Seizures - Uncontrolled

[robert0826]

Me- 42 year old male.

January 08, Had Tonic-Clonic @ work, went to ER, cat scan and ekg done, both clear.

Family Doctor sent me to Neurologist, Placed me on Keppra 1000 mg daily (2 X 500) April 08, began having Partial Seizures? (Left arm and hand would at time shake uncontrollably) Neuro raised dosage of Keppra to 1500 mg daily (2 X 750). Last week, another Tonic-Clonic, Neuro raised dosage of Keppra to 2000 mg daily (2 X 1000). Last night another Tonic-Clonic, waiting to hear back from Neuro.

Neurologist sent me for eeg on first appointment, was normal. He also sent me to Cardiologist, no problem. I can't have an MRI, as I have pellets in my head neck and around my eyes from shotgun wound as a child.

I have not seen Neurologist since March 08, he just keeps upping dosage by phone?

As a child I had Menningitis with Febrile seizures (104.. Could this or the gunshot wound be problems now?

Also, I am kinda concerned about Neuro not having me come in, but just upiing dosages via phone. Should I find another Neuro/ Epileptologist?

Currently taking 2000 mg Keppra (2 X 100) daily, and Zoloft 50 mg daily (for side effects of Keppra, irratibility, aggresion, etc....)

Any advice and/or comments are appreciated.

[MG (Admin)]

Was the CT of the brain done with iv contrast?

In this sort of situation it is very important to get a good picture of the brain with MRI. This means considering the possibility of surgically removing the metal (after checking by X-ray that it is actually metal which is a problem with an MRI...it is not always) to be able to do the MRI.

What are the results of the EEG....was a focus found?

[robert0826]

I was just told the the EEG was normal, as for the CAT scan, i dont know if there was an IV contrast or not.

If my Neuro ever calls me back, maybe I can get more info.

Thanks for your help.

P.S. - As for the pellets, they do show up on x-rays, I dont know if they are metal or lead. Shooting was in 1976.

Robert

[Dr_prakesh]

Well if they injected you with something during the CT then it almost certainly was with contrast.

As for the MRI...a good radiologist experienced in MRI should be able to look at the X-ray and decide whether the pellets are a problem. If they are near the skin surface then it may be easy to remove them to perform an MRI...in my opinion an MRI is important in your case.

Also I would repeat the EEG including possibly a sleep deprived and sleep study to localize the focus.

Keep us updated!