Shadia Care

Seizure History

Complete seizure event tracking and AED regimen history

Total Events

7

Last Seizure

10 Nov 2024

Days Seizure-Free

518

10 November 2024

Night

Mild

Type

Focal onset at jaw (myoclonic)

Trigger

Possible sleep deprivation

Consequences

No hospitalization. Self-limiting.

Duration

~20 seconds

AED Regimen at Time

Triple therapy: Tegretol 200mg BID + Keppra 500mg BID + Depakine Chrono 250mg BID

Notes

Brief focal seizure. Current AED regimen maintaining reasonable control. Non-convulsive seizures with focal onset at jaw are the typical pattern.

20 June 2024

Morning

Mild

Type

Focal onset at jaw (myoclonic)

Consequences

No hospitalization. Self-limiting.

Duration

~30 seconds

AED Regimen at Time

Triple therapy: Depakine + Keppra + Tegretol

Medication Changes

Doses adjusted upward

Notes

Brief focal seizure with jaw involvement. First event on triple therapy. Doses adjusted.

15 February 2024

Morning

Severe

Type

Tonic-clonic (suspected)

Trigger

Baclofen abrupt withdrawal (cold turkey) — recommended by local junior doctor

Consequences

Lost partial sight for 2 days. Hospitalized for 1 week. Significant functional setback.

Duration

Unknown — found post-ictal

AED Regimen at Time

Depakine only (monotherapy)

Medication Changes

Keppra (Levetiracetam) ADDED + Tegretol (Carbamazepine) ADDED → escalation to triple AED therapy

Notes

CRITICAL EVENT: Patient had been seizure-free approximately 9 years (Mar 2015 – Feb 2024) on Depakine monotherapy. The Feb 2024 event was precipitated by iatrogenic baclofen withdrawal, not spontaneous epilepsy worsening. Local junior doctor advised abrupt baclofen cessation which triggered this severe event. Led to escalation from monotherapy to triple AED therapy.

15 March 2017

Night

Moderate

Type

Myoclonic

Trigger

Possible medication non-compliance

Consequences

Resolved spontaneously. No hospitalization required.

Duration

~2-3 minutes

AED Regimen at Time

Depakine monotherapy

Notes

Brief myoclonic episode at home. Patient was seizure-free for extended period before and after on Depakine monotherapy.

14 June 2016

Morning

Mild

Type

Focal (left temporal slowing on EEG)

Consequences

EEG documented left temporal focal slowing. No clinical seizure observed.

Duration

Subclinical — detected on Video EEG

AED Regimen at Time

Depakine monotherapy

Notes

Video EEG at Continental Hospital, Hyderabad showed abnormal EEG with dominant beta activity (18-22 Hz) and theta slowing (5-6 Hz) over left temporal region. No spikes or sharp waves.

13 October 2015

Unknown

Moderate

Type

Non-convulsive (myoclonic)

Trigger

Post-traumatic epilepsy (subacute phase)

Consequences

Continued AED therapy. Monitored during ICU discharge preparation.

Duration

Brief episodes

AED Regimen at Time

Depakine monotherapy

Notes

Seizure activity noted around ICU discharge. Depakine continued as monotherapy. Patient GCS improved to 10/15.

01 March 2015

Unknown

Severe

Type

Non-convulsive

Trigger

Post-traumatic (acute phase after RTA)

Consequences

Diagnosed during ICU stay. Complications: Hyponatremia (SIADH), DVT, NSTEMI.

Duration

Unknown (during coma)

AED Regimen at Time

Started on Depakine (Valproate) monotherapy

Medication Changes

Depakine initiated as first AED

Notes

First documented seizure activity during ICU/coma period. Non-convulsive seizures detected. Led to initiation of antiepileptic therapy.