Tuesday, October 21, 2014
Breakthrough Seizure: Switch to Keppra XR
My brother has idiopathic epilepsy which has been well controlled by Keppra. He used to take 1000mg of Keppra twice daily. For two years he had no seizures.
Last week, he switched to Keppra XR from the regular Keppra on the recommendation of his neurologist. However on the very same night that he switched he had a seizure. It seems highly likely to us that the switch to XR has caused the breakthrough seizure. Do you agree with this?
However my brother`s neurologist insists that since Keppra XR and Keppra regular have the same formulation, the switch to XR does not have anything to do with the breakthrough. So he has recommended an increased dosage of 1500mg of Keppra XR taken twice daily.
Right now my brother has gone back to using regular Keppra. Do you recommend switching to XR again?
Please note that I cannot recommend specific treatments in this type of forum. I do agree that it is unlikely that the switch to Keppra XR is the reason for the seizure.
There are many possible reasons for breakthrough seizures including sleep deprivation, drug or alcohol abuse or missed medications. Many times, however, such causes cannot be identified. Breakthrough seizures need to be treated aggressively because we think that uncontrolled seizures may lead to other problems such as memory impairment and possibly more frequent seizures.
David M Ficker, MD
College of Medicine
University of Cincinnati