alcohol consumption and epilepsy / outgrowing epilepsy

Dear Doc.

I was diagnosed with epilepsy when I was 13 yrs old. (Juvenile Mayoclonic Epilepsy, or Janz Syndrome I think). I seen two different neurologists. They both diagnosed me the same, however one of them, who was a specialist in this area, said there was a chance I could outgrow this condition by my 18th or 19th birthday.  The other neurologist, said it was lifelong.  My family has always just figured it would be best to treat it like it will never cease just for practical reasons, however i wonder if maybe i have grown out of it.  I started off on Lamictil as my first medication and it was useless no matter how great the dosage.  Though I didnt have many grand mal seizures, the jerking/twitching that usually come before hand weren't suppressed at all.  Then I was put on my current drug, Depakote.  It has been fantastic.  Ive been using it for approx. 6 yrs. problem free.  I haven't had a twitch or seizure in about 7 years now and recently Ive been taking less medication than normal out of sheer forgetfullness.  When I had my bloodwork done this last time I was low on my levels and received a call saying that I need to continue taking my medicine so I'll reach those levels again even though I'm feeling as good as I ever have regardless of the medication intake or lack there of.  My questions are: 1) Can I drink alcohol? and if its just something I have to experiment with, what are the chances I could die via seizure?  2) Could I have grown out of it?  If so what would be the best way to find this out in your opinion? Thanks Doc

[Quixotic1]

You posted on a forum that does officially have doctors reading it.  I do happen to be one, but this is not my field of expertise.  You cannot depend on "outgrowing" a seizure disorder, though it does happen.  My strong advice to you is to discuss discontinuing your med with a neurologist.  It isn't uncommon to do trials off of meds as time passes without a seizure.  Did you have an abnormal EEG (brainwave tracing) in the beginning?  If so, then you should have one now to see if the abnormality is still there.  If the EEG is still abnormal it is VERY unwise to stop the Depakote.  This is fact and not my opinion.

There are two problems with alcohol, your seizure-potential and Depakote.  Alcohol is a direct poison to the brain and to the liver, especially in higher amounts. The first is this: The major concern in side effect of Depakote is sudden liver toxicity.  Usually this happens pretty early in therapy (the first few months) so you are probably in the clear, but I would be concerned about heavy or binge drinking causing sudden liver failure (needing a liver transplant - not good).

My second concern is the effect that alcohol has on the liver.  Heavy drinking (to drunkness) causes the liver to be temporarily incapable of making glucose for the brain.  Many seizures from alcohol happen the next morning or during the night when there hasn't been enough food eaten (just the alcohol) and the blood sugar drops to dangerous levels.  These seizures can cause brain damage.  Also the brain that has a tendency to have seizures will have one more easily with ANY kind of insult, such as low blood sugar or severe fatigue.

My recommendation would be for you to talk all this over with a neurologist.  Talk about the possibility of stopping the Depakote and see what his/her rec is.  If you have any - read that ANY - close family history of alcoholism, consider never drinking.  Yeah, I know that doesn't sound reasonable, but it's something you should think about.  If there is no history of susceptiblity to alcoholism, always keep your intake moderate.  Never let the people around you determine how much you drink.  Set a limit of a small number of drinks and don't exceed it.  (I sound like SUCH an adult, lol!)

Yes, there is ALWAYS the danger - usually very small - of dying from a simple grand mal seizure.  It might happen from aspiration into your lungs or from striking your head just the wrong way in falling, or from suddenly happening when you're doing something like driving or rock climbing.  It can happen.  Anyone who tells you it can't is either lying or ignorant.

The other reason for doing this carefully with a neurologist is that if you do it on your own and make the wrong choice, a seizure can yank your driver's license.

Good luck, I commend you for asking responsible questions!  Quix

[captainjack777]

Thanks for responding.  Im not 100% on this, but im prett certain the EEG wasnt abnormal, because I remember the specialist I went to didn't have a cleancut cause for my development of the disorder.  He said there didnt seem to be any obvious reason, unless it was hereditary(a few generations back) or he said maybe it was from a scar tissue I had in my brain that he detected in the cat-scan results.  But I don't remember anything mentioned about my EEG results. Again thanks