Driving and Other Risks After One-Year Seizure Free

[veryniceguy_]

Two years after a craniotomy to remove a left parietal AVM, I suffered a GM seizure and was put on dilantin (having not had seizures ever before, but having had a hemmorhage). I've now been free of seizures for another year. Two questions:
1. Just how safe is it to return to driving? Are there any statistics on the odds of a repeat seizure after 1 year seizure free, 2 years, 5 years etc?
2. I've had no problems on dilantin, but have been worried about evidence in the literature about risks of cerebral atrophy. How common/serious is this long-term side effect, and does it warrant a look at alternative AEDs.
Thanks.

[CCF-Neuro-M.D.-JT]

1.Depends on which state you live in (different states have different driving restrictions for seizure patients) and your doctor's own clinical judgement as to the risk of seizure recurrence. In someone who is neurologically normal with no source of seizure (like tumor, scarring or AVM)and normal EEG, the risk of recurrence at 2 years is 25%.I would suspect yours is higher as you have a chronic source of cortical irritation predisposing you to seizures.
2.You probably mean cerebellar atrophy which is the lower back part of your brain that helps fine tune your movements. It's quite rare but not unheard of. Other side effects of dilantin include gum overgrowth in patients who have poor dental hygiene and folate ( vitamin) deficiency. There are other drugs to choose from in the year 2002, but dilantin is tried and true. So if you're tolerating it well, it's ok to be on it long term. If you still have doubts as to whether or not you want to stay on it, talk to your neurologist for other options such as topamax and lamictal.  But keep in mind all of these antiseizure meds do have their share of side effects. Good luck.

[puma]

I prefer Klonopin myself, to take care of my seizures. It is the only drug I can tolerate, but beware, it is addictive and a killer to try to detox from later if you need to for some reason. I take a fairly high dose 8 mg's a day. I used to be on 10 mg's but was able to knock it down to 8 and still no seizures for over one month now. After I detoxed from alcohol four years ago, an improper out-patient detox, I developed the seizure disorder. Even while sober for two years I still averaged a seizure once every week to ten days, mostly partial focal, but I have recently had total black out types as well after relapsing. I am back off the booze again though and no more seizures. I hope it stays that way.

I hope you can keep you seizures under control. Good luck.

Chatahan