Tegretol Question

[Rob__0__0]

  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:
  1) myoclonic jerks in my limbs several times per day, sometimes
  on falling asleep, but also throughout the day.
  2) I switch words around or slur words when speaking. This was particularly
  bad the first few months, but seems to be decreasing.
  3) I have difficulty reading, my eyes float around and my comprehension
  seems impaired. This also seems to be decreasing as the months go by.
  4) In the past few months I've started noticing that when I turn my eyes
  to the side, the eye looking towards my nose has a blind spot toward the
  inside next the my nose. This is the same for both eyes.
  Is Tegretol the right drug for me to be taking?  Does 600mg seem like
  the right dose?  Could it be causing the symptoms listed above?
  Particularly the myoclonic jerks and blind spots which seem to be
  sticking around for the long haul?
  Also, what should I think of the fact the my EEG has not returned to
  normal?  Is it possible that I've always had the same theta slowing?
  Back in school I was always in gifted programs. Thanks for your help.
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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.