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Are Trileptal and Keppra the recommended drug for febrile seizures in a 12-year-old boy?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At December 25, 2019
Reviewed AtSeptember 28, 2023

Patient's Query

Hello doctor,

I have a question about my soon to be 12-year-old son. Since he was 1 year old he has had febrile seizures about once a year. They only happen at night. When he is sick during the day I would give him Motrin or Tylenol. Through out the night and he would not have any symptoms. When he did not show signs of being sick that night his fever would spike. Two years ago we had his first video electroencephalography (EEG) and there were no abnormalities or no concerns. We did magnetic resonance imaging (MRI), blood tests, and electrocardiogram (EKG) all are normal. He had two seizures this year both while being sick. So the neurologist wanted another EEG. So we did a video EEG. The first night nothing looked wrong so she wanted to keep him another night. During the day he was getting sick he was running a little fever. So that night they choose not to give him Motrin to see if he would have a seizure and he did. It lasted a minute and was a full-body one. They looked over the tape and said there was no evidence of one coming on it came so quickly. They believe (but are not sure) that it came from the frontal lobe. They put him on Keppra for two weeks and then the doctor looked it over with her partners and they decide that Trileptal and Keppra would be what he needs. I happen to total disagree. He has never had a seizure during the day or one without a fever. I feel they so quickly diagnosed him with epilepsy without considering that all his tests are normal. That seizure they saw came on because we didn't give him medicine for his fever. Which to me seems like he has the rare case of febrile seizures lasting till the age of 12 years. He did not have any seizures last year but just two seizures this year. I personally want to try and build his immune system to stop him from getting sick to see if that will prevent his seizures. His father disagrees with me and agrees with the doctor. I believe the side effects of both these medicine out way the actual problem. I am just overwhelmed and stressed. Because I do not know what is the right thing to do? Can febrile seizures last to the age of 12? Is it rare for someone to have a seizure maybe once a year then not have any, then have one the next year? Does the medicine he is on sound too extreme? Please advise.

Hi,

Welcome to icliniq.com. I understand your concern. I would say that both you and your doctor are correct. Your doctor diagnosed epilepsy because: 1. Primary epilepsy is more common in those adolescents who had febrile seizures. 2. Along with the fact, the EEG (electroencephalogram) was supportive of epilepsy, because, the febrile seizure would not start in a single region and spread over. Your concern is also justified because: 1. The child is a very classic case of febrile seizures. 2. The night when the child had a seizure, the child had a fever and the anti-pyretic was not given. I think what would have happened is, doctors would have thought that at 12 years it could not be a febrile seizure, along with that they found probable origin in the frontal lobe, so they prescribed AEDs (anti-epileptic drugs). Have patience, as of now continue the medicines. But three months down the line repeat an EEG when he does not have any fever (after taking off the medicines in a controlled environment, if we can do sleep-deprived EEG, would be better) if he has an epilepsy syndrome, the EEG would still be abnormal. This should be able to settle the whole issue.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Hardik Nareshbhai Rajyaguru
Dr. Hardik Nareshbhai Rajyaguru

Neurology

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