I can feel when my medication is wearing off. As I've said, it's normally about 6.5+ hours after I've taken my last dosage of Keppra. Sometimes it is sooner. Sometimes the medication never quite feels like it has "kicked in".
There was no "kick in" last night.
I take my medication at 8:00 AM in the morning and by 2:30 PM I normally feel the old familiar twang of ache from my right temporal lobe. And then I play the waiting game. I am prescribed to take Keppra twice daily, every 12 hours. I NEVER make it to hour twelve without having a seizure or six. I try to hold off. I don't take my medication until at least 5:30 PM.
I suffer through the Simple Partial Seizures (SPS) that creep over me throughout the afternoon. I don't worry too much about those - it's the Complex Partial Seizures (CPS) and the Tonic Seizures that really get me going. Simple Complex - my head hurts, my stomach is flipping, I feel fear, I'm freezing - this is my normal midday reality. I'm not quite there yet today. Give it time. It's creeping in the shadows just around the corner.
I took my second dosage of Keppra (1000 mg) at 5:30 PM. I made it! Only a few hours of SPS. If the meds work I get a few hours of peaceful normalcy and my life is happy and all is well. I try to go to bed before the meds wear off again.
Head still hurting. Still freezing. No appetite. Everything is blah.
According to my notes, it was 7:30 PM when I began feeling "off", not just SPS "off" but on the verge of CPS off - as though I might check-out at any time.
I was having a conversation with my boyfriend. Wow, my right temporal lobe is feeling super stabbity. Quiet down up there! *broom handle to upstairs brain bonk*
RQ: Amgydala are you there? It's me, RQ. Hello? Why is it so dark in here? Who turned out all the lights? Where did the happiness go? I'm afraid.
Amygdala: EVERYTHING IS WRONG!! RUN!!! FIGHT OR FLIGHT! FIGHT OR FLIGHT!
RQ: I'm afraid but I will fight! FIGHT!!!!!!I am arguing with my boyfriend. My brain has absolutely convinced me that I have every right to engage in an intellectual battle to the intellectual death. It is the most important battle of all time. It is my battle and I MUST win it.
BF: Your medication is not working. No more conversation. Let it go. Lie down.
RQ: You want to take EVERYTHING away from me! I won't let it happen! I won't!
BF: No more.
RQ: I WON'T LET IT HAPPEN!two minutes pass....
RQ: It's going away.
BF: What is?
RQ: The fear. It becomes EVERYTHING. It's going away now.
BF: Good.
My muscles are contracting. My body is contorting and curling. I cannot control this.
I cannot sleep until after 1:00 AM.
The amygdala has long been implicated in the semiology of temporal lobe epilepsy. John Hughlings Jackson's (1880) earliest description of the ‘dreamy state’ published in Brain stresses the sensations of terror and anger, as well as the premonitory and epigastric sensations, olfactory hallucinations and automatic behaviours that we recognize as features of complex partial seizures arising in the temporal lobe.Scientific Commentary:
Brain first published online September 14, 2011 doi:10.1093/brain/awr246
Terrific blog! Thank you x
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