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Dr. Andrew Rynne

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Suggest treatment for persistent nocturnal epilepsy

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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3631 Questions

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Posted on Mon, 19 Oct 2015 in Brain and Spine
Question: Hi. I am a male, 61 years old in xxxxxxx, and I continue to have occasional nocturnal seizures since age 12. I had a severe head injury at age 7 (depressed temporal skull fracture with submeningal hematoma), and needed speech therapy for two years afterwards as a result. My seizures occur when I am about to fall asleep, either at nighttime or for a nap. They are occasional, anywhere from 2 to 8 per month. I get an aura of increasing white noise, then an"explosion" hallucination of strong white light and white sound along with tightening of the scalp, neck, and paraspinal muscles. I then have a mild headache for a few minutes. I just want to get some more education on what is going on. I can live with them, and have for a long time. Thanks.
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Answered by Dr. Olsi Taka 42 minutes later
Brief Answer:
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Detailed Answer:
AfterwardsI read your question carefully and I understand your concern. I am a little puzzled that you haven't asked for medical help for all these years.

Brain injury is one of the main causes of seizures, due to some residual damage, scarring, being left in the brain, which leads to the increased likelyhood of abnormal electrical discharges of the brain nerve cells. So considering your history of trauma with brain injury it is most likely that those episodes are indeed seizures as you say. Of course the diagnosis must be confirmed by EEG and a control brain imaging should be scheduled as a rule (though I do not expect it to show much apart from remnants of the old injury).

Afterwards treatment to prevent these seizures can he started. I understand you claim these episodes do not affect you because they are during the night and you've lived with them for so many years, but still I do not see why you should not try to get better. Also there is always the possibility of complications like prolonged seizures, aspiration pneumonia, even sudden death in rare cases. Type of treatment may vary according to EEG info and seizure observation. There are many options these days like levetiracetam, lamotrigine, valproic acid etc. You should be followed by a neurologist in order to evaluate over time treatment efficacy, side effects, need for treatment change etc.

I remain at your disposal for further questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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