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Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
Question Title: Tegretol QuestionForum: Neurology Forum
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Can you please tell me if Tegretol is causing these symptoms and if Tegretol is the best drug for my condition? My situation is I had my first and only convulsive seizure 4 months ago in my sleep. I am a 26 yr old male. An EEG the day of the seizure and another EEG 3 months after the seizure showed some slowing (theta sharp waves) in both hemispheres, more on left than right. An MRI ruled out tumor. I am taking Tegretol, total of 600mg/day. I am experiencing: Is Tegretol the right drug for me to be taking? Does 600mg seem like
I will take the last three questions first, the side effects that you mention with speech, vision and comprehension are typical in someone who is starting Tegretol therapy, they typically fade away after the first few months of therapy, the fact that this seems to be happening in your case would support the supposition that these problems are in fact due to the drug. The dose is within the range typically used to treat seizures, at the low end if anything. As regards the blind spot, since you are more aware of your vision it sounds like you have discovered the physiological blind spot which we all have due to a defect in the retina at the back of the eye where the optic nerve enters the eyeball. The myoclonic jerks concern me, the are not part of the syndrome of focal epilepsy which is most commonly treated with Tegretol. Your EEg findings are not specific for focal epilepsy either, although I am reluctant to make a call without seeing the EEG personally. Myoclonic jerks are more commonly seen in conjunction with grand mal seizures as part of the generalized epilepsy syndrome which is more appropriately treated with drugs like Depakote and Dilantin. If these jerks persist I would suggest that you seek a second opinion and review the type of seizure disorder and the appropriate therapy. Slowing on an EEG does not necessarily correlate with learning difficulty or low IQ so it is not surprizing that you were academically gifted, you quite possibly have had this slowing of the EEg all your life. EEG changes do not necessarily go away with treatment , the medication merely prevents epileptic activity from progressing to full blown seizures, so the EEG is not expected to normalize.
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