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Re: epilepsy?! (long, some ranting) » Elizabeth

Posted by medlib on March 31, 2001, at 17:36:43

In reply to epilepsy?! (long, some ranting), posted by Elizabeth on March 30, 2001, at 6:20:36

Elizabeth--

What a truly horrific nightmare! Missing a good part of it sounds like a real blessing. I have a vague memory (but, lately, *all* my memories are vague) of an earlier Babbler with your handle who was a TRD with a specialized knowledge base, but I can't remember exactly what kind--chem, bio, ? Are you she?

The description of your "episodes" sounds like an autonomic system freak-out, er, overactivity--which would be consistent with a SPECT scan showing hyperactivation of deep brain structures. My son has had epilepsy for over 20 years without ever having an abnormal EEG or MRI. For some, the brain's abnormal electrical propagation (that causes a seizure) never reaches the surface and is not associated with a structural lesion or defect. In those cases, the only way *any* difference can be detected is with a process-type scan like a PET (the best--especially the new hi-res ones, but very expensive and still in limited locations) or a SPECT. The latter can be done in an exercise mode, useful because that can be a seizure trigger for some.

Your 2nd episode, if termed a seizure, would be labeled a "partial, simple." How's that for misnomer-of-the-month? Do you happen to remember any unusual sensory experiences during it (like weird smells, sounds louder, softer or different, vision blurred, etc.)? Did you have any warning, any premonition or vague feeling of uneasiness before it began? I realize that terror is a terrific memory eraser, tho.

What's puzzling is that adult-onset epilepsy seldom just appears out-of-the-blue. It usually has a discernible trigger--post-MVA or other head trauma, neuro damage from alcoholism or other substance abuse, *something*. (A one-time seizure can be caused by a drug reaction or very high fever, but that isn't termed "epilepsy.") Your symptoms also could be consistent with severe Seratonin Syndrome or MAOI-induced toxic shock, as well; but, I can't see you knowingly coming in contact with an MAOI no-no, and your meds aren't seratonin-mediated. Very strange!

Re Monday: I'd almost be willing to bet that they'll be unable to elicit prodromal symptoms with their flashing lights, repetitive noises, etc. (if, in fact, they bother with those tests anymore). Have you ever taken an anti-convulsant med for depression? I think that the therapeutic blood level for seizure control is higher than for depression relief (esp. since the AC is most often an adjunctive med)--but I'm not sure. I don't know of an AC that isn't sedating at therapeutic levels--they're all CNS depressants--but, Depakote is less so than some, I believe. If they put you on an AC, they might have to DC your current meds. Parnate, being a CNS activator, could interfere with the desired effect of some ACs and is contraindicated with others (Tegretol). Don't know about bupe (might it have an additive, if not potentiating effect with ACs?).

What a hassle--as if having plain old TRD weren't more than enough! Glad you survived your hospital experience (that's much more difficult than it used to be). Hope you find an atypical neurologist (not the usual cold fish who speaks condescendingly, answers no questions, and resents your asking them). Please, take care and do let us know what happens.

With fingers crossed---medlib


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