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Focal Onset Epilepsy in 2.5yo

Fri, 06/13/2014 - 23:24

I'm new to the epilepsy world, but this afternoon my son's neurologist called to say she had reviewed his ambulatory 24-hour EEG and she is diagnosing him with focal onset epilepsy. I like to think of myself as fairly educated, but I know virtually nothing about epilepsy other than it's related to seizures.

To back up a bit, my son had a tonic-clonic seizure in January at age 2 years 2 months. It lasted 4 minutes, and when we arrived at the ER via ambulance he had a temperature of 104F. Because of that and a normal sleep-deprived EEG following they figured it was a febrile seizure.

Two weeks ago (June 1) he had a tonic-clonic seizure while I was driving. It lasted 8 minutes, and when we again arrived at the ER via ambulance he did not have a fever or any other symptoms.

He has been seeing a neurologist since he was 6 months old for concerns related to his prematurity (37 weeks), and she ordered the EEG and another MRI (he had one when he was 8 months old).

We're still waiting on the MRI and hope to be able to get that appointment moved up - someone cancel, please!

But in the meantime, my husband and I are looking for information about this diagnosis as well as the medications. Our neurologist would like to prescribe trileptal.

I guess this is the very long way of saying... help, support, links, info? Thanks so much!

Comments

Focal seizures are common.

Submitted by Anonymous on Sat, 2014-06-14 - 01:55
Focal seizures are common. Also known as simple partial, complex partial, and secondarily generalized (your son's tonic clonics). They should have some nice links in the 'learn' section, see top of page. Focal seizures start out in one area of the brain but it helps to read about generalized seizures to get the differences and how it applies to your child since his are generalizing. There are a lot of ways focal seizures might be perceived internally or show externally, depends on the location(s) seizures are occuring and how much of the brain is affected.Our child has shown spikes and slow waves in the right temporal area and has a variety of aura seizure types and longish episodes of staring with mild to major confusion and memory issues afterward (no secondary generalization so far). Our neurologist suggested trileptal (oxcarbazepine) over keppra because there were fewer associated cognitive/behavioral side effects. For our child it has been a great drug. It has really reduced the simple partials (aura seizures), don't know if it reduced the complex partials as they were infrequent before starting medication.  Think there was some low level problem because the medication restored cognition even when it didn't impact seizures we could record so we are not taking her off the drug even though it hasn't completely controlled things, we are adding another drug (and the refractory terminology is starting to be dropped into the conversation). All the drugs sounded scary to me, but after a few weeks with minimal side effects (more tired for a few days after increasing the trileptal dose) and fewer seizures, meds can seem wonderful. Since everyone responds differently, you can only try it out.  Read the full drug side effects and warnings (don't have an handy link but I like the drug information from medscape). Focal seizures can be hard to control, prognosis is linked to cause of seizures (which they can't always determine).  So you'll know more after the MRI even if they don't see anything (there are seizure imaging protocols they'll likely be using which were probably not done in his previous imaging).Hope the best for you. Let people know how it goes.

Prematurity has been linked

Submitted by mereloaded on Sun, 2014-06-15 - 22:18
Prematurity has been linked to epilepsy. Focal seizures is actually a not too bad diagnosis because he "might" grow out of it, your child is young and still developing. Focal epilepsy also can be treated with surgery, unlike others that may have generalized epilepsy whom are not candidates. To explain a little, focal epilepsy means that the abnormal electrical activity comes from a distinct small area of the brain and it affects typically only that part of it. Of course partial seizures may generalize (tcs) but with focal epilepsy, medication may not be needed for life ans in some cases it can be cured by surgery, some others out grow it because the brain itself can 'rewire" itself around the problematic area. Most people that have epilepsy have clean MRIs.Google "tripetal" and there are several websites that have complete description and side effects. best wishes

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