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When are hallucinations actually seizures?

I visited my neurologist last Friday and told him about these small flashes of light that have been occurring in my eye since I have been diagnosed with Epilepsy, which has been about 25 years now. He told me "They might be seizures." However, he didn't tell me anything else. Does anybody else have this problem and would anybody else know more about it? It usually happens before I have a big tonic-clonic seizure, so I take it as a sign that I have to lie down. What about everyone else? Or am I crazy?

Comments

Re: When are hallucinations actually seizures?

Hi MichaelK,

If I have any other symptoms of a pain-free migraine, I write off my flashes of light as just a migraine.
Occipital seizures can also be confused with such migraines, and vice-versa. And if an otherwise focal
seizure spreads through the occipital region, or originates there, flashes of light are some of the most
common sensations. With secondary tonic-clonics, the original focal seizure is suppose to spread in a
more-or-less set manner per individual, but there are so many exceptions after having epilepsy a long
time, the exceptions seem to be the rule with me.

At times, I can have a very intense migraine with my vision flashing to a total white out (usually more
in one eye), then an aura of a seizure will occur, my migraine vanishes, and a tonic-clonic in a few
minutes is very likely. In my youth, my seizures where usually limited to TLE, but started to spread
out more often in my mid-30's, to about monthly secondary tonic-clonics during clusters of partial
seizures in my 40's to mid-50's.

Re: When are hallucinations actually seizures?

When I read your statement on clusters I have them too.  They just started me on Vimpat and that has stopped my clusters!  I have been taking the medication for a month.  I cannot believe it  This medication really is helpful, I would recommend a trial run on it!  I am on 150 mg. BID.  I wish you luck 3 hours!

Re: When are hallucinations actually seizures?

Hi 3Hours,

 

Do migraines run in your family? This seems to be very important, I found out. Your input has made me do some searching on the Internet to find out more, because it really surprised me. If a pain-free migraine occurs with an aura of a seizure, your migraine then vanishes and then a tonic-clonic is likely. This is exactly the same with me. I will have a pain-free migraine with an aura of a seizure and then it will stop. A tonic-clonic is then likely in me as well. 

I was curious about how to tell the difference between migraines with auras and seizures:

"There is no diagnostic test to confirm Migraine disease.
Diagnosis is achieved by reviewing both family and patient medical
history, evaluating the symptoms, and performing an examination to rule
out other causes of the symptoms. If there is any alteration in
consciousness, seizure disorders should also be ruled out."

source: http://www.healthcentral.com/migraine/types-of-headaches-38003-5.html

If there is an alteration in consciousness, then seizures may be the problem. Otherwise, by reviewing a combination of symptoms as well as patient and family medical history will lead to the answer.

For me, this is vital because it may mean that I have been misdiagnosed. Up to now, my neurologist has been treating me for temporal seizures, without any luck. If these seizures are occipital, then they may respond to different medicines. It may turn out to be a false lead, but I need to do whatever I can at this point. 

Thanks, 3Hours!

Re: When are hallucinations actually seizures?

Hi MichaelK,

Migraines don't run in my family. From the books/articles I've researched, the rule of thumb for
differentiating between migraines with auras and seizures is the 5 minute rule:
More than 5 minutes, call it a migraine;
Less than 5 minutes, call it a seizure;
About 5 minutes, call it migralepsy (especially if a definite seizure follows within one hour).

Many references try to restrict migralepsy to only migraine-triggered seizures:

http://emedicine.medscape.com/article/1142731-overview

The definition of consciousness, when it is given by the sources using the word, varies so much, it
makes it very difficult, if not impossible, to use it as a valid and objective concept. Like the
dividing line between simple partial seizures and complex partial seizures, using alterations in levels
of consciousness to distinguish between seizures and migraines creates paradoxes. But using the 5
minute rule creates paradoxes as well, because of the possibility of a series of quickly repeating
partial seizures, and/or status epilepticus of partial seizures, or just longer than normal seizures.

I've only had one eeg and one MRI (mounted in a mobile truck trailer, which greatly reduces precision).
Both of these, for me, came back as normal, but my neurologist asked me if I would agree to brain surgery
to stop my seizures anyway. I guess if I was willing, I might have received repeated and more precise
eeg's and MRI's. For one thing, originating causes like hippocampal sclerosis (and many other causes),
can be detected in 90% of such cases, but the other 10% require more heroic detection techniques:

http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2686888&blobtype=pdf

pages 3 - 4. This article also mentions sources of errors not usually considered in regular MRI's,
errors that easily hide the source, and presence, of true seizures, both in terms of better diagnostics
and more precise surgeries.

Re: When are hallucinations actually seizures?

When I first had seizures when I was 13 I had flashing lights that made me sick to my stomach and I wanted to throw up.  When I took microbiology I saw it under the microscope and I was able to describe it in detail to the Neurologist as mitochondria.  He laughed and told me to stop acting like a nurse. It grows and pulsates.  Some people have migraine w/ it and some have seizures w/ it.  It depends on the focus.  My focus is on the fourth ventricle.  Every one is different.  I was hoping mine was simple.  Some focuses are on the temporal lobe only, it varies from patient to patient.  Some patients just have headaches.  I hope you an MRI, blood test and an EEG and find out where your problem is.  Take care.

Re: When are hallucinations actually seizures?

I have had multiple EEGs, MRIs, blood tests, and CAT scans, all showing that I am a normal person. Yet I have flashing lights and/or hallucinations in the side of my field of vision. As you said, "Every one is different." My doctor has been focusing, unsuccessfully, on my temporal lobe. My seizures seem to originate, though, from the back of my head, at least that is what I feel. What 3Hours said below makes me wonder if there hasn't been a misdiagnosis due to misinformation. I will talk more with my neurologist soon. Thanks for your help.

Re: When are hallucinations actually seizures?

When I have a seizure I usually "white out" like have flashes of white light come across my eyes, and this happens before I have a migraine as well, so it's really scary, but if you're having hallucinations afterwards you might be having simple partial seizures as well as your tonic clonic seizures. It's pretty terrifying, because you don't really recognize that as a seizure but it is. So talk to your doc some more about it. Maybe you're having simple partial seizures.

Lorna Jane