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Should I Stop Seizure Medicines Inspite Of No Seizures?

Posted on Thu, 24 Apr 2014

Question: I am 26 years old male. I had seizure problem since 2003. Till 2011, I faced with about 7 - 8 seizures. No seizure after 2011. My activities during seizure - Sudden felling and unconscious, straining my muscles, throwing it out here and there, pressing teeth and cut at lips, confusion in my mind etc. My neurologist recommended for sound sleep and DIVAA - 250 drug. After this consultation in 2011 , I faced with seizure when I didnt take medicines for 3 - 4 days and last night without sleep and drunk alcohal. Three years passed without any seizure. My questions- 1. Should I stop taking medicines now. 2. If not till what time I have to continue same. 3.is there any side effects of this medicine on brain. 4. As i am student, I used to do late night studies. Though I take good sleep in total. Is there any issue if take sleep in day rather than in night.

Answered by Dr. Sudhir Kumar (7 minutes later)

Brief Answer: My reply is below. Detailed Answer: Hi, Thank you for posting your query. I have noted your symptoms. Regarding your specific queries, my replies are below. 1. Since you are seizure-free for three years, you should be given a chance to come out of medicines. This should be done under the guidance of a neurologist. 2. If seizures recur after stopping medicines, then, you would require long-term medicines, sometimes, even lifelong. 3. There is no significant side effect on brain due to medicines. 4. Night sleep is the best for brain. However, if due to some reason you can not sleep at night, it should be compensated with daytime sleep. I hope my reply has helped you. I would be pleased to answer, if you have any follow up queries or if you require any further information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist Apollo Hospitals, Hyderabad, For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar My blog: http://bestneurodoctor.blogspot.com/

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

Follow up: Dr. Sudhir Kumar (27 minutes later)

Hi Sir, Presently I am staying in place, where I can not find good neurologist in nearby place. is it necessary to be under guidance of any good neurologist during leaving medicines. please suggest. And kindly specify which type of guidance they give. Sir I mean , is there any prescription which is followed during no medicine period. Thanks

Answered by Dr. Sudhir Kumar (1 hour later)

Brief Answer: Thank you for getting back. Detailed Answer: A neurologist is required to study your old reports such as MRI brain and EEG before the medicine dose can be reduced or stopped. Also, in some cases, seizures would recur while the medicine dose is reduced or stopped. A neurologist would be required to re-start the medicines at that time and give medicines to control the seizures. Best wishes, Dr Sudhir Kumar MD DM (Neurology)

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

Follow up: Dr. Sudhir Kumar (1 hour later)

Hi Sir, Thanks for reply. In my case , my neurologist recommended medicine according to my symptoms during the seizure without asking for MRI and EEG. Though, on my initiative I got taken these tests and visited him second time with my reports. But he was not at all impressed with my initiative, he said that you should have asked me before going for these tests. He took very mundane view on reports and commented nothing. Sir my questions- 1. is it possible in some cases that these tests do not reveal anything. ( which I think in my case). 2. If above is case, on what basis my new neurologist would suggest for future medications. 3. Above mentioned drug 'DIVAA-250' is curative in nature or only prevents the seizure. Thanks

Answered by Dr. Sudhir Kumar (56 minutes later)

Brief Answer: My replies are below. Detailed Answer: Thank you for getting back. 1. Yes, the tests may be normal in about 50% of cases. If you have the reports, you can scan them and upload them here on healthcare magic. 2. Those old reports would be valid for the new neurologist to suggest about tapering the medicines. Normal MRI and EEG would mean lesser chance of seizures coming back in future. 3. DIVAA 250 prevents the future seizures, and is not curative. Best wishes, Dr Sudhir Kumar MD DM ( Neurology)

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Sudhir Kumar (13 hours later)

Dear Sir, Presently I can not avail my first test reports as they are not with me right now. Nevertheless, I have attached my MRI brain and discharge summary report taken during last seizure in 2011. Sir please find my uploaded reports and comment accordingly. Kindly suggest future course of actions. (As this is my last follow-up question, please give elaborated answer) Thanks a lot for your above valuable advices.

Answered by Dr. Sudhir Kumar (7 hours later)

Brief Answer: Reports are normal. Detailed Answer: I have seen the discharge summary and MRI brain report. MRI brain report is normal. I could not see the EEG. You need to repeat an EEG test now. If EEG comes as normal, then, you can decrease the dose of DIVAA and stop it in next three months. However, if EEG is abnormal, then, you should continue DIVAA for 2-3 years more. Best wishes, Dr Sudhir Kumar MD DM (Neurology)

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