Brief Answer:
Dosage of Keppra may be increased

Detailed Answer:
I read your question carefully and I understand your concern.

I am assuming that you have already had the necessary investigations over this past year. I mean at least brain imaging (preferably MRI), EEG and blood tests to exclude infections, metabolic abnormalities etc. These tests are done to search for a possible correctable cause of the seizures (not always found) and also to see the type of electrical activity as it may influence choice of therapy.

If all that has been then regarding therapy Keppra is a common popular first choice drug. Since it is not stopping the seizures first step would be to consider an increase of dose. You do not mention what dose are you getting. Dosage can be increased up to 3000 mg daily in total (unless there appear side effects). Of course it is increased gradually.

If an increase still doesn't work then there are still many other antiepileptics, which might work better in your case. The choice depends on type of seizure and EEG report. A new drug can be introduced instead of Keppra. If still ineffective then a combination of 2 drugs is the next step. Since these changes in therapy are done gradually, after considering seizure type and EEG, it is recommended to be followed by a neurologist as follow up visits will be necessary.

I remain at your disposal for other questions.

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Brief Answer:
Read below

Detailed Answer:
That dose is the lowest possible so there is certainly the possibility of increasing it. Your doctor is right in saying that a normal EEG doesn't exclude seizures, it helps us when it detects something but may happen to be normal between seizures, so when manifestations are clear treatment can be started with a normal EEG.

If you have only just started Keppra (in the last 2 weeks) I would give this dosage a little more time. If you have other seizures though or have been taking it for longer I would consider raising the dose to 1500 mg/day.

Let me know if I can further assist you.

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Brief Answer:
Read below.

Detailed Answer:
If you have had seizures on more than one occasion by definition you have epilepsy. So if we are going to call those episodes seizures then you have epilepsy. Now whether they are seizures or not it's tough for me to say as you have given no description of the episodes. But since a fellow neurologist (who I assume was given a detailed description) and also the EMT relative who saw you think they were seizures I am inclined to believe that that is indeed the case. The EEG may reinforce the diagnosis when it detects epileptiform changes, but doesn't exclude it when it doesn't. The other tests I mentioned (MRI and blood tests) are done to search for a cause of the seizures (not always found), not to make the diagnosis of epilepsy. The diagnosis is based on the seizure clinical manifestations, not on tests, so if seizures are clear, so is the diagnosis of epilepsy.

So if you have had several seizures, you have epilepsy and you should take Keppra, it is not the medication which makes the diagnosis. If current 1000mg dose is deemed to not be enough it should be increased as I said.

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Brief Answer:
Hope you will feel better soon.

Detailed Answer:
You're welcome. Hope you feel better soon.

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