Not for the Faint of Heart. Seizure Log November 7, 2020

 Lucas' seizures have recently made a comeback with a vengeance.  On the 7th, he had a cluster of 15 seizures in a span of two hours with vomiting three times in between.  We held his morning dose of lamictal 25 mg and are not sure if this is the cause of his cluster seizures.  Recent blood lamictal level came back at therapeutic range  but it is in the low end so we have room to increase dosing (he is at 2.7 and therapeutic range is 2.5-15).  I hate the prospect of having to give him more meds so we are going to see if getting his lamictal on schedule will help stop the cluster seizures.  

I worked a full 12 hour night shift and slept for about 4 hours and came downstairs to find Lucas starting his seizures immediately. We had declared a nursing colleague's dad dead from COVID and I was already emotionally drained.  Of course, management asked if we could stay 4 hours overtime.  The nursing staff are strained right now with COVID hospitalizations skyrocketing.  Every week I go back to work, another unit seems to have converted into the COVID unit.   I was tired, hungry, groggy and not in the mood to do more of nursing which I had been doing all night with COVID patients in the step down unit.  But there I was, an emotional mess as I tried to capture every seizure on video for the neurologist.  

After viewing the video, Lucas' neurologist said these seizures were frontal lobe seizures.  According to Lucas EEG from a few years back, it showed right frontal and left central/temporal sharp waves indicative of complex parital seizures.  He described these seizures as frontal lobe complex partials.   The frontal lobe is responsible for cognition and higher thinking. temporal lobe for memory and speech.  This explains why he is nonverbal and has cognitive delays.  But really, I think the whole brain may be affected.  

For now, we will stay put with no med increase and continue to monitor.  

One year report for Lucas Agn Date created: December 09, 2020   Start Month: January 2020 End Month: December 2020 Weight: 44 lbs. (as of November 22, 2020) Birth date: May 19, 2011 Current Medications: Banzel 10.00 mL Daily Banzel 10.00 mL Daily Lamictal 25.00 mg Daily January, 2020 Week 1 0 Week 2 0 Week 3 0 Week 4 0 Total: 0 February, 2020 Week 1 0 Week 2 0 Week 3 0 Week 4 0 Total: 0 March, 2020 Week 1 0 Week 2 0 Week 3 0 Week 4 0 Total: 0 April, 2020 Week 1 0 Week 2 0 Week 3 0 Week 4 0 Total: 0 May, 2020 Week 1 0 Week 2 0 Week 3 0 Week 4 0 Total: 0 June, 2020 Week 1 1 Week 2 3 Week 3 0 Week 4 4 Total: 8 July, 2020 Week 1 0 Week 2 0 Week 3 0 Week 4 0 Total: 0 August, 2020 Week 1 0 Week 2 0 Week 3 0 Week 4 1 Total: 1 September, 2020 Week 1 8 Week 2 7 Week 3 4 Week 4 2 Total: 21 October, 2020 Week 1 2 Week 2 7 Week 3 4 Week 4 6 Total: 19 November, 2020 Week 1 5 Week 2 5 Week 3 11 Week 4 0 Total: 21 December, 2020 Week 1 14 Week 2 1 Week 3 0 Week 4 0 Total: 15   Total events in report period = 85