First Tonic Clonic in months.

[Freda]

My daughter carly has been put on lamotrigine alongside her levetiracetam to help with mood swings, she's been on a low dose for three weeks and in that time has had increased focal seizures which last night culminated to a tonic Clonic. It's the first tonic Clonic she's had in three months and we are thinking it may point to the new med and the levetiracetam reduction.
She emailed her consultant but she's away until Jan 2nd but the nurse said to continue to increase the new med but don't reduce the levetiracetam for now until she sees the epileptologist in the new year.
This tonic Clonic was more violent than her past four and she's bitten her tongue really badly this time, however the recovery stage was faster. So fed up the seizures have started again and do you think she will have more before stabilising on the new med?
Lam 25mg twice daily - to be increased on 30th Dec
Lev 1250 twice day - too be decreased on 30th Dec
Clobazam 10mg once daily after a focal

 

[Nakamova]

Sorry to hear about the T-C seizure. Really tough to know what provoked it or what will happen next. Her daily dose of Lamotrigine is still pretty low -- average range for seizure control is usually closer to 200 or 300mg/day. Consider asking her neuro about holding off on reducing the Lev any further until the Lam is at a higher dose?

 

[Freda]

What a brilliant answer Nak, you have suggested exactly what her neuro advised. Thank you.