Department of Neurology

Medically resistant epilepsy in India

Q: Hello! My son is 7 years old & suffering from partial epilepsy for the last 18 months. He suffers seizures in the form of blank expression with faster heartbeats. His seizures are cyclic in nature & erupt approximately every 15 days . During the day he gets them multiple times. Currently he is on Tegretol (carbamazepine) 200 mgms 3 times daily. There is no improvement except for lower intensity of seizure.His treatment was changed to Epilex (valproic acid) 900 mgms & Tegretol 800 mgms in two doses daily but that side effects & he lost appetite so he was brought back to only Tegretol. His EEG & MRI was found normal. His current blood report for tegretol level is 7.3. I would like to know what furthur treatment is possible & whether such partial seizures if not treated can lead to long term damage.

A: Your son's problems are typical of what we see in a comprehensive epilepsy clinic. There is no single approach to persons with drug resistant epilepsy. Some of the strategies that epileptologists use are: 1) go with a high dose single drug therapy and increase the dose until either seizures are controlled or side effects occur; 2) add on a different seizure medication -- there are many different new medications in the U.S. and Europe; 3) evaluate for epilepsy surgery.

Uncontolled seizures are believed to cause brain injury over the long run (see previous postings on this Web site). While I do not know if the latter two options are available in India, I understand there are several epilepsy specialists there. It would be worthwhile for you to check these programs out.

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