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Neuro Doctor
Neuro Doctor, Neurologist (MD)
Category: Medical
Satisfied Customers: 5229
Experience:  American Board Certified Neurologist, Internal Medicine
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Ive just started taking Keppra for seizures ...the dosage

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ive just started taking Keppra for seizures ...the dosage prescribed was 1000 per day ....its making me feel zobie like and I can not see my doctor for advice until monday
JA: What medications do you take daily? Are you allergic to any medications?
Customer: fentenal patch ..neck break...chronic pain, hydrocodone for breakthrough pain as needed 10mg...some hormone replacement therapy....larazapam for anxiety....im having undcontrollable crying spells
JA: Anything else in your medical history you think the doctor should know?
Customer: allergic to sulfa

Hi, I am an American Board Certified Neurologist with vast experience in treating all neurological & health conditions and I am very glad to help you with your health concerns.

Sorry to see you are experiencing side effects from Keppra. First I will ask few questions which will help in gathering additional information related to your health concerns;

1) For how long are you on Keppra?

2) Did you start 1000 mg from day 1, or was the dose gradually increased to 1000 mg?

3) What kind of seizures you get?

4) What is causing your seizures?

5) How often you get seizures & when was your last seizure?

Hi, have you received my questions posted above? I hope you are not encountering any technical glitches to access this site properly. If you require more time it is perfectly fine. Please take your time and reply to the above posted questions when your time permits & when you can and I will get back to you with my recommendations at the earliest.

Thanks!

Customer: replied 5 months ago.
I had a head injury on vacation. I Hawaii last December...my head took the brunt force...dr. said I would be leaving against medical advice. she ordeted a ct scan ..by then I was back in alaska..she got a positive for seizures report I neever got the report...if im having seizures it will explain alot of last years behaviors

Hi, I am sorry I cannot do the phone service due to certain technical issues. If you have received any phone call request it is an automated response from the system and you may please ignore it. If you wish to continue with this current question & answer format I will be very glad to continue assisting you further. Please let me know.

How often do you get seizures recently?

How do you take your Keppra? Is it as 500 mg x 2 tablets, or 1000 mg x 1 tablet, or any other way?

Customer: replied 5 months ago.
I started kepra in November this year 1000 mg...but it made me feel unmovable too strong..I cut it in half felf some relief but I was going into rages for no reason those started before the keppra..one on the plane to kona one at walmart one in our condo...I was seriously out of control

Okay I see, have you tried any other seizure medications? or keppra is the only one tried so far?

Customer: replied 5 months ago.
Dr. C .said unspecified seizures

Okay I see.

I have posted another question too above, it is "have you tried any other seizure medications? or keppra is the only one tried so far?"

Customer: replied 5 months ago.
daily seizures...nighty wake up in fetal position feeling like I ran a marathon then did weigjt lifting all night ...my stomach seizes the hardest..n shouldets and neck

Okay I see. Have you tried any seizure medications other than Keppra so far?

Customer: replied 5 months ago.
last seizure was about an hour ago...I took a ten milligram diazapam

Okay I see, you did the right thing by taking diazepam.

Have you tried any medications other than Keppra or Diazepam for your seizures?

Customer: replied 5 months ago.
my goal is to ask dr. l in Anchorage on mondday if we can change the medication..I do not want to take tonights doseage its too dramatic
Customer: replied 5 months ago.
I have to travel alone on Monday and can't be dopey on airlines...

Yes, I am also going to make the same recommendation, to change the medication. My answer is ready, I will post it here very soon.

Yes, I agree with your concerns, I will post my answer here very soon.

Okay I am ready; I am posting my answer here;

Since keppra is producing you side effects and also you are having other manifestations like rage attacks too so it is better if you switch keppra to another seizure medication which does not cause sedation or zombie side effect like keppra and also it can help you with your rage attacks too

This seizure medication is called as Lamictal (Lamotrigine)

It can help with seizures, it is tolerated better than keppra without much sedation/drowsiness or zombie effects, and it can help in controlling the rage problem too

So you may ask your doctor to switch Keppra to Lamictal which will help you in many different ways compared to keppra you have been using now – as discussed above.

Please let me know if you have any further questions. And please click a positive rating (preferably 5 Star/Excellent) to credit for the time & effort put by me in answering your health question, and this is the only way I will be credited for my service to you. If you have follow-up or additional questions you can ask them after the rating too.

