Department of Neurology

Re-emergence of epilepsy

Q: My daughter is 24 and has recently started having absences after a period where she was off medication. She has been back on medication for 6 months but the absences have increased, there appears to be some memory loss and a recent EEG was normal. Her doctor is at a loss and as she lives in the country she is coming to the city to see an epilepsy specialist but that is still a month away and things seem to be getting worse. Could there be some other reason for the absences and is there some other tests she should have ??

-Cathy - Australia.

A: If her spells are not controlled, she definitely needs to see a physician with expertise in epilepsy. Common reasons for non-response to medications in this situation are: 1) the spells are a different type of seizure than originally thought; 2) the medication is not matched for the seizure type; 3) the amount of medication is insufficient; 4) the spells are not due to epllepsy; and finally, 5) some persons may develop a true resistance to medications.

It is important that she see a specialist who has the expertise to sort out her spells, verify the spells are seizures, and match her to the most appropriate medicine(s). Although some further testing may be needed, usually involving EEG studies, the key point is that tests alone will not give you a solution; clinical expertise in epilepsy is needed to sort out the problems and arrive at a therapeutic plan.

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