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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Fits And Convulsion Even After Trying Several Medications?

My mother is a patient of Epilepsy since 1992. Earlier she was diagnosed in Kolkata as GTCS and CPS and given Eptoin 100mg BD at first, then Zeptol CR 400mg BD with Cloba 10mg HS for fits, convulsions and senselessness. But still it was going on. Now, last two years, we consulted at NIMHANS, Bangalore to Sr. Prof. Dr. P. Satish Chandra, who diagnosed that her treatment was not in right way, the seizure was Idiopathic Generalised Epilepsy with Absence Seizures and was given Encorate Chrono 500mg BD with Cloba 10mg HS. After this, she was well two year. Then she again developed fits, senselessness and convulsions, unmindful so we went to NIMHANS this year, 2015 and the diagnosis is Combination of Multiple Seizures with Psychogenic Non - Epileptic Seizure and was given Encorate Chrono 500mg BD, Levipil 500mg BD, Cloba 10mg HS, Nexito 10mg HS. But still fits and convulsion is going on after coming back from NIMHANS. Please advice what to be done. Whether the treatment is on right way or not. May there is needed for Topiramate or Lacosamide or Tiagabine medicines.
Wed, 29 Jul 2015
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Internal Medicine Specialist 's  Response
Hello...
Your mother has Epilepsy since 23 years. It is a very long time period. Actually the treatment of Epilepsy is no static. According to time span the drug effects gradually declines and patient needs more and more combination along with higher and higher doses. Because Antiepileptic drugs became ineffective after use of long time that is more than 5 years and so.
In this case, this is the main reason to be ineffective drugs to control the seizure. Your mother already taking 4 drugs those are Tab Encorate, Levepsy, Clobazam, Nexito plus. You can add Tab Topiramate and Tab Carbamazepine to see the control of seizure.
But according to Epilepsy guideline if any patient is on three or more than three antiepilepetic drugs and still seizure continues then should go for surgical ablation. Although it is not 100% curable procedure but no other choice is remaining to control seizure.

Thank You
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What Causes Fits And Convulsion Even After Trying Several Medications?

Hello... Your mother has Epilepsy since 23 years. It is a very long time period. Actually the treatment of Epilepsy is no static. According to time span the drug effects gradually declines and patient needs more and more combination along with higher and higher doses. Because Antiepileptic drugs became ineffective after use of long time that is more than 5 years and so. In this case, this is the main reason to be ineffective drugs to control the seizure. Your mother already taking 4 drugs those are Tab Encorate, Levepsy, Clobazam, Nexito plus. You can add Tab Topiramate and Tab Carbamazepine to see the control of seizure. But according to Epilepsy guideline if any patient is on three or more than three antiepilepetic drugs and still seizure continues then should go for surgical ablation. Although it is not 100% curable procedure but no other choice is remaining to control seizure. Thank You