Dr. Robert M. Miska, M.D.

There really are no guaranteed-safe antiseizure medicines, nor indeed any guaranteed-safe pharmaceutical medications of any kind during pregnancy (other than prenatal vitamins, which aren't really medications per se), but it's accurate to say that both levetiracetam (Keppra) and lamotrigine (Lamictal) are fortunately not known to be associated with any particular risks to fetal health during pregnancy, which is of course not quite the same thing as saying that those RX are known to be completely safe.


(This is in contrast to certain other anti-seizure Rx which do have known and defined safety risks during pregnancy, though you're not taking those, and in any case the risk is most important for most Rx of any kind during the first three months of pregnancy, when the baby is going through his earliest development.)


You should understand that the risk to the baby from uncontrolled seizures is higher than any risk from your Rx, so you should definitely not stop taking your Keppra or Lamictal. You should take prenatal vitamins, especially folate, if you do become pregnant.


Your primary care physician or obstetrician-gynecologist can advise you about these things in greater detail, but you should not fear to become pregnant while on the medications you mentioned.

Generally no, since most vertigo has to do with problems in the "balance organs" in the temporal bones (above and behind your cheek bones, but down deep), and the problems there are typically microscopic in nature. MRI won't show that type of detail. Sometimes (much less often), vertigo is caused by a brain, brainstem or 8th cranial nerve problem, though, and MRI usually will show problems in those areas, if evidence of such things as tumors or Multiple Sclerosis are present.

It's always difficult to reliably predict someone else's experience of discomfort. That said, I would describe the nerve conduction (NC) test as merely trivially annoying or minimally uncomfortable, not painful. It involves delivery of brief small-current shocks to peripheral nerves in order to elicit and record both motor and sensory responses. Most instruments used for NC studies can deliver a maximum current (DC) of 0.1 Ampere, which is quite small, yet would feel like a fairly good "jolt" when delivered to an individual nerve. Almost all shocks used in testing are considerably smaller than this, however. Some patients find that it helps to take a dose of 400-800mg of ibuprofen before the test. Having performed thousands of these tests, I've found that almost all patients tolerate them quite easily.

Dementia is a label for a type and degree of cognitive dysfunction, the operational definition of which requires:

1.) cognitive decline or loss in 2 or more spheres of cognitive function (e.g., memory, judgement, calculation, language, spatial orientation; not memory alone);

2.) that said cognitive decline is stable or progressive over a period of 6 months or more;

3.) that the cognitive decline is of sufficient degree as to interfere with social or occupational function.

Dementia of Alzheimer type is merely the commonest of the dementias. There are other types, such as Frontotemporal Dementia, Subcortical Dementia, and Vascular Dementia, as well as mixtures.
(FWIW, we cannot actually speak entirely accurately of Alzheimer's Disease without having a tissue diagnosis, via biopsy or necropsy, showing senile plaques and neurofibrillary tangles. It is more precise to speak of Dementia of Alzheimer type, otherwise, when a patient's dementing illness shows the features commonly identified with Alzheimer's Disease during life.)