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Epilepsy

Anxiety and seizures

09/05/2008

Question:

Two years ago I had a Grand Mal seizure and was diagnosed with a brain tumor on my right temporal lobe. I had no prior warnings or history of seizures in my life. After the Grand Mal I was put on Keppra immediately at a dose of 500mg 2x/day. Currently I take 2000mg 2x/day with Trileptal. I have also tried Lamictal, Dilantin, Depakote and Tegretol in conjunction with the Keppra, but all produced severes allergic reactions. In the past I have taken 3000mg of Keppra a day but suffered from severe axiety and hallucinations. I was prescribed Xanax for the Anxiety and hallucinations and remarkably the seizures decreased, infact almost stopped. I average atleast one partial seizure a day. Is there a link between stress and/or anxiety and seizures? At the time of my Grand Mal I was severely depressed due to a failing marriage. I only have seizures at times of high stress or worry, but my doctor doesn`t seem to beleive this even after several EEG tests which produced no results due to sitting in bed all day in a relaxed state. Is it not possible that I have had the tumor all my life (32 years)and it would not have ever been found except for one seizure due to stress that prompted a MRI and CT scan of my brain?

Answer:

Stress is a known potential trigger for many patients with epilepsy. However, it is never safe to assume that stress was the only reason for a breakthrough seizure. I suspect that you would have had a seizure at some point in time (regardless of stress level) because of the brain tumor. I also think you are at continued risk for more seizures if seizure medication is ever stopped.

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Response by:

David M Ficker, MD David M Ficker, MD
Associate Professor
College of Medicine
University of Cincinnati