u/IgorBessaa

Hi everyone!

So, I have a sleep related epilepsy. My seizures strictly happen right in that transition phase when I'm falling asleep (drifting off from being awake to sleeping).

I know that medical literature usually says sodium channel blockers are the "gold standard" for sleep related epilepsy, and honestly, my brain agrees. I achieved 100% seizure freedom with with Lamotrigine in the past, and currently, I am also 100% seizure-free on Lacosamide (Vimpat).

But here's the catch: both of them gave me absolutely unfixable insomnia. I'm talking about the kind of insomnia that doesn't respond to anything, no sleep meds, no perfect sleep hygiene, nothing works. It's really taking a toll on my quality of life.

Because of this, I'm seriously considering talking to my neuro about switching to the SV2A class of meds, either Levetiracetam (Keppra) or Brivaracetam (Briviact). My reasoning is that even if they do cause some sleep issues, insomnia from Keppra/Briviact seems way more "fixable" and actually responds to sleep aids and good sleep hygiene, unlike the hardwired insomnia from sodium blockers.

But here is my dilemma and my biggest fear: I've been trying to find success stories, and it feels hard to find people with exclusively nocturnal/sleep related seizures who are 100% completely controlled just by Keppra or Briviact alone. I'm scared that my 100% seizure freedom is only happening because I'm on the "perfect mechanism" (sodium blockers), and not just because my brain responds well to meds in general.

Just a quick note: I'm really looking for cases of true monotherapy (only Keppra or only Briviact). I know a lot of people take benzos for sleep, but since benzos are also anticonvulsant drugs, it makes it hard to know if the Keppra/Briviact is actually doing 100% of the work.

So I'd love to know: is there anyone here who only has nocturnal seizures and is 100% seizure-free taking ONLY Keppra or Briviact (without any other AEDs or benzos)? Can this class of meds completely shut down sleep seizures on its own?

Any experiences or advice would be hugely appreciated! Thank you!