changing seizure severity

[M]

I started topamax for partial complex seizures on sept. 1. I started slowly and have built up to 50 mg since then.

This past sat. I had a seizure that started as a normal one for me . i was sitting at a chair and then had my usual aura but then  my legs stiffened and i guess i sort of bounced off the chair and my husband was able to catch me and lay me on the floor. (this was in the kitchen) and put a towel under my head.
the three people that witnessed it, my husband and two of my children, have slightly differing stories although they agree my face turned red and i stiffened out. it seemed as though i was having difficulty breathing and was gasping at times. it lasted only a few minutes. i did not lose urine.

this is the only time that I awoke and did not know why or how i had gotten where I was.  The back of my head hurt terribly.  My daughter says I hit it but my husband claims I did not, so I don't know. I have never lost memeory or consciousness with seizures.  Do you believe this could be the medication or just the changing nature of the condition, or both? I should mention that since '93 I have gone frome absence seizures to this type.

Thank you for your time and consideration,
M

[CCF Neuro[P] MD, RPS]

Dear M:

Sorry to hear about your epilepsy.  Topramax is a very good medication and broad spectrum antiseizure medication.  We start it very slow to avoid side effects and wean it up to therapeutic doses (those doses that stop seizure activity).  There are several things to consider, one is that your likely not at therapeutic levels yet.  You likely had a break through seizure.  Whether this is a new seizure type or worsening of your seizure activity can't be known (or at least I can't tell).  One needs to wait on proper dosing of the medication.  The fact that you had your usual aura let me know that the general progression of seizure activity was likely the same orginally and the low medication level probably allowed the motor expression of your seizure to break through.  I would hang in there with the topramax until proper dosing is reached.

Sounds as if you have temporal lobe epilepsy?  If so, the general feeling is that these type of seizures are often difficult to control and these can worsen over time.  I hope you have the well controlled type if you do have temporal lobe epilepsy.

Sincerely,

CCF Neuro MD

[barbara to pain and lortab]

I was just diagnosed with Temporal Lobe Epilepsy and I have similar type seizures to what you describe only I have never completely lost consciousness either. I heard partial complex can worsen and eventually go generalized in which case the entire brain is affected and you black out and lose memory of the event or at least most of it.

I am on Neurontin and Klonopin. The Klonopin is excellent for the anxiety and stopping the violent shaking. The Neurontin has been mostly effective at stopping the seizures altogether but lately I have developed break through seizures upon physical exertion over a period of time. My Neurologist may raise or even double my current dosage after a few more tests are run. I currently take 1200 mg of Neurontin a day. He raised it from 300 mg three times a day to four times a day last week. I still had break through seizures this past weekend when I was really physically active in the hot sun for several hours.

The only side effects from the meds are slight sleepiness which I don't mind. I take two Ultram every four hours as well for chronic pain and I've heard pain meds lower the seizure threshhold and may aggravate breakthrough seizures. I may try to go back to only Advil or Motrin but the Ultram is for mood elevation as well as pain control.

Good luck with your condition I know what you are going though.

Email me if you would like to talk more about it.

email- ***@****