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First seizure and would like your advice

Mon, 08/07/2017 - 05:54
Hi Everyone, I had my first seizure on the 25/5/2017 (approx. 2.5 months ago), I'm 28 years old and have never had anything like this before. Since my seizure I have had CT, MRI and EEG tests. The CT and MRI have come back normal, but the EEG did show "a couple of bursts of spike and wave activity, in the front right of my brain. Leading up to my seizure I was under a lot of stress at work and as a result I was working 14 hour days (without having any breaks), missing meals and not sleeping very well (typically 5 hours a day). This sleep and work pattern lasted for approximately 6 months (certainly no less). During this 6 month period I had also started drinking quite heavily (for me), I was drinking approximately a bottle of red wine a night. The weekend before my seizure I had also spent 3 days in full sun (temp approx. mid 20’s, I live in the UK) gardening, this did give me heat stroke the day before my seizure. The day before the seizure I ate 3 meals at appropriate times and had 2 pints of cider and a bottle of red wine, throughout the course of the day (all alcohol was consumed during or after a meal). Luckily when I had my seizure a friend was with me. Before the seizure I had a really bad headache (the worst I’ve ever had). My friend said that my arm dropped to my side (we were sat eating breakfast at the time) I then fell to the floor and started convulsing. I was not conscious throughout and he said I stopped breathing and turned blue. He thinks the seizure lasted 2-5 minutes. I bit my tongue and dislocated my shoulder but didn’t wet myself. I was also instantly fully conscious, able to answer where I was, how old I am, I didn’t feel tired or disorientated etc. and the headache had gone completely. Since having my seizure I’ve not had any alcohol, I’ve talked to my boss so that my hours and work load are managed better, I’m getting regular exercise and I’m making sure I eat well. I’ve not had another headache or seizure since. As a result of my EEG the neurology consultant I saw has suggested I start taking Lamotrigine, gradually building to a maintenance dose of 150mg per day. I would like to get your thoughts as I’m not very keen to starting medication that I will be reliant on for the rest of my life, but equally want to get back to a normal life (I’m currently banned from driving for 12months). I accept I’m probably predisposed to have seizures given the EEG results. But my thoughts are if I don’t take the medicine and make sure I keep on top of the possible stimulus (stress, lack of sleep, food etc) and don’t have another seizure in the next 12 months I may be able to control it without the intervention of medicine, what are your thoughts and suggestions? Thank you for your time

Comments

that's a very low dose of

Submitted by Amy Jo on Mon, 2017-08-07 - 08:29
that's a very low dose of lamotrigine for an adult, lower than normal maintenance doses fyi (e.g. my 10yo takes more than that). that dose might be reasonable insurance for someone who doesn't have a strong likelihood of another seizure if they make positive lifestyle changes. the problem with a seizure and your EEG is that another seizure is more likely (vs before even with your changes). sounds like you are onto good changes that can help but many people can't put that genie completely back in the bottle once it's been let out. lamotrigine has fewer cognitive side effects and isn't associated  with bad moods (vs other epilepsy meds). did your doc say it looks like a lifelong epilepsy? not all of them are, scientists don't know why but many people go into remission. different types of epilepsy have different chances so it is something to ask about at your next appt. I'm not really familiar with epilepsy associated with the frontal lobe, assuming that's really the right location. often people stay on a drug a few years and then can try getting off it. something about the meds can be protective. 

am on carbamazepine, 2 X 200g

Submitted by Bluey on Tue, 2017-08-08 - 10:06
am on carbamazepine, 2 X 200g, by 2 times a day. Can i take a beer? say 2 beers per day?

hi Nick,I can relate to the

Submitted by Amy Jo on Tue, 2017-08-08 - 12:41
hi Nick,I can relate to the worry the drug might stop working if one stops but... AEDs sometimes stop working even when one is staying on the drug so you can't control everything. also, it doesn't sound like you've started the drug, know not every drug actually works for every patient so the first steps are trying a drug, getting to some moderate dose and testing to see if the activity is controlled. you can only make the best decision by getting the best available info at the time. so EEGs at certain points help. asking for one right after getting off a drug should also indicate if there's still activity and hopefully the formerly drug would still work if you get back on then.

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