Symptom? Side effect?

[Mandy34621]

I have been on Lamictal 200 mg BID for several years for partial complex seizures due to a skull fracture at age 2.  It has been more successful at seizure control than any other drug I've tried.  I do have a question, though.  I've begun to have random myoclonic jerks in my fingers/wrists/other muscles, etc. both at rest and with intentional movement (while typing this, etc).  They are usually small and not really noticeable by others and they do not "feel" like seizures (I've certainly had enough to tell the difference!), but I am wondering if these are likely some new seizure symptom or if they might be a Lamictal side effect.  

[Godofredo MD]

Hi.

How old are you now? When did the new symptoms start to appear? When did you start taking lamotrigine (Lamictal)?

It would be difficult to say whether the myoclonic jerks are a new seizure symptom or they are side effects of lamotrigine. However, if you have been taking the drug for a long time now, with no change in dosage, and you only recently began to develop these symptoms, it is less likely that the myoclonic jerks are caused by the drug.

Another possibility for the myoclonic jerks could be physiologic tremors which could have been exacerbated by stress or anxiety, or even just fatigue. Have you recently experienced any psychologic stress?

You can opt to observe these symptoms for the moment and see if it worsens. If you are bothered and concerned about it, you could consult your doctor to check whether there is anything serious that may be causing it.

Hope this helps.

[Mandy34621]

I am 53 and have been taking Lamictal for about 4 years.  I have been aware of these sudden jerks for about 6 months.  You are right, they do seem worse with stress and fatigue, though they are there most of the time.  Having them certainly increases my anxiety over their possible cause and may compound the problem.  I am waiting for the results of my first MRI and EEG in years from a new Neurologist I've only seen once (mine of 20 years retired last summer) and that is certainly a big anxiety.  In fact, at that visit I could not suppress them though I tried as hard as I could, not knowing the man and what he would say about them.  I don't know if any of your patients have felt this way, but I felt I had to try to hide them so he would not think my seizures were not as well controlled as I had said.  However, now that I've met him I guess I could bring this up and see what he thinks.
Oh, I have one other question, if you have the time.  I am really worried about that EEG.  If it is negative, does it mean the seizures are gone?  If it is positive, does it mean the seizures are not controlled at all?  Can it predict seizures, whether it is positive or negative, or is it simply a picture of how things are at that moment?  Waiting to find out ...now, that's anxiety for you!  Thanks for your time.