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Epilepsy

Husband and son with seizure disorders

07/07/2009

Question:

My husband began having seizures in may 2003, my then 3yr son had his first seizure in Jan of 2004. We later found out a neighbor had new onset seizure in Feb (i think) of 2003. My sons started with drop attacks then went to convulsions. My husbands are atypical. Both husband and sons are pretty well maintained with Lamictal. Both have had normal eegs until this year my now 8 year old son had abdnormal right hemisphere bursts during sleep. My son was taken off the lamictal in 2005 and did well until this year. He is now back on it. My husband was diagnosed with lupus 2 yrs ago. My son now has a low positive ana. I want to know of studies relating to environmental causes of seizures, possible drug induced autoimmune disease, anything that can rule out causes. We have lived in the same home through out all of this, we are moving in a couple of weeks. Genetics, environment, infectious disease? I work in Microbiology and my coworkers can not make any connections. Pediatrician has mentioned PANDAS. Any suggestions on where to take them to for help. There is much more but this covers the basic history.

Answer:

This is a complex problem without a clear answer. However, I believe it is unlikely that there is a common autoimmune disorder underlying the familial seizures. Seizures associated with autoimmune disease usually have clear underlying autoimmune findings on laboratory evaluation. There are likely some genetic factors here, but the genetics of almost all epilepsy syndromes are so poorly understood at this time, that no treatment would be directed based on genetic testing. The only feasible infectious cause I can think of is if both father and son had mild encephalitis that later caused seizures, but this would be a long shot. Lamotrigine is very unlikely to cause drug induced autoimmune disease, but blood tests are the best to evaluate that.

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Response by:

Michael   Privitera, MD Michael Privitera, MD
Professor of Neurology
College of Medicine
University of Cincinnati