Best Regards!

Neuro Doctor

Hi, like I mentioned above earlier since keppra is causing problems you need to change your seizure medication and lamictal can be a good choice for you since it can help you in multiple ways as discussed above.

Since you are not tolerating keppra even after reducing the dose so there is no point in continuing with this medication now, so you may stop it now, in the meantime if you get seizures you can use some diazepam intermittently, and when you see your dr on Monday you may ask them to prescribe lamictal for you in place of keppra and as I have mentioned above it has many advantages over keppra so it can be the right choice for you. There are many more choices too, and lamictal is one among them.

Hi, please do not forget to click a positive rating for my services to you. If you have follow-up or additional questions you can ask them after the rating too and I will be very glad to continue helping you as long as you need my services.

Best Regards!

Customer: replied 4 months ago.
I am trying to determine if I am actually having seizures or was I misdiagnosed....I have been having serious concentration issues, speaking issues, vision issues .....this is all so confusing because I live in a village we have limited access for medical issues...I see a pain management Dr. once a month in the nearest city.....I am really confused about my recent diagnosis for seizures...since returning to Alaska from our two months vacation where my doctor there looked at my history and my current behaviors and came to her conclusion that because of a positive ct scan for seizures and my behavior changes that I needed to start anti-seizure medications. Can a ct scan show positive for seizures?...so at my last appointment with my pm Dr. L. he saw what Dr. C changed in medication and is questioning the new diagnosis...Dr. L. asked if I was having seizures and I answered no I've been having issues but never had a GM seizure...now Dr. L wants me to undergo procedures that will be time and financial burdens how do I know if I should get these costly tests done or not...Virginia
Customer: replied 4 months ago.
I am taking time today to look at your responses ....I did not get immediate response...that you for your suggestion to switch medications....
Customer: replied 4 months ago.
I do have new insurance for 2017 so with approval I can have these procedures done....there will be financial responsibilities not paid by my insurance ie...travel...food ...I don't know if I should have the seizure tests done or was I misdiagnosed...
Customer: replied 4 months ago.
I currently did not answer all the prior questions because I just now found them on my emails..we were having a text conversation then I saw the emails as the text version failed...so I have new questions above....I actually quit taking the anti-seizure medication.

Hi, you have asked a question whether you are actually having seizures or were you misdiagnosed, could you describe your episodes in more detail? You have mentioned here you are having serious concentration issues, speaking issues, vision issues etc, is it possible to describe these symptoms in more detail? for example are these symptoms intermittent in nature or constant? do you feel confused or disoriented? did others notice you are having these issues or is it just you have noticed? and any other details related to these manifestations. This will help me in deciding these are really seizures or not.

Please describe the events in more detail and I will follow up with you with my analysis asap.

Best Regards!

Customer: replied 4 months ago.
What I notice most is any time there is change ....my brain doesn't want to follow or understand the change ....it could be a c.c. number it could be the trip to Kona...etc....any change ...then I go into a rage like a fit ...my heart races I feel trapped anxious...I feel like I am no longer in control...it can last up to an hour...it takes a couple hours to recover ....I usually go lay down in a quit place with my 6lb Polmerianian....I notice lately I don't care who sees me raging...it doesn't matter at the time ...by then I'm out of control....during the rages anything can happen...I tried to make arrangements to see the doctor my monthly visit to Dr. L. in Anchorage ...I made several mistakes trying to make the reservation etc...It feels like I'm starting to have one now...its because my brain doesn't want to think to finish this..it is also exhaustion....when I talk I repeat the same words ...like saying ::::I cant...cant do this ....I have double vision during the episodes....it feels like if it gets worse I could absolutely not know where I am etc....that scares me because I travel alone to Anchorage once a month..
Customer: replied 4 months ago.
Last year in Kona Hawaii...2015..I fell ...my left leg gave out ..didn't support me ...I fell hitting my head hard..I got help to get to my hotel....that is the only head trauma I remember...
Customer: replied 4 months ago.
When I am on the spot to answer a question sometimes I cant answer the question unless I am left alone to figure out how to answer the question....very scary as I was a multitasker for years .....running two business. ...now all of a sudden I cant make a flight reservation or answer a question....Dr. C. in Kona noticed this she would tell me information regarding my treatment for pain and HRT and ask me to repeat what I'm suppose to do and I would look at her blank...she then called my husband into the room for a conference and he said yes she is doing that more and more...
Customer: replied 4 months ago.
It took me this long to figure out that you responded to my question via email ....I got the bill on my cc so I started searching why I was getting charged
Customer: replied 4 months ago.
I take hydrocodone 5 mg two times a day for spine injury ...had three neck surgeries ...I broke my neck in 2003...I have DDD...and OA....there...I use a 25mg fentynal sp? patch every three days change it...other than vitamin mineral therapy ...that is it...
Customer: replied 4 months ago.
I was invited to NY dinner at my sisters...I got so angry ...I didn't want to go ...but they were waiting I went into a rage ....like I'm afraid to leave the house...I went into a rage with her on the phone ...I had to apologize later....same sister that joined us to help get me home from Kona....the rages escalated in Kona....we invited my sister to join us and help me for two weeks...and get me home....I quit functioning because I was afraid of what I might do...

