[epilepsy] Re: Maximum Keppra Dosage

 

Bruce,

Every time yet that Jonathon has complained about the "funny" feeling, he's had other symptoms that he was close to having a seizure: difficulty paying attention and focusing, short-tempered, emotional, headaches, problems sleeping. All but one of his seizures have occurred when we try to wake him in the morning, so he is unaware of any type of an aura indicating the start of a seizure. I don't think he's able to determine the start of an aura until he feels off-balance, and by then the feeling seems to be through his whole head. That's the kind of aura I get with a migraine, so I can kind of understand what he's talking about.

Every time I've called his neurologist to explain Jonathon's complaints/symptoms, they've decided to increase his meds to see if it helps. Within 3-4 days of the increase, he says that feeling is gone, and he's good to go for several months more. Typically he's in the middle of a large growth spurt when he starts having problems. The "funny" feeling occurs at different times during the day, so I don't think it's related to the timing of his meds. However, since his seizures have been (almost) completely nocturnal, if the increase is 1/2 a pill, it will be added to his nighttime dose.

We will hopefully get a neurology appointment next month, unless something changes that we need to get Jonathon in sooner. Our neuro is about 2 hours away, and comes to our area once a month to see patients up here, so if we can wait, we will.

As for the therapeutic range of Keppra, I'm assuming that it's because of his age that the neuro doesn't think his blood needs to be tested. As you said, meds usually go through a child's body quickly. We have a pediatric neuro, and he says none of his patients have regular blood tests if they're taking only Keppra. I will however ask again and show him the article.

I will be sure to talk with the neuro about spreading out the dosages, but I'm a little concerned with Jonathon having to take the meds at school. We are in a small parochial school with no school nurse, and Jonathon's teacher doesn't seem to understand how serious Jonathon's medical conditions are, and he doesn't typically think about whether any behavior issues may be signs of a seizure (such as licking/smacking his lips or appearing to be in a "daze") or low blood sugar (such as slurred speech/glazed eyes), so I'm not sure how successful we'd be if Jonathon had to take meds every day at school. It's worth considering and doing a trial run, if the neuro thinks it might help.

I really appreciate the suggestions! As parents, we're sometimes too close to the situation to find alternatives. And, with Jonathon in particular, it's very difficult to determine if any issues are related to his diabetes or the epilepsy.

Thank you!

Dawn

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