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Seizure Problem
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Seizure Problem

I had my first grand mal seizure a few months ago.

A couple of days ago, I had a a second grand mal seizure.

The first lasted around 4-5 minutes and the second lasted for around 2-3 minutes.

I had an EEG, CT Scan, blood work, and a holter monitor for the heart, and all of my results came back normal.

My neurological exam was also normal.

I had the aforementioned tests 1-2 days after my first grand mal episode.

I had several aura episodes, and I had many panic/anxiety attacks.

I am almost 20 years old, and I live in Canada.

What do you recommend I do at this stage?

Do I need anymore investigations, or should I be treated for epilepsy?
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If these were true generalized or grand mal seizures (often accompanied by tongue biting, bowel or bladder incontinence, witnessed shaking/stiffness, period of drowsiness and confusion afterwards), then you definitely should be treated. Further workup should include an MRI of the brain (may be a long wait in Canada) and an EEG with hyperventilation and photic stimulation at the very least. Depakote (causes weight gain),Dilantin (gum, liver problems) Lamictal (rare severe rash), and Topamax (kidney stones)are meds that can possibly help depending on what kind of seizure you have.

At this age, we would think of a condition called juvenile myoclonic epilepsy which  is a syndrome composed of grand mal, absence (brief sparing spells), and myoclonic (jerks especially in the morning on waking) seizures. Usually presents at about 16 years old (+/- a few years) as kids start to stay up more and experiment with alcohol, both of which provoke seizures. Can be brought out with flashing light stimulation during an EEG. Not difficult to manage but requires lifelong treatment. If you don;t have any of the other types of seizures I mentioned, then you could just have grand mal seizures. But I still recommend treatment. Good luck.
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