What is causing three seizures in a day after delivery?

Question

Hello doctor,

I am a 24-year-old female. I am looking for some help. I feel no doctor understands what is wrong with me. I have had epilepsy since around puberty around the age of 12 when I got my period. I had a lot of seizures until I was finally controlled on Tegratol 200 mg. Throughout my teenage years, they decreased. When I married and got pregnant, my doctor lowered my dose to one pill 200 mg only at night. This was because I had no seizures for at least six months. Then I had no seizures for five years.

Now I am 24, suddenly I had three seizures in one day. I was taken to the hospital and given a Magnesium injection. This was two months after giving birth and not getting periods back due to breastfeeding. I made myself sick fearing to eat anything or stress myself as I never knew what triggered it. I visited a neurologist, he said my dose is too low. He said to take 200 mg at night and 300 mg at night because I mainly get seizures when I am awake.

Anyways through all of this, I get symptoms of seizures throughout the afternoon and night and when I wake up. So I get a lot of auras but no seizures. I have had this problem since I have had epilepsy. How would I get rid of these auras? My doctor seems to be confused and says it is just anxiety but I know what I am feeling. And it is the same feeling before my seizures (electric shock feeling in my right thumb). He wanted to put me on Xanax. Do I need this much medication? When I used to have seizures I would have only one in a day but after having three in one day, I got worried. I have had multiple ECG and MRI and they never found anything. Please, if you can help me. I am sick of living life in fear. What would you advise me to do?

Answer 1

Hello,

Welcome to icliniq.com.

I read carefully your question and would explain that the aura that you explain (electric shock feeling in the thumb) are not typical of epilepsy. So, considering the fact that you have been on 200 mg of Tegretol (which is a really non-effective dose) with no seizures, I do not think that these auras are related to the seizures. Besides all your repeated EEG are normal (which would not result in case of frequent seizures).

They seem to be just anxiety, especially after giving birth (depression and anxiety are quite common after giving birth). For this reason, I agree with your doctor on the recommendation of trying Alprazolam. It is fine to increase the Tegretol dose to 600 mg daily. It can help against anxiety too. I would also recommend checking Tegretol (Carbamazepine) plasma levels in order to make the proper adjustments to the dose based on its plasma levels. If Alprazolam helps, I would recommend adding low dose Sertraline or Fluvoxamine to your therapy.