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I'm wondering if anyone has some thoughts on the behaviour of my partner (female 52 yr old) who has recently started on Keppra.
She had her first "event" in April this year - thought she was having a stroke - tunnel vision, tingling in arms, couldn't speak, lost movement in legs. Rushed into A&E where CT scan was clear - to be told this was an aura for a migraine.
Started migraine meds (beta blocker) but had similar events a few weeks apart - always tingling in arms, moving to face, loss of ability to speak or forgetting words, losing vision, intense fatigue.
Just before we got to see a neurologist she had a full seizure - tonic/clonic, frothing at mouth, loss of consciousness. On the back of that she had an MRI scan, which was clear and the neurologist put her on Topiramate.
Three days after starting the topiramate she was in hospital after what sounds like a partial seizure - couldn't speak, very confused, non-responsive, clumsy - and into a full psychotic event. She was paranoid, delusional, didn't sleep for 5 days straight, was convinced the staff were trying to kill her, talking complete gibberish. They stopped the topiramate and over the course of the week she calmed down and back to relative normality. Had another MRI - which was clear; an EEG - which was normal (even though she was still "tripping" at the time and had not slept for 3 days); and a Lumbar Puncture - which was also clear.
After a week at home relatively normal, she had another event of stumbling, followed by inability to articulate clearly. For a week after this she was like a zombie - distracted by the simplest things (you couldn't get her to tear herself from the TV) - could answer simple questions relatively clearly, said she felt fine, but a lot of her speech was completely unrelated to the question - and some questions would take 15 minutes to get a yes/no answer - interspersed with lots of ums and ahs and long silences. She was also very tired in the afternoons and spent a lot of time sleeping. Took her to the docs and back to A&E for a CT scan - which was clear.
Then she had another partial seizure - again looked like a stroke - very agitated, clutching and de-clutching bedclothes with a vice-like grip, moaning but unable to speak at all. Rushed back to A&E - CT scan clear. Kept in for 4 days and diagnosed as having an epileptic partial seizure.
The day after she was clear as a bell in the morning, but by evening was "slowing down" and introducing random comments into her conversation. By the second day she was talking complete nonsense again - couldn't even recoginise her sister.
Docs put her on Keppra and sent her home. Three days later she's still quite confused - yes/no answers (she used to be very alert and chatty) - almost zombie-like at times - very easily distracted. Almost no independent thoughts - but quite calm and happy. Vacant I guess I'd describe it.
We're waiting to get back to the neurologist.
In the meantime, I'm worried that her behaviour is odd - I've read about post-ictal confusion but that seems to be for a few hours - this has been going on for days.
I've heard people talk about some level of confusion/poor memory on Keppra - but this behaviour is similar (although not as bad) as before she started taking it.
She had her first "event" in April this year - thought she was having a stroke - tunnel vision, tingling in arms, couldn't speak, lost movement in legs. Rushed into A&E where CT scan was clear - to be told this was an aura for a migraine.
Started migraine meds (beta blocker) but had similar events a few weeks apart - always tingling in arms, moving to face, loss of ability to speak or forgetting words, losing vision, intense fatigue.
Just before we got to see a neurologist she had a full seizure - tonic/clonic, frothing at mouth, loss of consciousness. On the back of that she had an MRI scan, which was clear and the neurologist put her on Topiramate.
Three days after starting the topiramate she was in hospital after what sounds like a partial seizure - couldn't speak, very confused, non-responsive, clumsy - and into a full psychotic event. She was paranoid, delusional, didn't sleep for 5 days straight, was convinced the staff were trying to kill her, talking complete gibberish. They stopped the topiramate and over the course of the week she calmed down and back to relative normality. Had another MRI - which was clear; an EEG - which was normal (even though she was still "tripping" at the time and had not slept for 3 days); and a Lumbar Puncture - which was also clear.
After a week at home relatively normal, she had another event of stumbling, followed by inability to articulate clearly. For a week after this she was like a zombie - distracted by the simplest things (you couldn't get her to tear herself from the TV) - could answer simple questions relatively clearly, said she felt fine, but a lot of her speech was completely unrelated to the question - and some questions would take 15 minutes to get a yes/no answer - interspersed with lots of ums and ahs and long silences. She was also very tired in the afternoons and spent a lot of time sleeping. Took her to the docs and back to A&E for a CT scan - which was clear.
Then she had another partial seizure - again looked like a stroke - very agitated, clutching and de-clutching bedclothes with a vice-like grip, moaning but unable to speak at all. Rushed back to A&E - CT scan clear. Kept in for 4 days and diagnosed as having an epileptic partial seizure.
The day after she was clear as a bell in the morning, but by evening was "slowing down" and introducing random comments into her conversation. By the second day she was talking complete nonsense again - couldn't even recoginise her sister.
Docs put her on Keppra and sent her home. Three days later she's still quite confused - yes/no answers (she used to be very alert and chatty) - almost zombie-like at times - very easily distracted. Almost no independent thoughts - but quite calm and happy. Vacant I guess I'd describe it.
We're waiting to get back to the neurologist.
In the meantime, I'm worried that her behaviour is odd - I've read about post-ictal confusion but that seems to be for a few hours - this has been going on for days.
I've heard people talk about some level of confusion/poor memory on Keppra - but this behaviour is similar (although not as bad) as before she started taking it.
