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@jakedduck1

@dap
You made a statement I’d like to briefly address.
“I know any reduction in dose is also a possible trigger for a breakthrough seizure.” Although I generally agree with your premise that statement is not always true. I’ve known some people who lowered their medication and either reduced and one mans seizures stopped.
Cognitive, mood, gait and balance problems are side effects of his medications. I have known countless people who discontinued Keppra due to mood issues, most often women. I’ve been on Anticonvulsants for 52 years, when I walk down the sidewalk I sway from the street to people’s lawns. I also fall occasionally. You mentioned he’s having “Ability to function” issues. Are you talking about his Functional abilities like activities of daily living? For instance,
Walking, Talking, Eating, Dressing, Bathing, Drinking or more cognitive problems like Memory, speech, vision, making decisions, solving problems. I assume he’s having Tonic Clonic Seizures. If not could you describe them.
Take care,
Jake

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Replies to "@dap You made a statement I’d like to briefly address. “I know any reduction in dose..."

Hello, and thanks for responding. His first seizure, at 5 months after his stroke, was a really bad grand mal. Each seizure had an aura where he sees red overlay over his vision. The second and third seizures were him just fading out after the aura- no convulsions, but his head and eyes got torqued to the left and his pupils were extremely to the left as well. He has had Todd’s paralysis after the last three seizures. He becomes unconscious for a couple days in the post-ictal stage. It takes weeks to have him come close to baseline. Each time he seems to have more and more setbacks with gait, ADLs, and aphasia, (which he always has had since the stroke). The ability to function is in some ways global- like not being able to remember how to fasten his watch band, remembering where things are in the house, putting on his clothes backward, and not being able to construct logical thought processes. He has not been able to read for pleasure since the stroke and of course, cannot drive. The mood swings are really awful. He is kind of flat most of the time but occasionally gets really angry and feels like breaking things or expresses desire to jump out of the car if we go over a bridge. This is so unlike him, ever, and has only been happening for the last month. (The most recent seizure started on 8/27.)

I just heard back from the neurologist about an hour ago, via the portal. She wants him to continue increasing his Lamictal from the 25 bid to 150 bid. She said he probably won’t need to be on all three medications forever, and maybe the Vimpat can be dropped, and that after we get the new neurologist (we have no appointment with the local one, who is an epilepsy specialist) until December 6. We live in a rural area with no neurologist at the local hospital. I don’t know if this can go on like this until then. He is on the waiting list for a cancellation. I think one option would be to drive to a nearby city where he was inpatient twice and go to the emergency room. It seems like any adjustment may take time? He is extremely averse to hospitals in general- probably because of the aphasia, which so many providers just don’t understand, and think he has dementia instead.

After reading more of the postings on the Mayo site, it is sobering to see how many people face so many hurdles to being seizure free. Any help is appreciated and I respect the experiences you have been through in your own life, and the breadth of your knowledge.