High Keppra Dose

Re: High Keppra Dose

Submitted by jennylynn26 on Sun, 2013-09-29 - 07:54

I know this is an old discussion, but figured id go ahead and share my experience anyways. A few years ago I decided to switch from Depakote to keppra because My husband and I were getting close to ready to want to try and have a baby and I've been told that keppra is the safest anti-seizure medicine for pregnancy.During the switch I had multiple break through partial seizures as 2 grand mals (first ones in about 6 years). My neurologist finally got my seizures under control with 3,500mg/day. Just this past May I found outI was pregnant. I have had a pretty rough pregnancy with lots of nausea, vomiting, and dehydration. Ia was so sick that I lost 23lbs within the trimester,but thankfully no seizures! A few weeks ago, around 22 weeks, I started feeling on the verge of having a partial seizure and a few days later I had several break through partials. (I have simple motor seizures in my right leg and occasionally they have spread to a grand mal seizure). My neurologist checked my keppra levels and discovered they were about 1/2 of what they had been (when my seizures are under control, my keppra levels are around 50). She was hesitant to increase the keppra dose due to the fact that I was pregnant and because I was already on a high dose. She did go ahead and increase it to 4,000mg/day. After the increase, my keppra levels increased slightly to 28 (50 is my normal keppra level). I was still feeling miserable and was having a difficult time just walking as I felt like I could have a seizure at anytime. In addition to that, I get bad anxiety due to my seizures as I never know if a partial will lead to a grand mal (which do to past experience, I have to come be terrified of). My neurologist was uncomfortable increasing my dosage any higher, so she referred me to an epitologist. The epilotologist seemed to be an answer to my prayers. He assured me it is the amount of keppra in my blood that matters and not the amount I'm physically taking. He immediately wanted to get my keppra levels back up to around 50. I am currently now taking 6,000mg/day and my levels are up to 43. He said many pregnant women end up needing to pretty much double their doses during pregnancy due to their bodies not absorbing it as much. He also assured me that the baby only gets a fraction of the amount that is in my bloodstream, not the amount I'm physically taking. I'm feeling much better now that I no longer feel on the verge of having a seizure, however, since my medicine increase I have started experiencing what I believe are nocturnal seizures followed by "Todd's paralysis" in my right arm. I had experienced this paralysis in my arm back when I first started taking keppra, but did not know what it was. After some research, I found what is called"Todd's paralysis" which is a temporary paralysis that can occur after a seizure. I've started experiencing this type of paralysis multiple times a night since my medicine increase (I wake up when the paralysis sets in). Yesterday was the first time who woke up and experienced a simple motor seizure in my arm immediately followed by the paralysis. (This paralysis is sometimes a total paralysis in my entire right arm that usually goes back to normal within a minute, but occasionally it is a partial paralysis whet I can move my arm and hand, but I have no coordination and cannot point, hold my hand flat, hold/grip anything (essentially my entire right arm is useless until it goes back to normal). It sometimes can take up to 6 hrs for it to go back to normal (thus why I have been typing this entire post with my left hand. Will be anxious to see what my neurologist and epilotologist have to say.