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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Exp 50 years

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Treated With Keppra, Depakote For Seizures. Now Again Having Breakthrough Seizures. EEG And MRI Done. Any Treatment?

My daughter is 8 yoa. Prior hx of generalized tonic-clonic seizure disorder from age 2 (probably before but not known until then) to age 7. EEG at age 2.6 showed the above and she was treated with Keppra and then depakote (both with side effects although meds. did help keep seizures at bay) She went over 2 yrs seizure-free from Feb. 10 to March 12 so Neurologist tapered off meds from April thru May, 2012, completely off of meds by June, 12. (EEG at this time was normal) As of March, 13, she began having breakthrough seizures again, 2 in 4 week period of time. Neurologist did EEG which showed abnormal bi-frontal spoke and slow wave complexes. We also did MRI to make sure nothing was developing in brain - MRI results showed (and this is what I don t understand?): Multiple small nonspecific T2 hyperintensities w/in cerebral white matter, primarily frontal & Parietal lobes. They may represent foci of gliosis but appearance is nonspecific. Otherwise unremarkable. She began back on Keppra (which was awful for her before but b/c of increase in her age now, seemed best starting point per MD) last week and I m just double checking to see if there isn t something else that needs to be done for her. I hate it for her to be back on meds but I don t want her having seizures either... thanks in advance, Lynn
Fri, 17 May 2013
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Neurologist 's  Response
Hi,
Thank you for posting your query.

I can understand the discomfort your daughter is going through because of side effects. However, at this stage, continuing medications is the best option, as seizures can cause more harm.
I agree that MRI findings are non-specific and nothing needs to be done about that.
If she does not tolerate keppra, she could try trileptal (oxcarbazepine) or lamotrigine.

Please get back if you require any additional information.

Best wishes,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)
Senior Consultant Neurologist
Apollo Hospitals, Hyderabad,
My personal URL on this website: http://bit.ly/Dr-Sudhir-kumar
My email: drsudhirkumar@yahoo.com
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Treated With Keppra, Depakote For Seizures. Now Again Having Breakthrough Seizures. EEG And MRI Done. Any Treatment?

Hi, Thank you for posting your query. I can understand the discomfort your daughter is going through because of side effects. However, at this stage, continuing medications is the best option, as seizures can cause more harm. I agree that MRI findings are non-specific and nothing needs to be done about that. If she does not tolerate keppra, she could try trileptal (oxcarbazepine) or lamotrigine. Please get back if you require any additional information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, My personal URL on this website: http://bit.ly/Dr-Sudhir-kumar My email: drsudhirkumar@yahoo.com