Keppra and Increased Seizures
((((((Hugs to All))))))
A dear friend of ours called this morning to ask my advice regarding her son, B, who is in his late 30's and has developmental disabilities. He and Michael were classmates, bus-mates, and best buds.
B has had a seizure disorder for most of his life. He is taking Keppra, which he began a year or two ago. He is on no other meds.
B started having cluster seizures last weekend, out of the blue, for no apparent reason. Every 5 - 10 minutes or so, he is seizing for 30-45 seconds. B's mom took B to see his neuro, but B stopped seizing (naturally) while they were at the appointment. The neuro offered her no help. As soon as she got B back in the van, the seizures returned.
She ended up taking B to the ER. B was given an Ativan injection, which put B to sleep. But when he woke up, he was still seizing. The on-call neuro was contacted, and he told her to increase B's Keppra from 250 mg every 12 hours to 500 mg every 12 hours. Doubling the dose.
B's mom took B home, increased his Keppra as instructed, but the seizures haven't stopped.
When B is upright, he seizes less than when he is laying down or prone.
The constant seizing has prevented B from being able to eat or drink, so he is dehydrated and under nourished. At the ER, B was given IV fluids and catheterized, but he produced very little urine, and he only got 5 hours worth of IV fluids.
Blood work up in the ER was essentially normal, no evidence of infection. But they did not test for his Keppra level!
B's mom had a call into B's neuro and intended to keep calling until he responded to her.
I think B is and has been in status for days now. The response of the neuro and the ER baffles me. I think B needs to be admitted and thoroughly assessed to determine what is causing these sudden seizures, so they can be stopped. It may mean a different seizure med. He needs to be observed.
One of the more serious side effects listed for Keppra is increased or different seizures. B is experiencing both of these things. So, could the Keppra be the culprit?
My suggestions were: get a Keppra blood level and test his thyroid; get an EEG and a CAT scan (to rule out tumor/cyst/bleed), get him on IV fluids, monitor his urine output. He needs to be hooked up to a monitor to follow his vitals.
If you have any experience with Keppra, or with a seizure med causing an increase/change in seizures, or any other insight to provide, please share it with me so I can help B and his mom. She is on her last legs, just exhausted, stressed, and frightened for her precious son.
Thank you so much ~
Love & Light,
Rose
(PS ~ Posting this in the Child Neurology forum also)
A dear friend of ours called this morning to ask my advice regarding her son, B, who is in his late 30's and has developmental disabilities. He and Michael were classmates, bus-mates, and best buds.
B has had a seizure disorder for most of his life. He is taking Keppra, which he began a year or two ago. He is on no other meds.
B started having cluster seizures last weekend, out of the blue, for no apparent reason. Every 5 - 10 minutes or so, he is seizing for 30-45 seconds. B's mom took B to see his neuro, but B stopped seizing (naturally) while they were at the appointment. The neuro offered her no help. As soon as she got B back in the van, the seizures returned.
She ended up taking B to the ER. B was given an Ativan injection, which put B to sleep. But when he woke up, he was still seizing. The on-call neuro was contacted, and he told her to increase B's Keppra from 250 mg every 12 hours to 500 mg every 12 hours. Doubling the dose.
B's mom took B home, increased his Keppra as instructed, but the seizures haven't stopped.
When B is upright, he seizes less than when he is laying down or prone.
The constant seizing has prevented B from being able to eat or drink, so he is dehydrated and under nourished. At the ER, B was given IV fluids and catheterized, but he produced very little urine, and he only got 5 hours worth of IV fluids.
Blood work up in the ER was essentially normal, no evidence of infection. But they did not test for his Keppra level!
B's mom had a call into B's neuro and intended to keep calling until he responded to her.
I think B is and has been in status for days now. The response of the neuro and the ER baffles me. I think B needs to be admitted and thoroughly assessed to determine what is causing these sudden seizures, so they can be stopped. It may mean a different seizure med. He needs to be observed.
One of the more serious side effects listed for Keppra is increased or different seizures. B is experiencing both of these things. So, could the Keppra be the culprit?
My suggestions were: get a Keppra blood level and test his thyroid; get an EEG and a CAT scan (to rule out tumor/cyst/bleed), get him on IV fluids, monitor his urine output. He needs to be hooked up to a monitor to follow his vitals.
If you have any experience with Keppra, or with a seizure med causing an increase/change in seizures, or any other insight to provide, please share it with me so I can help B and his mom. She is on her last legs, just exhausted, stressed, and frightened for her precious son.
Thank you so much ~
Love & Light,
Rose
(PS ~ Posting this in the Child Neurology forum also)
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