Hi, thanks for all these additional information.

I have carefully analysed all the information you have provided above. It is correct what the most recent dr you saw told you. You need further testing to clarify whether you are really having seizures or not. Your symptoms can be produced by seizures, or your symptoms can also be produced by other brain conditions without any seizures too. So you need further investigations and this is the only way to tell what are these episodes - are these seizures or not seizures. I am not sure what your doctor has ordered, but you need an EEG which is the study of the brain waves. A cat scan of the brain is not sufficient to tell whether you are having seizures or not so you need an EEG. This is routine eeg if you never had one. If routine eeg does not help then you need prolonged monitoring eeg like Ambulatory eeg or Video eeg etc and the eeg can help in finding out whether you are indeed having seizures or not. Another test I may also recommend is a brain PET scan or brain SPECT scan which is a special brain scan which also can help us in finding out the cause for these episodes. But you may start with the eeg first and if eeg does not help them you can go for the PET or SPECT scan, so step by step approach this way you are not spending money unnecessarily, rather spending money prudently. Once investigations help us in ascertaining the cause for your manifestations then we can start you on the appropriate treatments so that we can help you in stopping these manifestations occurring in the future.

Please do not lose hopes, I will try my best to help you and I will try to resolve your health issues, and you may start with the investigations now (first the EEG - which will tell us whether you are indeed having seizures or not).

Please let me know if you have any further questions. And please click a positive rating (preferably 5 Star/Excellent) to credit for the time & effort put by me in answering your health question, and this is the only way I will be credited for my service to you. If you have follow-up or additional questions you can ask them after the rating too.

Best Regards!

Neuro Doctor

Customer: replied 4 months ago.
I am very impressed thank you ..you have given me several things to work with...one you give me hope ...two your concerned enough to give me useful tools..I hope I am allowed to print this page as a recommendation only...I see Dr. L on Monday Jan. 16th ...I know he sent a request for further evaluation..he mentioned a test they use needles connected to the head ...?? that's all I remember today ....sounds terrible I cannot remember but when your being told there may be underlying issues it is very life changing ...dealing with chronic pain is difficult as it is..however if this leads to further diagnosis or eliminates ...I am on the right track...no I have never had any brain scans...when I know exactly which test Dr. L has ordered then I can do more research...Thank you I hope to follow up with you as information becomes available...sometimes at my appointment with Dr. L I am too overwhelmed to ask the questions I need to and then its another month before seeing him....again TY

You are very welcome! I am very glad to be of help! Thanks for the compliments too! Appreciate it!

Please try to get the earlier mentioned investigations as soon as possible and the report of these tests will help us in choosing the most appropriate treatments that can help you to resolve your health conditions.

Please follow up with me when you have more information and also if you have further questions.

All the very best with your tests!

Best Regards!

Yes you can certainly print this page if you wish so.

Hi, please do not forget to click a positive rating for my services to you. If you have follow-up or additional questions you can ask them after the rating too and I will be very glad to continue helping you as long as you need my services.

Best Regards!

Customer: replied 4 months ago.
I rated your service...if you do not see it make a note for me...sometimes lately I will read something and it will take several minutes for me to understand it...

Hi, thanks for informing me this.

At my side I am unable to see the rating. May be it is some technical glitch it seems. I will appreciate if you could retry it and if still it does not appear then you may please contact the company and let them know and they can help you with completing the rating process. Please tell them what rating you want to give and they can enter it for you. Or alternatively you may write down here what rating you want to give and I can contact the company and show it to them.

Best Regards!

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