Hi kcurf,
Welcome to neuro talk! I've had absence, complex partial, and tonic clonic (grand mal) sz. for 37 yrs. I've had 2 brain surgeries to help reduce my sz. If you are tired all the time the tegretol may be at a toxic level and you should get your drug level checked. If I were in your place I would start taking keppra to control the sz. it's done a great job for me. It sounds like you have both audio and possibly visual sz. that's where sounds and certain colors can trigger sz. for you. My best advice to you is go to an Epilepsy Center and see an Epileptologist (Dr. specializing in epilepsy) I've had a lot more success with them than any neuro over the yrs. The Dr. should do a special e.e.g. on you where they will flash one color strobe light one at a time by doing this they can find what colors are triggering your sz. They will do the same thing with sounds. I found that florescent green, amber, and bright white like the sun shining on the snow are the 3 colors that triggered sz. for me. Try taking vitamin B12 1000 mcg. once a day it can be a big help and stay away from cell phones and nutra sweet they can trigger sz. also.
Here's wisihing you well and May God Bless You!

Sue