Re: reducing anticonvulsant medication after brain surgery

Posted By CCF NSG MD /gsh on August 07, 1998 at 10:32:18:

In Reply to: reducing anticonvulsant medication after brain surgery posted by Lindsey on August 06, 1998 at 16:59:00:






Hi! I had brain surgery for seizures at CCF in 1990 and it was successful. I have not had any full blown seizures for over 8 yrs. but, sometimes experience auras (about 4 times a yr.)  I was taking tegretolxr 400 mg twice daily.  I recently went to my local neurologist to see if I could possibly begin to reduce my medication again. I have reduced it twice since my surgery. I am ultimately wanting to come completely off of it.  He did an EEG awake and asleep and I failed to fall asleep however, the EEG was normal and he would only reduce my med. by 200 mgs. He put me on a new drug, Carbatrol, and I am now on 600 mg total daily.  I am going back in 6 mo. for another EEG and possibly reduce my med. again. He says he can have me off of the medication completely by years end ( I sure hope so!).  My question is this: If the brain was cut on and stopped the full blown seizures I experienced, wouldn't the auras I have also be stopped ( or atleast be non productive and not lead into a full blown seizure) since the pathway for the seizure was cut during surgery?  Will I have auras if I eventually come off of the medicine? My neurologist seems to think that I can come off of my med. completely. I believe in my mind that I can as well.  What do you think? Thank you in advance for responding.
Lindsey
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Dear Lindsey,
The ultimate goal of epilepsy surgery is to render you completely seizure-free
and off seizure medications.  We routinely continue seizure medications after
surgery for a variable period of time, after which the medicine may be weaned.  
It is important to wean the medication because seizures may recur if the
medication is abrubtly stopped.  Each patient is different in regard to
their tolerance to weaning the seizure medications.  Clearly one would like to
see their patients without seizures and off medication, but this isn't always
possible.  You'll have to see how it goes, but trying to stop the medicine
is the right thing to do if your seizures don't recur.
Good luck with weaning the seizure medicine!