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Why breakthrough seizures several months after increasing dose?
aprilofvt posted:
My husband has a left temporal lobe mass (benign) that has been watched for about 20 years using regular MRI's. The mass became apparent when his first seizure occurred 20 years ago. The seizures are pretty well controlled and present in this manner:

A sudden pause in what he is doing, usually during something tedious like folding laundry (and in his sleep), he begins smacking his lips like he is sucking on his own mouth, staring off, and moving his right thumb in circles or rubbing his thumb and fingers together. He sometimes responds during these episodes, which do not last very long, but doesn't remember anything after.

He is currently taking Lamictal, which has controlled his episodes pretty well even at low doses. The problem is, each time he has breakthrough episodes, they increase his dose a bit and it works for several months only to breakthrough again, increase the dose, repeat.

I am wondering--why? What is going on in the head that his body "gets used to" the medicine and the episodes come back.

Currently they are very brief and very few. Tonight it occurred as he was putting a trash bag in the container. I heard the plastic rustling and his mouth going. I walked about to him, put my arm around him and asked if he was okay. He said yes, that he felt weird though. He came around quickly but behaved oddly--which is the usual way it goes.

I'd like to understand it. I plan on calling his dr., who will likely raise the dose and we will do this again in a few months...

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