The accepted guidelines state that in treatment of seizures, we start the patient on a single drug and adjust the dose to the maximal tolerated dose that achieves optimal seizure control( start low and go slow). If the breakthrough seizures have been occurring increasingly more often , then changing the drug or adding another drug maybe advised. To answer your question, Keppra
are not the same(have different mechanisms of action), but are both effective for a lot of the different types of seizures(broad spectrum). A practical approach to seizures while on medication is to maintain a seizure diary or calendar, so that triggers of seizures maybe identified and avoided (stress
, alcohol, menses, lack of sleep). If this does not help, talk to your doctor about changing\ adding another drug. I hope your brother feels better...