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Took epsolin for seizures. Got severe after taking oxcarbazepine and sertaline. Best remedy?

I have faced headinjury in 1996. from1997 I am facing seizures(tonic clonic). I was on drug (epsolin 400mg) and I was getting one seizure each year. last year doctor changed the drug to- Oxcarbazepine(750 mg BD), Encorate Chrono (500mg BD), Sertaline (50mg OD). Now I am facing one heavy seizure each month. Please suggest the best remedy.
Asked On : Wed, 23 Jan 2013
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Neurologist 's  Response
Thanks for posting this question in HCM
I am a neurologist and epilepsy specialist responding to you
First of all let me tell you that treatment of epilepsy largely depends upon the exact type of epilepsy (it may be a focal epilepsy due to brain tumor, scar related to head injury or other cause or it can be genetically mediated generalized epilepsy). For a proper diagnosis of epilepsy, a neurologist will need EEG test and MRI scan of brain; both of these data are not available to me in your case.
Let us see your case.
I understand that you had a head injury. This might have resulted in a focal scar in the brain which can cause epilepsy. I am not sure the exact severity of head injury and if there is a scar or not. One interesting thing which you have to note that some types of epilepsy namely primary generalized epilepsy can become worse after treatment with Oxcarbazepine. However this possibility is low in your case but cannot be excluded without a long term EEG and MRI scan of brain.
Once, a long term EEG and MRI can identify he exact type of epilepsy. We will have the following options
1. If focal: Encorate chrono will not be a good option. You can continue higher doses of Oxcarbazepine upto 30mg/kg (i donot know your body weight). If this fails, you may try adding Clobazam. If MRI shows scar the other options (if these medicines fail) you have to undergo a detailed presurgical evaluation in an epilepsy centre.
2. If your diagnosis turns out to be primary generalized epilepsy, you have to withdraw oxcarbazepine. You will only benefit with Encorate chrono
I advise you to meet one epilepsy expert in your place who will deal the way i have described
Hope this will help you
Answered: Thu, 24 Jan 2013
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