Q. Is PET scan necessary for epilepsy diagnosis?
Hi doctor, My four year old son, weighing 16 kg is taking medicine for benign childhood epilepsy. Medicines he is taking are namely Topamac 100 mg a day in two divided doses and Lobazam 15 mg a day (5-0-10).  His MRI for epilepsy protocol is normal without abnormalities. I would like to know whether he is taking overdosed medication. Does anti-epileptic drug cause lot of side effect? Doctor suggested PET scan. Is PET scan required for epilepsy diagnosis? Please suggest.
Hello. For benign childhood epilepsy (BCE) your child is on 6.25 mg/kg/day of tablet Topiramate (anticonvulsant) which is a medium dose and is fine. Side effect to look from Topamac is dehydration. For dehydration, he needs to drink at least 700-1000 mL water daily. He can get tingling in finger which usually responds to taking high potassium diet like banana or raisin. Occasional side effects are kidney stones and word finding difficulty. All anti-epileptic medication comes with some side effects and one has to choose between them and benefit one can have with control of seizures. PET scan is performed in epilepsy patients for surgical evaluation in refractory cases. Is your child still having seizures after taking these two medicines? Also, has he been tried on other medicines before?