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Late Onset Seizure, Taken Eptoin. Problem Due To Sudden Stopping?

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Posted on Mon, 1 Oct 2012
Question: Hi, my husband, aged 50, was on Eptoin 100 (3 tabs per day at night) from the last one year due to "late onset" seizures. From the last three months, he just stopped taking them on his own accord. Although there have not been any seizures in the last one year, would such sudden cessation, without medical advice, have any repercussions?Speciality shows Stroke- I am sorry if I made a mistake as I am new to this...he was NOT diagnosed as having a stroke- they just said "cryptogenic" for cause. He had three- four episodes of black-outs which was followed by siezures only during the last three black-outs. Scans did not show a stroke.
doctor
Answered by Dr. Dr. Prasad J (20 hours later)
Dear XXXXXXX

Seizure is some times associated with strokes and other neurological conditions. Quite commonly when a cause is not identified (but thought to be present), we consider the cause as 'Cryptogenic'. Since your doctors mentioned the cause as cryptogenic, I presume that all the test, MRI and EEG have come out clear.

It would have been better if you had mentioned the number of seizure episodes he had in the past and when did he last suffer from it.

As a practice, Neurologist suggest seizure medications for a long time (sometimes for lifelong) in the hope of keeping seizures at bay. If a person has been seizure free for a period of year to year and half, a gradual and slow reduction of medications is tried. If this trial doesn't induce seizures, medications can be stopped. This obviously needs to be done under guidance of neurologist.

You have reported that your husband has stopped anticonvulsants since 3 months and has been seizure free without medications, I would like to discuss about it with an expert neurologist and post the further course of action to you. I have already in touch with an expert and shall get back to you with an answer soon.

Hoping for your co-operation

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Prasad J (3 hours later)
Dear Doctor,
Thank you for your response.

I am providing the additional information you had asked. He's had about three episodes of black-outs over two-three years prior to this. In the last blackout, in 2006,there was suspected convulsions but as there was no one with him we were not sure. The latest episode happened in March of 2010, when he first had a black-out was taken to the ICU and then he had two episodes of seizures while in the ICU.

Yes, you are right, the MRI, ECG and the VEEG were clear. How long do we have to wait to be in the "all clear" to be safe from the withdrawal effects? Is three months a good time?
doctor
Answered by Dr. Dr. Prasad J (17 hours later)
Hi and thanks again,

It is good to know that your husband has been seizure free for more than a year.

Now that there have been no recurrence of seizures (even after the medications were stopped), I feel there is no need to restart the medications again. As promised, I have discussed this issue with a neurologist, Dr. XXXXXXX XXXXXXX and he agrees with me.

You may want to look at his profile here
WWW.WWWW.WW
Abruptly stopping anticonvulsants, as explained in the previous reply will induce seizure. As there were none, no withdrawl symptoms are expected.

Hope I have sorted all your doubts. I also hope the answers are acceptable both by you and your Neurologist.

Wish you and your husband good health

Regards
Dr. Prasad

*************************************************************************************************
Dear XXXXXXX

Thanks for discussion your husband's case with me.

Abruptly stopping anti seizure drug is frequently associated with seizure recurrences within a week.

However, if 3 months have passed and he is still seizure free, restarting drugs is not required.

Seizure drugs need to be restarted only if a seizure recurs, chances of which are very small though.

Wish you good health

Best wishes

Dr. XXXXXXX XXXXXXX
M.D., D.M (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Dr. Prasad J

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Practicing since :2005

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Late Onset Seizure, Taken Eptoin. Problem Due To Sudden Stopping?

Dear XXXXXXX

Seizure is some times associated with strokes and other neurological conditions. Quite commonly when a cause is not identified (but thought to be present), we consider the cause as 'Cryptogenic'. Since your doctors mentioned the cause as cryptogenic, I presume that all the test, MRI and EEG have come out clear.

It would have been better if you had mentioned the number of seizure episodes he had in the past and when did he last suffer from it.

As a practice, Neurologist suggest seizure medications for a long time (sometimes for lifelong) in the hope of keeping seizures at bay. If a person has been seizure free for a period of year to year and half, a gradual and slow reduction of medications is tried. If this trial doesn't induce seizures, medications can be stopped. This obviously needs to be done under guidance of neurologist.

You have reported that your husband has stopped anticonvulsants since 3 months and has been seizure free without medications, I would like to discuss about it with an expert neurologist and post the further course of action to you. I have already in touch with an expert and shall get back to you with an answer soon.

Hoping for your co-operation

Regards