I would definitely push against switching to the Keppra. Even if the Keppra does work... that doesn't mean you have epilepsy! As you said, it could be a one-off. Risking another seizure and the risk of a one-off being read as epilepsy are both things that need to be taken into consideration. Also, the fact that the lacosamide is doing double duty is important -- you don't want to switch to a medication that will, overall, increase your med load.
I don't know much about PNES, but the name would indicate... a rather large amount of psychological pain kinda short-circuiting your brain and causing a seizure. And that feels very much like the dismissive "it's all in your head" bullshit that you get with a lot of doctors when faced with patients with chronic illness. I would ask for more information about their opinions of PNES before allowing that to be given as a diagnosis.
I get that, in the case of seizures, it's important to know the cause of things. But, otoh, this is the first time you've had a seizure, right? You've been told it could possibly be a one-off. Yes, monitoring the situation does risk another seizure. But, if I were in your shoes, forcing me to commit to a diagnosis that requires heavy duty life-long meds before knowing if this is something that will happen again would make me very hesitant. If you have another seizure, you'll know that it's something that you need a legit, set-in-stone diagnosis for. But, since we have no idea whether this is a one-off or not, prescribing lacosamide for its mood stabilizing functionality seems like it's the safest bet. Lacosamide would limit the chance of having more seizures if you have epilepsy, while not being as strong as Keppra. If you get a breakthrough seizure, you know that you have epilepsy and need stronger medications.
It seems like the doctors you're dealing with are running towards the fear of you having epilepsy without any actual evidence that you do have epilepsy. One seizure does not equal epilepsy! And overmedicating someone is just as dangerous as undermedicating them.
no subject
I would definitely push against switching to the Keppra. Even if the Keppra does work... that doesn't mean you have epilepsy! As you said, it could be a one-off. Risking another seizure and the risk of a one-off being read as epilepsy are both things that need to be taken into consideration. Also, the fact that the lacosamide is doing double duty is important -- you don't want to switch to a medication that will, overall, increase your med load.
I don't know much about PNES, but the name would indicate... a rather large amount of psychological pain kinda short-circuiting your brain and causing a seizure. And that feels very much like the dismissive "it's all in your head" bullshit that you get with a lot of doctors when faced with patients with chronic illness. I would ask for more information about their opinions of PNES before allowing that to be given as a diagnosis.
I get that, in the case of seizures, it's important to know the cause of things. But, otoh, this is the first time you've had a seizure, right? You've been told it could possibly be a one-off. Yes, monitoring the situation does risk another seizure. But, if I were in your shoes, forcing me to commit to a diagnosis that requires heavy duty life-long meds before knowing if this is something that will happen again would make me very hesitant. If you have another seizure, you'll know that it's something that you need a legit, set-in-stone diagnosis for. But, since we have no idea whether this is a one-off or not, prescribing lacosamide for its mood stabilizing functionality seems like it's the safest bet. Lacosamide would limit the chance of having more seizures if you have epilepsy, while not being as strong as Keppra. If you get a breakthrough seizure, you know that you have epilepsy and need stronger medications.
It seems like the doctors you're dealing with are running towards the fear of you having epilepsy without any actual evidence that you do have epilepsy. One seizure does not equal epilepsy! And overmedicating someone is just as dangerous as undermedicating them.