Q. My brain tests came normal. Do I still need treatment for epilepsy?

Answered by Dr. Aida Quka and medically reviewed by Dr. Divya Banu M

 

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Hi doctor,

Is it normal to be treated for epilepsy without an epilepsy diagnosis and all brain tests came back clear?

I had three generalised seizures, each of which lasted around a minute in the beginning of this year and none since. CT, MRI and EEG all came back clear. I have recently been diagnosed as B12 deficient and read that this can cause seizures and believe this may have been what caused mine. My aunt also had seizures all in the same day 20 years ago, all tests came back clear. They said it must have been viral. She refused to take medication when leaving hospital as they had told her it was viral, and never had a seizure since. She was then also diagnosed as B12 deficient. My neurologist still expects me to take epilepsy tablets. I am told that epilepsy is the working diagnosis.

I never had any health problems in my life until I had these seizures. I took myself off the medication over two months ago due to side effects including that they were making me forgetful, not just forgetting to do something but my mind would be totally blank which really freaked me out as it is not like me at all. My memory is always 100 %. Since coming off them I feel so much better, and my only symptoms at the minute are from B12 deficiency and I am being treated for that with injections. I am 38 years old and female.


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Dr. Aida Quka
FACULTY OF MEDICINE, UNIVERSITY OF TIRANA., NEUROLOGY POST GRADUATION DEGREE, UNIVERSITY HOSPITAL CENTER
Neurology

Hello,

Welcome to icliniq.com.

I read carefully your question and would explain that a normal EEG does not exclude seizures. Anyways, there are many other causes that may trigger seizures even in healthy persons like insomnia, alcohol or drugs, thyroid gland dysfunction, electrolytes imbalances, anemia, head trauma, etc.

Epilepsy is a disease which leads to repeated seizures in the absence of the above triggering factors or other medical disorders. Coming to this point, as you have stopped medication and you are feeling great, I would recommend just wait and see if you will have any seizures while free of AED. If this happens, I would recommend starting another AED like Levetiracetam in low dose.

In the meantime, I would recommend following a regular sleep hygiene, eating a balanced diet, avoiding caffeine, alcohol or smoking. I would also recommend avoiding driving in the next months as we can not predict if seizures will reoccur or not.

 
 
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