Epilepsy: Managing Symptoms and Seeking Solutions - Neurology

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Questions about epilepsy?


Hello, Doctor.
I was diagnosed with abnormal brain wave activity due to sleepwalking and other factors when I was five years old, and I started medication until middle school.
I discontinued the medication in middle school as my symptoms improved.
However, during my first year of high school, I fainted at school and experienced convulsions and foaming at the mouth.
The school nurse recommended that I go to the hospital for an examination.
After undergoing an EEG and MRI, the doctor diagnosed me with absence seizures and prescribed Depakote, Topamax, and Lamictal (the latter was prescribed because I had ongoing issues with dreaming and difficulty sleeping).
After a period of consistent medication, I began to experience persistent headaches that seemed to worsen over time.
Initially, the doctor prescribed a pain reliever, but it was ineffective and my pain intensified (I maintain a normal routine and do not have significant stress).
During my next follow-up, I mentioned this to the doctor, who looked puzzled at the MRI report and said that my previous examination was normal a year ago, so it was unlikely for something unusual to suddenly appear.
He then prescribed stronger pain relievers (Neurontin and Klonopin) for me to try.
While they sometimes help alleviate the pain, there are times when the pain becomes unbearable (lasting 5-10 minutes, sometimes longer).
I have gradually become reluctant to discuss this with my doctor because the responses seem to be the same.
I would like to know if there are other ways to address my headaches.
I regularly practice running (marathons) and often feel dizzy, with my body shaking involuntarily.
However, since these symptoms occur frequently and I read online that some types of epilepsy can present with similar symptoms, I have refrained from mentioning them to anyone.
Should I discuss these symptoms with my doctor? I apologize for the trouble, and I appreciate your help with these two questions.
Thank you.

Lingmeng~, 10~19 year old female. Ask Date: 2020/06/25

Dr. Cai Zongzhang reply Neurology


Hello, based on your description, it seems to be symptoms of epilepsy.
There may be an adjustment period during the medication process, so I recommend that you continue to communicate with your physician.

Reply Date: 2020/06/25

More Info


Understanding epilepsy and its management can be quite complex, especially when symptoms vary widely among individuals. Based on your description, it seems you have been diagnosed with absence seizures (失神性癲癇) and have experienced a range of symptoms, including headaches, dizziness, and involuntary movements. Let's break down your concerns and explore potential solutions.


Understanding Your Condition
Epilepsy is a neurological disorder characterized by recurrent seizures, which are sudden bursts of electrical activity in the brain. These seizures can manifest in various forms, including absence seizures, which may cause brief lapses in awareness. Your history of abnormal brain wave activity and the subsequent diagnosis of absence seizures indicate that your brain may be prone to these electrical discharges.


Headaches and Pain Management
You mentioned experiencing persistent headaches that have worsened over time. It's important to differentiate between headaches that may be related to your epilepsy and those that are primary headaches, such as migraines or tension-type headaches. The medications you are on, such as Depakote (帝拔癲) and Keppra (克他服寧), can sometimes contribute to headaches as a side effect.
1. Medication Review: It’s crucial to have an open dialogue with your neurologist about your headaches. If you feel that your current medications are not effective or are causing side effects, ask about alternatives. Sometimes, adjusting the dosage or switching to a different medication can alleviate headaches.

2. Pain Management Strategies: In addition to medication, consider non-pharmacological approaches to manage headaches:
- Lifestyle Modifications: Ensure you maintain a regular sleep schedule, stay hydrated, and manage stress through relaxation techniques such as yoga or meditation.

- Physical Activity: Since you are already running, continue with regular exercise, as it can help reduce the frequency and severity of headaches for some individuals.

- Dietary Considerations: Keep a headache diary to identify any potential dietary triggers. Certain foods or drinks, such as caffeine or processed foods, may exacerbate headaches.


Dizziness and Involuntary Movements
Dizziness and involuntary movements can be concerning, especially when they occur frequently. These symptoms may be related to your epilepsy or could be indicative of other underlying issues.

1. Communicate with Your Doctor: It’s essential to report these symptoms to your neurologist. They may want to conduct further evaluations, such as additional EEGs or imaging studies, to rule out other conditions that could be contributing to your symptoms.

2. Monitoring Symptoms: Keep a detailed log of when these symptoms occur, their duration, and any potential triggers. This information can be invaluable for your healthcare provider in determining the best course of action.


Seeking Solutions
1. Regular Follow-ups: Ensure you have regular follow-ups with your neurologist. Consistent communication about your symptoms and treatment efficacy is key to managing epilepsy effectively.

2. Consider a Second Opinion: If you feel your concerns are not being addressed adequately, seeking a second opinion from another neurologist or epilepsy specialist may provide new insights or treatment options.

3. Support Systems: Engage with support groups for individuals with epilepsy. Sharing experiences with others who understand your challenges can provide emotional support and practical advice.

4. Education and Awareness: Educate yourself about epilepsy and its management. Understanding your condition can empower you to advocate for your health and make informed decisions regarding your treatment.


Conclusion
Managing epilepsy and its associated symptoms, such as headaches and dizziness, requires a comprehensive approach that includes medication management, lifestyle modifications, and open communication with healthcare providers. Don’t hesitate to express your concerns and seek the support you need. Your health and well-being are paramount, and with the right strategies in place, you can work towards a better quality of life.

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