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Epilepsy or "Pseudo Seizures"

Sun, 03/25/2007 - 18:30
In Oct. 2005, I suffered a head injury in a cab accident. About two months after the accident, I began experiencing nocturnal seizures. My primary care physician referred me to a neurologist, and after an inpatient and outpatient EEG and MRI that came back normal, and 6 months of ongoing seizures, my neurologist prescribed Trileptal and the seizures stopped. My seizures would typically happen shortly after falling asleep at night, although I've had some during the day when I take a nap. They would start with a loud buzzing noise or disjointed music in my ears that would progress into an electric shock feeling in my body. My muscles would tense and I'd feel like I couldn't move and then I'd lose consciousness. Following the seizures, I would be confused about who I was initially, where I was, feel like a truck ran over me, find it difficult to move, and noticed that I bit the inside of my cheeks or sides of my tongue. I would feel weak and my muscles would be sore the next day, and I often noticed unexplained bruises on my body. Unfortunately, I developed an allergic reaction to Trileptal and broke out in a rash, and then my neuro prescribed Keppra which has worked fine and I am mostly seizure-free. The only seizures I have had since being on medication were a result of forgetting to take my meds over the holidays for 4 days and drinking too much wine one night, which I knew I shouldn't have been doing. Since the car accident is a legal issue, I retained an attorney. He referred me to a neuropsychologist who diagnosed me with "pseudo-seizures," despite his knowing that my neurologist had diagnosed me with epilepsy. I did a lot a research on the internet, and I do not believe that I have Psychogenic Non-Epileptic Seizures (PNES), which is the correct term for it. I also believe that a lot of patients diagnosed with PNES are mistreated by the medical profession and accused of "faking" their seizures when the seizures are indeed real, but not caused by abnormal brainwave activity. The only rationale the neuropsychologist gave for his diagnosis of "pseudo-seizures" is that I have suffered from PTSD in the past due to having lived through childhood abuse (I'm now 54). The PTSD was something that I sought treatment for over a period of 7 - 8 years in the late 80's and early 90's, so it has not been an issue for me for over 10 years, and I had no recent symptoms of PTSD prior to the car accident. The only symptoms of PTSD that I've had since the accident have been related to my fear of going to bed at night due to having endured untreated nocturnal seizures for about 6 months before being put on AEDs by my neuro. This fear has subsided. I also had a sensitivity or fear reaction to buzzing noises or loud disjointed music, which happened when I would go into a seizure shortly after falling asleep. Once I figure out where the buzzing noises or music is coming from, I'm fine, and even this fear has subsided. I do not agree with the neuropsychologists diagnosis. What I've read about PNES on the internet doesn't fit with my seizure pattern prior to being successfully treated with AEDS. In PNES, the seizure symptoms differ from mine, and from the lists I've read on the internet, my seizure patterns don't fit this diagnosis. Also, with PNES, seizures often grow worse or continue despite treatment with AEDs (although I know this can happen to people with epilepsy given that it's difficult to find the right AED combination), rarely happen at night, can sometimes be induced by stress, etc. My neuro has advised my attorney that he believes that the only logical reason for my seizures is probably the head injury even though the EEGs and MRI are normal. He diagnosed me with epilepsy, and he told me that my positive response to the AEDs is a good outcome in that the treatment is working. My biggest fear is that my neuro will take me off AEDs because of the neurospsychologist's diagnosis, so I am making an appointment with him to discuss it since my attorney is forwarding the neuropsych's to him. I'd welcome any comments from anyone who has been faced with a mixed diagnosis from a neurologist and a neuropsychologist.

Comments

Re: Epilepsy or "Pseudo Seizures"

Submitted by Peaches78 on Tue, 2007-03-27 - 13:40
I haven't been diagnosed with pseudo seizures, but at first I thought mine were caused by stress so I ignored them. They continued to get worse so after nine months I finally told my doctor. He did a CT scan, blood test and EEG which were all normal. Then he referred me to a neuro who did an MRI which was also normal. He went ahead and put me on meds. As soon as I got on meds the seizures stopped and as long as I stay on them I don't have any problems. But I still wonder if mine are caused by stress even though meds work. I don't really fit the symptoms of pseudo seizures, but I guess I just have trouble accepting the diagnosis since my tests have been normal, I have no family history and I haven't had a head injury. My neuro has never suggested I'm "faking" it. Which I'm thankful for. I was afraid he would since everything has been normal. I hate being on meds so there for a while I would skip them a lot, which of course caused problems such as almost biting a hole in my tongue during sleep. I was on Keppra for a while but it made me so irritable I was taken off it and now I take Lamictal which works great. I also just started taking Lexapro due to depression caused by the seizures. Now I keep thinking maybe the seizures are due to my depression. After biting my tongue though I don't really want to test that theory. My neuro has discussed doing a VEEG which I was thinking of doing since you go off meds. I was just wondering if anyone else had this problem and knew if pseudo seizures stopped with meds.

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