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What causes skin rashes while on Levetiracetam?

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Dr. Neeraj Kumar

Neurologist

Practicing since :2006

Answered : 2263 Questions

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Posted on Mon, 26 Oct 2015 in Epilepsy
Question: ny grandson almost four years old this month had one seizure about 9 days ago, was diagnosed as being epileptic.

neurologist prescibed one medicine levetiracetam, dis not work out well, developed skin rash.
he now started taking oxcarbazepine, making him drowsy and agitaed at times.

? how long it normally take to get adjusted to this type of medicine, on the new medicine now two days
? is medicine really needed since sine there was only one incident of seizure
doctor
Answered by Dr. Neeraj Kumar 18 minutes later
Brief Answer:
provide more details

Detailed Answer:
Hello XXXXXXX XXXX,
I have gone through your question and understand your concerns.
Seizures in childhood may be due to various causes like febrile seizure, idiopathic seizures or seizures due to some syndrome.
Was there any fever preceding the episode of seizure?
Is there any developmental delay, mental retardation or any neurological disorders?
In cases of febrile seizure no medication is advised . Only antipyretics are indicated.
Treatment after first episode of seizure is controversial and requires investigations like MRI and EEG.
It may be started after first episodes in patients with abnormal MRI , focal onset seizures, status epilepticus episodes.
Drowsiness due to drugs may be dose related, It improves if adequate doses in 3-4 days.
You can upload images and prescription of treatment for better advice.
Hope you found the answer helpful.
Do get back to me for further queries.
Regards
Dr Neeraj Kumar
Neurologist


Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Neeraj Kumar 12 hours later
thank u for prompt response.

cole, my grandson will be four october 24, 2015 did have a fever around 101, and vomited at the time of seizure.
His eyes rolled into his head and was spaced out according to the parents. they called 911 the evening of sept. 23 and was taken to hospitals( second one specialized in neurlogy for children);
eeg and mri (done morning of september 25) did detect evidence there was a seizure the previous night sept. 23 2015.

The neurolgist explained late afternoon sept. 24 ( less than 24 hours after the seizure) that medication would be necessary to deal with this on a continuing basis .Cole can resume normal activities but needs to be watched closely and take the medication.
The first medicine ,levetiracetam, cause a rash the first few days, so it was stopped on saturday sept. 26. It was first given at the hospital on sept.25 about 18 hours after the seisure. The new medicine, oxcarbazepine, was given a few days later, evening of sept. 29 after the rash went away.

so it has been almost 9 days since his first and only seizure on Sept. 23
i am concerned about cole being on this medication and its side effects. so far he sems to be more drowsy and has mood swings.
?Does it take awhile for the child to adjust to ant-convulsion or seizure medication
? also if thre are no future seizures, can the medicine be stopped under supervision of the doctor).
? how long do u wait before the medicine can be stopped?

Thanks for your assistance



doctor
Answered by Dr. Neeraj Kumar 30 minutes later
Brief Answer:
Consult a paediatric neurologist

Detailed Answer:
Hello XXXXXXX
I have gone through all the details provided by you.
It seems that your grandson sustained febrile seizure ( if the fever was present previous to seizure as seizures also leads to increase in body temperature after the ictus).
The treatment with antiepileptics is not recommended in first episode of simple febrile seizure.
Treatment is to be given in cases with complex febrile seizures(episode greater than 15 minutes, more than 1 episode in 24 hours, focal seizure, abnormal MRI findings).
If treatment is started it can be continued for 3-6 months and re-evaluated for need of continuation.
In cases with other cause of seizure the drug has to be continued for 2-3 years.
If drowsiness is more you can consult regarding dose of drug.
In a weeks time most person adjust to drug levels.
In last , i will advice to consult a paediatric neurologist for evaluation.
Hope you found the answer helpful.
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Neeraj Kumar 9 hours later
thanks for the information.
My daughter told me that the EEG scan was used by the doctor(pediatric neurologist) to determine that Cole my grandson has epilepsy and needed to be on medication. No mri was done.
My daughter is supposed to have a follow-up with the specialist , but is waiting to hear back from the medical staff.
should a MRI be requested to be done also.
What are good questions shoud we ask the pediatric neurologist who used the EEG to determine that Cole has epilepsy, though only one seizure occurred.
doctor
Answered by Dr. Neeraj Kumar 1 hour later
Brief Answer:
Requires MRI in atypical or complex febrile cases

Detailed Answer:
Hello XXXXXXX XXXX,
Epilepsy and seizures are two different terms.
IN simple terms Epilepsy is two or more episode of unprovoked seizures.
Seizure is any episode of fits.
The justification to start anti epileptics ,after single episode of febrile seizures requires atypical findings like prolonged seizure(>15 minutes) , focal onset in one limb, status epileptics, recurrent episodes within 24 hours , abnormal MRI, EEG showing focal discharges.
MRI is not indicated in most simple febrile seizures and no anti-epileptics prescribed.
If complex febrile seizure is suspected then MRI should be done.
You can ask for duration of treatment planned and further investigations in future.
You can also ask regarding need of drugs for single seizure.
Hope you found the answer helpful.
Do get Back with further queries.
You can also upload reports or prescription of treating doctor for better evaluation which will avoid information loss via you.
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Sonia Raina
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