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What Causes Uncontrolled Movements Of The Face And Neck After Taking Anti-eileptic Drugs?

Posted on Thu, 3 Jul 2014

Question: My husband had a hypoxic brain injury.He is on Keppra twice a day but was put on Tegretol as he had very bad heads.We had hope to exchange Keppra with Tegretol.So we lowed the Keppra XXXXXXX over the long time to 375.Then we star with Tegretol very slowely 100mgat night one week later 100mg added in the morning.Until it was 200mg in the morning and 300mg at night.It help him to sleep at first but it stop him walking and made him irritable did not stop the heads,so the GP told as to cut down the Tegretol 100mg at a time and up the Keppra to 625.This has been over the last few days and my husbandhas had generacise tonic clonic seizures over the last 2 days no sleep for 3 night or days.Uncontrolled movements of the face and neck,headache,continous back and forth eye movements.One seizures lasted up to 8 minutes,weakness,trembling,imagined he saw a man in room,sweating a lot.He was on Keppra for over 4 years and he had never had this before.There is no infection in body.Are these 2 drugs incompatibility?Also he is taking:omeprozole,ibuprofen,carveditol,aspirin,ramipril,tamsulosin,senna,simvastitin,clonazepam.

Answered by Dr. T Shobha Deepak (1 hour later)

Brief Answer:
Could be due to reduction in dosage of tegretal

Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day

Dear Ms,

I understand the difficult situation you are faced with.

The problem is not due to incompatibility of both the drugs with each other.

Both are anti-eileptic drugs and have different mechanism of action. Sudden alteration in dosage can cause alteration in hyper excitability of cerebral cortex and precipitate convulsion.

The sudden decrease in dosage of Tegretal(Carbazepine) from 300 mg at night to 100 mg at night could have possibily precipitated the Generalized tonic clonic convulsion. I would suggest you to increase the dosage of Tegretal to 300 mg at night time. I would also suggest you to consult your Neurologist or your Physician at earliest for further assessment.

Do get back to me if you need any further assistance, will be glad to assist you.

Take Care
Best Regards
Dr T Shobha Deepak
MBBS,MD

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. T Shobha Deepak (1 hour later)

tegretol is just 200mg at night,the morning dose has been cut out.what time would you increase this morning or night and what dose?as he is very agitated by this drug.and shall we also increase keppra from 500mg to 625mg at night?

Answered by Dr. T Shobha Deepak (9 minutes later)

Brief Answer:
Institute morning dosage of tegretal

Detailed Answer:
Hi
Greetings

Institute the morning dosage of Tegretal, since after the withdrawal of that drug the Generalized tonic clonic (GTC) convulsion have been precipitated.
Have persistent GTC is more harmful. So suggest you to institute the morning dosage and contact your Physician at earliest.

Take Care

Regards
Dr T Shobha

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar