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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 5 to 29 of 29. Go back in thread:
Posted by Phillipa on January 25, 2007, at 16:44:40
In reply to Re: medication for epilepsy / anxiety and depressi, posted by rovers95 on January 25, 2007, at 14:40:02
I agree with the hospital as seizures continuously can damage your brain. Do you have a brain injury from the past that is causing this. Love Phillipa
Posted by blueberry1 on January 25, 2007, at 21:29:03
In reply to medication for epilepsy / anxiety and depression, posted by hobbsster on January 25, 2007, at 13:15:03
Your situation sounds very serious and I think needs professional attention right away without any hesitation or waiting.
The top long time first line med for epilepsy is depakote. It can also treat the bipolar, depression, and anxiety at the same time.
In really tough cases, lamictal can be used with it. But lamictal has to be started at super low doses (12.5mg) and increased slowly in 12.5mg steps. Depakote could provide rapid relief.
Posted by med_empowered on January 28, 2007, at 2:43:19
In reply to Re: medication for epilepsy / anxiety and depression, posted by blueberry1 on January 25, 2007, at 21:29:03
Here's the thing: Epilepsy is a very real illness, with very real symptoms. Psychiatric diagnoses are largely guesses, and they vary from doc to doc. So..I'd say...first treat your seizures. When those are truly under control, then address any remaining psychiatric symptoms. Keep in mind that both seizures and anticonvulsants can have psychiatric effects.
Have you tried Phenobarbital? Its old school, but added to other anticonvulsants it can help. Plus, it's cheap, readily available, and can help with sleep, anxiety, etc. There's also Frisium, which might help more than the Valium but keep you in the benzo family. Depakote is a good call, and Dilantin might also help--its older, but also has some uses in bipolar. I think there's a version of it pre-mixed with phenobarbital.
Also, consider trying supplements under the guidance of a trained professional. Some people with epilepsy find that supplements reduce the number of meds they take and the dosages of meds.
Good luck.
Posted by hobbsster on February 4, 2007, at 7:46:25
In reply to Re: medication for epilepsy / anxiety and depressi, posted by med_empowered on January 28, 2007, at 2:43:19
Dear ed_uk, rovers95, polarbear, phillipa, blueberry and med-empowered
YOu have been friends in a very weird distant way. I am out of hospital now and literally just told my psychiatrist that "it was time". I had 4 grand mal seizures in 4 days. My body still aches... after one of the seizures (about 2 hours later) an EEG was done. According to the doctor there was NOTHING wrong, no indication whatsoever of any epilepsy.
I was diagnosed as a 12 year old and this was the first time ever I had a "clean" EEG... the psychiatrist is of the opinion that I have conversion disorder - due to traumatic childhood.
Presently I am on 800mg tegretol, 200 lamictin, 150 stressal (new drug apparently without any side-effects...), 300mg neurontin... I also take 2 mg ativan in the morning, 2mg in the afternoon and 4 mg in the evening and (just as a precaution 10 mg valium at night).Firstly, this disorder seems weird and i do not know how my brain was able to "fake" the previous EEG's.
YOu are right, I should get to a neurologist. The psychiatrist tried to "cure" me from valium addiction and now I am on Ativan - what's the diffs?
Sometimes I feel suicidal, sometimes I cry a lot (not like me to cry at all), my whole life seems like a fake.
And even if I had some traumas in my childhood is this sudden onset of "conversion disorder" possible? And all the preivous EEG's clearly indicating epilepsy??? I'm LOST.
Thanks for your messages
Hobbster
Posted by Phillipa on February 4, 2007, at 18:08:50
In reply to epilepsy / conversion disorder??? » med_empowered, posted by hobbsster on February 4, 2007, at 7:46:25
So sorry for your suffering yes I think a neurologist would be the best thing at this point as he will run further tests more definitive. Love Phillipa
Posted by notfred on February 4, 2007, at 20:05:53
In reply to epilepsy / conversion disorder??? » med_empowered, posted by hobbsster on February 4, 2007, at 7:46:25
"Firstly, this disorder seems weird and i do not know how my brain was able to "fake" the previous EEG's."
There is no gold standard test for epilepsy, many have normal EEG's and yet have epilepsy.
Posted by Phillipa on February 4, 2007, at 20:49:56
In reply to Re: epilepsy / conversion disorder???, posted by notfred on February 4, 2007, at 20:05:53
Just thinking wouldn't an MRI pick it up? Love Phillipa
Posted by notfred on February 4, 2007, at 20:57:49
In reply to Re: epilepsy / conversion disorder??? » notfred, posted by Phillipa on February 4, 2007, at 20:49:56
> Just thinking wouldn't an MRI pick it up? Love Phillipa
No, there is no gold standard test for epilepsy.
There is no one cause for epilepsy.
Posted by gardenergirl on February 5, 2007, at 19:39:36
In reply to Re: epilepsy / conversion disorder??? » notfred, posted by Phillipa on February 4, 2007, at 20:49:56
> Just thinking wouldn't an MRI pick it up? Love Phillipa
An MRI gives you a picture of the brain. You need to see electrical activity in order to "see" a seizure in the brain. That would require an EEG, or perhaps an fMRI or PET scan. My sister had an MRI to rule out any anatomical or physiological abnormalities. She also had an EEG during which they had her do or they did various things such as holding breath, hyperventilating, flashing lights, etc. in order to try to induce a seizure, if one were to happen. That wouldn't show up on an MRI or CT scan.
namaste
gg
PS: I miss "fondly". :)
Posted by gardenergirl on February 5, 2007, at 19:43:45
In reply to epilepsy / conversion disorder??? » med_empowered, posted by hobbsster on February 4, 2007, at 7:46:25
Hobbsster,
This must be a very confusing time. Personally, I think that it's wise to get a second opinion when someone is diagnosed with a conversion disorder. You sure don't want them to miss something that needs medical care.And if it is a conversion disorder, there's treatment for that, too. It doesn't mean you didn't experience what you've experienced. It doesn't mean you were faking it. It doesn't mean that it shouldn't have bothered you. It's just a way of understanding what's going on, and that's good, because it will lead you to the right treatment, if that's the case. Otherwise, again, assuming that diagnosis is correct, you might continue to seek medical treatment at the expense of psychological, and that could stall your progress to wellness.
I hope that however it turns out, it leads to some relief for you.
namaste
gg
Posted by Phillipa on February 5, 2007, at 20:49:33
In reply to Re: epilepsy / conversion disorder??? » Phillipa, posted by gardenergirl on February 5, 2007, at 19:39:36
GG really don't you remember what happened on Social because of that? Love Phillipa former fondly Phillipa
Posted by gardenergirl on February 5, 2007, at 21:46:43
In reply to Re: epilepsy / conversion disorder??? » gardenergirl, posted by Phillipa on February 5, 2007, at 20:49:33
But I disagreed with it. We all get to have our own opinions.
namaste
gg
Posted by Phillipa on February 5, 2007, at 22:19:15
In reply to I remember » Phillipa, posted by gardenergirl on February 5, 2007, at 21:46:43
I know I kind of liked myself. Too much of a people pleaser I guess. But couldn't win that one if you know what I mean. Love sounds so personal. Fondly Phillipa
Posted by yxibow on February 6, 2007, at 23:34:50
In reply to Re: epilepsy / conversion disorder??? » hobbsster, posted by gardenergirl on February 5, 2007, at 19:43:45
> Hobbsster,
> This must be a very confusing time. Personally, I think that it's wise to get a second opinion when someone is diagnosed with a conversion disorder. You sure don't want them to miss something that needs medical care.
>
> And if it is a conversion disorder, there's treatment for that, too. It doesn't mean you didn't experience what you've experienced. It doesn't mean you were faking it. It doesn't mean that it shouldn't have bothered you. It's just a way of understanding what's going on, and that's good, because it will lead you to the right treatment, if that's the case. Otherwise, again, assuming that diagnosis is correct, you might continue to seek medical treatment at the expense of psychological, and that could stall your progress to wellness.
Conversion disorders, which are part of the Somatiform spectrum and is likely what caused my Somatiform NOS, although one can never say for sure -- the overwhelming anxiety from 9/11 is still 5 years later, much better albeit, but manifesting itself in a visual Somatiform disorder.The most common conversion/somatiform disorder is a pseudoseizure, and as the previous poster said, it does not mean you are faking it. There is just beginning to be a better understanding of it -- yes, there is a DSM code for malingering, but that is not the most common condition. Something, some anxiety causes a person to have pseudoseizures and these are often seen in the ER. EEGs and possibly PET/SPECT scans although the latter have limited diagnostic capability in terms of magnification are one way of ruling out an organic (true) epileptic condition, but other tests should be run by a neurologist.
I would second the second opinion because if it isn't an organic disorder, psychotherapy remains one of the ways to overcome this condition. The good prognosis is if it is a pseudoseizure, unlike my special senses disorder, pseudoseizures typically only last weeks when treated well.
In the past, conscious sedation (Versed, phenobarbital, etc.) was used, but this is mostly an illegal practice in hospitals today and doesn't do the patient the most justice because they're not actively engaging with the therapist to "free" the trapped anxiety for a lack of better description. This isn't science fiction, its reality if you ask any good ER physician.
To better health-- Jay
Posted by SLS on February 7, 2007, at 5:21:52
In reply to Re: epilepsy / conversion disorder??? » gardenergirl, posted by yxibow on February 6, 2007, at 23:34:50
Hi Jay.
Would you say that a somatiform disorder digs its grips in more tightly the longer it is left untreated? Sort of like kindling?
- Scott
Posted by yxibow on February 8, 2007, at 0:29:30
In reply to Re: epilepsy / conversion disorder??? » yxibow, posted by SLS on February 7, 2007, at 5:21:52
> Hi Jay.
>
> Would you say that a somatiform disorder digs its grips in more tightly the longer it is left untreated? Sort of like kindling?
>
>
> - ScottFrom my experience, yes, I would say so. With the idea of Conversion Disorders becoming Somatiform conditions, the more left untreated, the likelihood of more time gone by is certainly possible. Is it measurable on a certain timescale? Probably not, because each condition is different of course. I would say more concretely that unless it is a very mild conversion disorder it is not going to disappear on its own -- I mean, we all hope that sort of thing would happen.
I didn't sign up to have my brain change overnight on Nov 17, 2001, but it did for whatever reason. I had "peter pan" issues and low self esteem and dissatisfaction with attempting to find jobs even before my disorder happened, so it kind of compounds things, basically MDD on top of a Somatiform NOS with MDD.
But I would say that if a person continues to present themselves with pseudoseizures at an ER without followup counseling, there is a likelihood that they will continue to persist, and they're everything like a seizure, the dangers and all, but the person doesn't have an organic condition. So, its not a good state to be in. Fortunately it is the most common conversion disorder and more physicians are familiar with it and it takes weeks to months instead of the depth of complexity of mine which, well, has already eaten 5 years of my life.But I have made strides, I volunteer, I have taken some extension courses and I got a certificate to better my resume in the hopes that continued positive activity will push the visual symptoms downward in a positive manner.
Hope that helps-- Jay
Posted by hobbsster on February 8, 2007, at 9:56:12
In reply to Re: epilepsy / conversion disorder??? » SLS, posted by yxibow on February 8, 2007, at 0:29:30
Hi everybody!
Well, I am back in hospital - this time in Johannesburg. THe neurologist who examined me and did EEG's etc, was clear that I have epilepsy. THe EEG was in this case not "clean" - any way, he changed all my medication and I am on the adapting process again. THe best advice ever is always to get a second opinion...
just wanted to let you know what's happening.
Hobbsster
Posted by yxibow on February 8, 2007, at 13:08:33
In reply to conversion disorder: what the neurologist says, posted by hobbsster on February 8, 2007, at 9:56:12
> Hi everybody!
>
> Well, I am back in hospital - this time in Johannesburg. THe neurologist who examined me and did EEG's etc, was clear that I have epilepsy. THe EEG was in this case not "clean" - any way, he changed all my medication and I am on the adapting process again. THe best advice ever is always to get a second opinion...
>
> just wanted to let you know what's happening.
>
> Hobbsster
I'm not sure that congratulations is in order, that would come off rather wrong, but I am glad you got a second opinion.I hope you are able to get your epileptic disorder under control so you can enjoy a productive life.
-- to wellness
Jay
Posted by hobbsster on February 14, 2007, at 2:30:32
In reply to Re: conversion disorder: what the neurologist says » hobbsster, posted by yxibow on February 8, 2007, at 13:08:33
THanks Jay,
I am back at home and have been having seizures at least 3 x daily, ended up in hospital again. And I really need to get back at work - I'm a social worker, but cannot have seizures at work.
Apparently the blood levels / therapeutic levels of the new anti-epileptics could take up to 6 weeks to become effective.
I wake up in the mornings, unable to breath, sweaty palms, scared, heart beating so fast... i am too scared to go out because the simplest thing can trigger a fit - loud noises, lights, agoraphobia... whatever.I realize that the anxiety and fear can also increase the possibility of seizures. It feels as if i lack all the skills that i'm "teaching" my clients. it feels as if my life is suddenly "possessed" with epilepsy and fear.
Luckily I have a good neurologist, but since he is one of the best in this country, it is impossible to just phone him and tell him what's going on and I've been in hospital for 3 weeks and really do not want to go back.I am so glad I discovered this website where i can find a support system even though it is far far away and "faceless" - one can feel the heart and warmth.
