lamictal as a single med for frontal lobe epilepsy

[An__0__0]

  My 14 year old son had his first seizure when he was a week short of 2. We did not know what it was because it looked like his seyes were fluttering and he could not breathe. It was very scary. We took him to the neurologist and had an eeg. It was normal. For the next 3 years he would have a grand mal seizure every time he was sick or had a slight fever but no other time. Then when he was 6 he had a seizure which was unprovoked. He was started on tegretol but then he had a seizure every time the meds were increased. We eventually put him on dilantin 200mg and he had no seizures for over 3 years. A neurologist told us that tegretol could have worsened his seizure condition and changed his eeg. In any case his eeg for the past several years shows left front spikes in a very small area but the MRI is also normal. After the long time with no seizures we took him off all medicine and a week after he finished his last dose he has a seizure while getting his teeth fixed in the dentist chair. We then put him on a trial drug oxycarbazepine but were very unsure if this was a good thing because of all the problems he had with tegretol. Believing the Dr. and not following our hearts we proceeded with oxycarbarb and he has now had 4 seizures in the past 2 years which is exactly as we were in his earlier years. We want to take him off and put him on lamictal because we heard it had fewer side effects. CAN HE BE ON LAMICTAL ALONE? ALSO WILL HE EVER OUTGROW THIS CONDITION? Also I have always wondered if a person has firing in the front of the brain are they normal between seizures or will this always be a problem? We never know if our sons behavior is caused by meds or his own personality. He is a challenging child. We ask but never get a straight answer. Please help!
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The reason you are probably not getting " straight "answers is because
there is simply no way to answer some questions without making irresponsible
predictions without any scientific basis.
It is never possible to predict in any given case whether a person will outgrow an epileptic tendency.
Statistics are available for some types of epilepsy like childhood
absence epilepsy and benign focal epilepsy of childhood but not for most epileptic syndromes.
Certainly some children outgrow these forms of epilepsy, focal epilepsy
of the frontal lobe is not an epileptic syndrome in which this is the usual
pattern so unfortunately I feel it is unlikely he will outgrow this problem.
As regards Lamictal therapy, Lamictal is currently licensed as  an adjunctive medication only,
however there have been a number of trials which have shown it to be effective when used alone, and an FDA license may possible be approved for its used as a single drug in the near future.
it has certainly been shown tobe effective although not dramatically better than comparable drugs like tegretol, its use depends on whether your physician believes it is indicated and is prepared to prescribe it
given the licensing constraints.
As regards behavioral problems these have never been shown to correlate with inter seizure spike activity on the EEG.