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Altitude Change and Medication Effectiveness?

Sun, 01/02/2005 - 17:12
Hi - I've been diagnosed with epilepsy for about 15yrs (am now 43yrs). Until Christmas last yr I was seizure free for 7 yrs. We went on holiday for 2 weeks down to the coast and then returned to altitude in Johannesburg (6 000ft?) and 2 days later I had a seizure - my mediction was increased by 50% and was then found to be in the therapeutic range. Then 2 days ago it happened again after coming back from holiday at the same place. My meditation is Convulex (3x300mg/day) i.e. valproic acid. My pharmacist thinks there may be a link with haemoglobin level changes with altitude and medication effectiveness - any ideas?

Comments

RE: Altitude Change and Medication Effectiveness?

Submitted by RobJW on Sun, 2004-04-18 - 12:50
Going back on holiday sounds an EXCELLENT plan - thanks - will inform my boss and take out a loan since I'm now broke! Tried to see my neuro 2 days ago but he was also on holiday! His stand-in gave me the advice to increase the meds in the mean time.... My regular neuro should be back tomorrow. From my recent (today!) reading I probably relatively often have very early morning (within 30min of waking) "Absence" and "Myoclonic seizures" (about one a month) but the ones I had in the last week and the one in December last year (all very early morning) were probably "Tonic-clonic" in December and "Atonic" this last week - I was definitely unconcious (so couldn't diagnose myself!) but according to my wife (and the neuro for the December one) this sounds about right. Had a brain scan in December so that rules out tumour etc. I think a typical EEG conclusion is "Mild to moderatey abnormal EEG. A right hemispherical dysfunction maximal in central temporal and anterior temporal regions is noted. Features are non-specific ion nature"Thanks again for the thoughts and ideas.

RE: Altitude Change and Medication Effectiveness?

Submitted by tibet2 on Sun, 2004-04-18 - 13:57
if only i were a neuro and i could convince insurance companies to finance vacations instead of increased anti-convulsants.... we could all have a "working holiday" and go help chad with his forum in zambia...it must be very difficult for your wife to sort out what happened when you had those seizures because it happens so quickly and must be very distressing to her. the first time i saw a friend have a partial seizure i had no idea what was happening, just that he wasn't well. at that point i didn't know he had epilepsy. i think were one of my children or my husband to have a seizure i would not be the best witness. i hope i am never put to the test on that one. are you familiar with juvenile myoclonic epilepsy (JME)? don't let the name mislead you - it is often not diagnosed until a person is in their 20s or older.... and contrary to the expectation you might have because of the name - it is not a condition you outgrow. i only ask because the hallmark of JME is myoclonic seizures upon awakening and you are taking the med that works best for JME. if your sleep cycle is off that might be part of the problem with seizures following holiday. http://www.emedicine.com/NEURO/topic416.htmhttp://www.epilepsy.org.uk/info/juvenile.htmlhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12612320&dopt=Abstracti'm hopeless, positively hopeless, with EEGs, so i can't help you out there. hopefully i am going to learn a little something about them over the next few months, so maybe then i will have a vague understanding of what that EEG summary means. it is abnormal. if the literature on JME sounds familiar to you, you might want to ask the neuro about it. there are anti-convulsants that you would want to avoid if you have JME. good luck. hope you get in to see the neuro soon.

RE: Altitude Change and Medication Effectiveness?

Submitted by RobJW on Mon, 2004-04-19 - 14:58
Well - I went to the neuro today and what was his diagnosis? - JME!!! Who needs a neuro when you have a community! He increased my meds somewhat - still within the right dosage range for my weight and I'm sure the blood levels will be within the upper limit of the therapeutic range - I'm very happy with Convulex (i.e. Valproic Acid) few side effects and have controlled my seizures very will for many years - the conclusion today was that I'm rather stressed and my sleep patterns had deteriorated recently. Thanks for the links etc - will read tomorrow - need to get some sleep ......

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