My son is 6 months old and has seizures. We%E2%80%99ve
Need to check the drug level in blood, may need to change the medication
Thanks for asking on Ask A Doctor platform
I have gone through the query and do understand your concern. I can understand your problem as few seizures in this age group are really very difficult to control even after giving combination of seizure medications with highest possible dose.
In your condition although the detail regarding the diagnosis and investigation details are not there I can assume this seizure to be a variety which is difficult to control.
All the given medication like keppra which contains levetiracitam, trioptel which contains oxcarbamazepin and CBD oil(used in seizure which are difficult to control) can cause the side effects which you have noticed. The dosage given are also at upper limit.
I would like to get the drug level done in the blood to see if it has reached at toxic level.
Accordingly we can adjust/stop the medication. We may need to add some other anti seizure medication for better control and to avoid the side effects.
Although sometimes It is difficult to find out the underlying cause but its important to rule out all the causes of seizure including metabolic, structural etc.
I hope this helps.
Please let me know if you have any more questions.
Wishing for better health of your baby.
I avoid using valproate in children below 2 years of age
Thanks for follow up
Depakote contains valproate and is having very high risk of liver toxicity particularly when used in children below 2 years of age. Valproate is a good choice for almost all type of seizures but at the cost of high toxicity. I personally don't recommend it below 2 years of age.
I agree with your doctor regarding interaction between keppra and trieptal & that is the reason I am in favour of getting blood level of all the current medications.
There are many other medications apart from depakote which can be added based on the underlying cause of seizures. I suggest you to discuss this with your doctor in your next visit.
Please feel free to ask if you have any more doubts.
Management and medications depends upon type of seizures
The treatment of seizure in infancy depends on type of seizure, it's severity and side effect of the medications.
Refractory seizure in infancy can be Dravet syndrome, West syndrome and other types.
Some medication can worsen particular syndrome or seizure while can be very effective in other types. There are many newer medications like lamotrigine, clobazam, vigabatrin etc which can be given to control the seizures.
I can understand your concern but I am really very sorry as for me it's very difficult to say any particular medication for your baby as I don't know the exact condition. So I request you to better discuss this with your treating neurologist.
Blood level of medications need not be done at regular interval and usually indicated if side effect or poor response is concerned.
Wishing for your baby's good health.