Well, we are officially in Keppra Hell.

I spoke with Leigh (Dr.P's nurse) yesterday due to a very rough weekend. Saturday evening Ri had a Tonic Clonic, the first in a while that was not due to a fever or being sick. Sunday morning another shorter one, Sunday night 2 of them, one nearly 5 minutes long from the time I first swiped the VNS and ended only after giving her diastat. Monday afternoon she had one of her regular ones in the van on the way to therapy, then another at the dinner table. Thankfully the VNS stopped those as they both were pretty intense complex partials and could have become ugly quickly. (kudos to the VNS for doing something) Leigh relayed that Dr. Parrott still wants her to continue to decrease the Topamax, when she told me that I admitted to her that I was only reducing by 25mg a week, not 50 and that she had JUST gotten down to 275mg , this week she would be down to 250mg. She said Dr. Parrott wants her on only 200mg a day and when we get to that point to stop decreasing it. He increased her Keppra by 1/2 a pill at night, which puts her on 675mg a day.

I hate coming down so much on Topamax it has been the ONLY seizure drug that controlled her big seizures. I am not sure I am going to have the guts to take another Topamax away tomorrow evening.

The Keppra is contributing to her attitude as well which is very Unpleasent Not as bad as last time thankfully. Maybe we will make it through and it will level off a bit.

We finally have her appointment for the Neuropsych testing. November 13th we take her back to Charlotte to see Dr.Ewert, then on the 27th Robert and I will go alone to see him and get her results. I really hope that this testing gives us some idea about how to better meet her educational and developmental needs instead of tossing me into a pit of despair. I know no matter how much I tell myself that the numbers don't mean anything, she is still Riley just as before we saw them, it still stings.

~back to the keppra

How much is a "typical" dose? I am trying to see where Dr. P is headed with it. I do hope it will help, but at what dose should we expect to see some results? Where is 250mg in the am, and 375mg in the evening on the typical dose scale?