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My son has right frontal lobe dysplasia. Diagnosed at 16months. For 4 years hes been on keppra, until he started having breakthroughs. Which we've never seen before, focal aware seizures. I wanted to switch to briviact anyway, so we did, and it worked for a good month. A higher dose only made his behavior crazy. So they added lacosamide and weaning briviact. he was still having breakthroughs and more of them a day, so they stopped the wean of briviact. Still having them, especially at night or… read more

September 6
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A MyEpilepsyTeam Member

Many of us who have had experience with seizure medicine know there's NO easy solution, and wish we could hand a 1,2,3 guide on what to do for your son. I'm not cold hearted, because I love your boy more than you'll ever know, but here's the facts. Each brain along with how any particular seizure or seizures is extremely individual and in order for you and your medical team to find what's best for your son isn't necessarily going to simple or ever a solution once the seizures are under control for x amount of time, because for many of us this is a lifetime of continuous challenges and changes. I'm not about to tell you all 54 years, but I been on and off about every Anticonvulsant medicine ever made and many that aren't FDA approved over the years, along with two brain surgery and still have seizures on two seizures meds.
Love your boy and know he's done nothing to deserve these seizures.

Much kindness and love

September 7
A MyEpilepsyTeam Member

It’s more up to the Dr. the Dr. knows what meds best helps your son for his kinds of seizures.
Overall it’s not easy finding the right meds for many of us. .

We all react differently to meds. What may not work for your son may work wonderfully for someone else

Then there are people like myself. I’ve been on many different seizure meds throughout my life. Non of them worked 100% . I have Refractory Epilepsy ( I’m resistant to the meds ).
Today my seizure are still not 100% control. But my DBS ( deep brain stimulator ) has helped reduce my seizures .

September 6
MyEpilepsyTeam

What a journey you and your son have been on — navigating all of this with a young child takes incredible strength and persistence. These are really important questions to bring to his neurologist, but here's some helpful context.

Lacosamide and oxcarbazepine are both sodium channel blockers. Some people who don't respond Show Full Answer

What a journey you and your son have been on — navigating all of this with a young child takes incredible strength and persistence. These are really important questions to bring to his neurologist, but here's some helpful context.

Lacosamide and oxcarbazepine are both sodium channel blockers. Some people who don't respond well to one sodium channel blocker may also find others in that same class less effective. This is worth raising directly with his neurologist before agreeing to oxcarbazepine. Onfi (clobazam) works differently — it enhances a calming brain chemical called GABA rather than blocking sodium channels, so it's a different class entirely. It's used for focal seizures and has shown effectiveness for drug-resistant epilepsy. That may make it a more logical next step given lacosamide hasn't helped.

Other medications that work through different mechanisms and are used for focal seizures include:

- Topiramate (Topamax) — works through multiple pathways
- Zonisamide (Zonegran)
- Levetiracetam/Briviact — your son has already tried both of these
- Valproate — broad spectrum, though has specific considerations for some patients A MyEpilepsyTeam member shared advice about pushing for genetic testing, as it can help pair a patient with the most effective medication and avoid ones that could make seizures worse. This is especially relevant for focal epilepsy linked to cortical dysplasia.

It's also worth asking his neurologist about the ketogenic diet as an add-on option. Research has shown it can meaningfully reduce seizures in drug-resistant epilepsy, even improving brain activity patterns on EEG. Given his history with right frontal lobe dysplasia and drug-resistant focal seizures, a referral to a pediatric epilepsy specialist or epilepsy surgery center — if not already done — could also open up additional options worth exploring with his care team.

September 6

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