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Thank you all for your input! It’s so helpful to get so many different perspectives. We did end up imaging this patient’s brain and there was no edema around lesions. Our neurology team thinks that his dizziness and imbalance may be related to the increased dose of keppra. He is a bit better this week so hopefully he is adjusting to the meds. If his symptoms persist, we will plan to change his anti-seizure medications.