First Neuro Appointment after Surgery

DECEMBER 2, 2010

1)    Ryan weighed 22 lbs. 13.5 oz.   His temperature was 101.6 and he was obviously not feeling well.
2)    Dr. Joseph said the latest EEG was normal.
3)    She said whenever you manipulate the brain, as in Ryan’s surgery, there is a chance of a seizure.  When a seizure is due to surgery, it is called a provoked seizure. Ryan has been on Keppra since he had a seizure while in the hospital in September.  At that time Dr. Joseph said Ryan would be on Keppra for 6 months post surgery.  Dr. Joseph reiterated today that Keppra does not cure seizures.  She said that seizures happen in the gray matter of the brain.  The surface cells of the brain contain the gray matter, so seizures come from the surface of the brain.
4)    Dr. Joseph said she has to evaluate the risk of seizures in the future.  If Ryan is prone to seizures, he will stay on Keppra.  She will await the results from Genetics to see if a possible genetic disorder will make him more prone to seizures.  She will also await the results of an MRI scheduled for December 22nd and, in fact, she will also order an MRI of his spinal cord, to be done that same day.   It was agreed that Ryan will stay on the Keppra until all the test results are in.
5)    Thus, Dr. Joseph gave Robin a prescription for Keppra.  She also ordered a blood level for Keppra that could be done locally and results sent to her.  Robin will call her when the MRI is completed.  Schedule a follow up appointment with Dr. Joseph in 6 months.    So when Dr. Joseph gets the results of the MRI, the blood level of the Keppra, and the results from Genetics, she will then make a decision about staying on Keppra.  But until then, Ryan will stay on the Keppra. 


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