Thanks
Marlize H
Posted by gardenergirl on February 14, 2007, at 10:10:19
In reply to Re: thanks jay, epilepsy + anxiety » yxibow, posted by hobbsster on February 14, 2007, at 2:30:32
> I am back at home and have been having seizures at least 3 x daily, ended up in hospital again. And I really need to get back at work - I'm a social worker, but cannot have seizures at work.Ugh, that sounds frustrating if not exhausting.
>
> Apparently the blood levels / therapeutic levels of the new anti-epileptics could take up to 6 weeks to become effective.Hopefully you'll be on the shorter end of that range estimate.
> It feels as if i lack all the skills that i'm "teaching" my clients.
I can relate. The first time I tried to apply deep breathing relaxation when I was experiencing a great deal of anxiety, I realized how hard that actually is in the moment. No wonder my clients had trouble with it! But, it's much easier to teach it to others when we have some distance from their situation. When it's us, there's no distance. It's in our face. Much harder, imo. You'll get through it, though. Even having awareness of skills helps make it more likely you can use them.
> I am so glad I discovered this website where i can find a support system even though it is far far away and "faceless" - one can feel the heart and warmth.I'm glad you're finding support here. Wishing you good health...
namaste
gg
Posted by Jeroen on February 14, 2007, at 20:15:56
In reply to Re: thanks jay, epilepsy + anxiety » yxibow, posted by hobbsster on February 14, 2007, at 2:30:32
hi, i'm sorry to hear you have a hard time aswell!
i hope you will be ok very soon..
Posted by Phillipa on February 14, 2007, at 20:59:33
In reply to hi there!, posted by Jeroen on February 14, 2007, at 20:15:56
Jeroen you popped out of nowhere how are you? Love Phillipa miss seeing you
Posted by Jeroen on February 14, 2007, at 21:37:01
In reply to Re: hi there! » Jeroen, posted by Phillipa on February 14, 2007, at 20:59:33
not well, side effects of seroquel arent cool
i want to give it up, and try to reverse my TD before i take any other med again
Posted by yxibow on February 15, 2007, at 2:10:19
In reply to not well, side effects of seroquel arent cool, posted by Jeroen on February 14, 2007, at 21:37:01
> not well, side effects of seroquel arent cool
>
> i want to give it up, and try to reverse my TD before i take any other med again
Jeroen, is your doctor tracking your progress at all with any AIMS levels? I know I've said this about three or four times, but you will not know if something has improved your TD if you don't take a simple 5 minute AIMS baseline and then measure it later when you've tried another medication to attempt to make changes to your TD.
There's nothing special about an AIMS exam, your doctor asks you to move certain muscles in your body and notes responses and he should be doing this.
Sorry you are not reacting well to Seroquel, it is second if not first in sedation to all neuroleptics with the possible exception that Clozaril can be even more sedating. Other than that effect, Seroquel's side effects are usually fairly mild in comparison in the EPS range, dependent on dose.
Posted by hobbsster on February 16, 2007, at 3:32:22
In reply to Re: not well, side effects of seroquel arent cool » Jeroen, posted by yxibow on February 15, 2007, at 2:10:19
Dear Jeroen
I'm nearly too scared to tell you what seroqual did to me, but it could just be some help to you... i developed neuroleptic malignent syndrom from it. You can read up on it on the internet. I gained so much weight and it worsened my epilepsy. A psychiatrist described it after I became a bit psychotic after a couple of epileptic seizures - I did not go for the follow-up and literally nearly died and was in hospital for 6 months on and of last year before the reason for my intense shakes and sudden weight lgain *15 kg / about 30 pounds, and weird behavioral changes could be found. I also had some bad withdrawel symptoms, but not as bad as with valium / diazepam - that was hell! I specifically became swollen on the left hand side of my face and the most terrible breast pains (like a teenager) - BUT like always there is some hope, in spite of. That is the one thing that one learns - to live not "because of" (circumstances), but to live fully IN SPITE OF.
I truly wish you the best. Get a second opinion, get a third if needs be, but do not change your medication without medical assistance.
Something else, I suddenly started snoring at night and had terrible sleep apnea and became very confused.
There are certain "symptoms" and signs that you can look for- PLEASE tell the dr about every single one of them. Write it down if you need to and read it to him, get someone close to you to "refresh" your memory or go to the dr with you - he/she will know you well enough to see the changes and influences. And it helps to remember what the dr said, one tends to forget all the "overload of information" that a dr can give you.
All my best wishes and I pray that you will find medz that will truly help you.
Marlize H
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