshold, even if they are on meds.
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Old 09-25-2018, 01:07 PM
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That's very helpful to know. My son is on a very low dose (I believe typical for his size is about 1,000 mg per day, and he's on 500 mg. I do know that some of his bloodwork in the past has shown very low blood serum levels.

He is prone to insomnia. He had a TERRIBLE night sleep the night before his first EEG. Last night he slept OK, but the night before he was up a bit. The EEG is this afternoon. I guess we'll see what happens and take it from there.
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Old 09-25-2018, 01:51 PM
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Good luck! Keep us posted.
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