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Hello. Thanks for the question.
I think part of the issue here is the timing of the meds. Keppra is a medication that has to be given every 8 hours. If you're off more than 30-40 minutes, you won't get good control. If you're giving it every 12 hours, it's really not going to be effective. If you're unable to give a medication every 8 hours, then you can't use Keppra. In that case, you should use Zonisamide. Zonisamide can be given every 12 hours and be effective.
I would also make sure you have Phenobarb blood levels run. If they are < 20, then the dose should be increased before adding a second line drug. If we're in the mid 20's or up around 30, then we add Zonisamide at twice daily or Keppra at 3 times daily. You may want to consult with a neurologist to get this better controlled.
I wouldn't worry about the other organs. Just monitor blood levels every 6 months to make sure they are ok. The more important issue is getting the seizure numbers down to < 6-8 per year.
I hope this helps, let me know if you have any other questions.