Dr. Aida Abaz Quka
Neurology
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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Patient's Query
Hi doctor, I am a-28-year old female diagnosed with systemic lupous erythematosus (SLE) six years ago. I was on medication for four years and I stopped the medication when there had been no flare-ups or any syndrome for a while. Three months back, I had a flare up for the first time in three years. The symptoms were low fever, joint pain, and headaches. One night I had a seizure due to the flare up and low blood pressure. The doctor put me back on all the medications plus Keppra. My first question is how long should I keep taking Keppra? When I checked with my neurologist, he said it is supposed to be a lifelong treatment even though the seizure only happened once. All other doctors said it was associated with the lupus flare. I know Keppra can cause side effects so I am wondering if it is really necessary to take this drug for life when I had the seizure only once and it was due to lupus. If the dosage can be reduced (or eventually eliminated), at what pace should I do that? I am currently taking 500 mg twice a day.
Hello,
Welcome to icliniq.com. I read carefully your question and would explain that this is the lowest therapeutic dose of Keppra. So the dose cannot be reduced further. Regarding the period of treatment, I would explain that it is necessary to take Keppra (Levetiracetam) at least three years after the last seizure. After this period of time, we can try to reduce the dose very gradually. If seizures reoccur, treatment should be continued with this dose for another three years and so on. We cannot predict if you will be on this medication for your entire life.
Patient's Query
Hi doctor,
Thank you for the quick reply. Three years definitely sound much better than a lifetime, if my conditions are stable. I have been experiencing hair loss because of Keppra. Is there any recommendation to counter this side effect? I am currently taking some biotin supplements. I have also gained some weight, not sure if this is from the steroid or Keppra or both. Any suggestion on that?
Hello,
Welcome back to icliniq.com. Loss of hair is a very rare adverse effect of Levetiracetam. But it could also be related to SLE (systemic lupus erythematosus). Anyway, I would recommend using a specific shampoo against hair loss and take Zinc supplements coupled with Magnesium. Regarding Levetiracetam, this is a very low daily dose, so it is really less likely to be the cause of your hair loss. The investigations to be done are EEG (electroencephalography) and brain MRI (magnetic resonance imaging).
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Neurology
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