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Re: Temporal Lobe Epilepsy Mitch

Posted by Elizabeth on May 18, 2001, at 21:01:16

In reply to Temporal Lobe Epilepsy-anyone out there?, posted by Mitch on May 18, 2001, at 11:46:40

> Does anyone out there have a *confirmed* diagnosis of Temporal Lobe Epilepsy or know someone that does?

I know someone who does, yes. She also has been diagnosed with rapid-cycling bipolar II disorder with dysphoric hypomanias and borderline personality disorder. She has occasional hallucinations and illusions, as well as spells when speaking is very difficult for her (often associated with the hallucinations).

> I went through a TLE checklist and went to the ADD checklist site and came up with an ADD diagnosis with "temporal lobe problems" response.

Me too, but there's never been any conclusive evidence that I have any sort of epilepsy (3 EEGs (one sleep-deprived, one 24-hour), 3 MRIs, all unremarkable. (However, I *still* haven't gotten my hospital records with the writeup about my SPECT scan, which I have been told was abnormal in some really obvious way.)

> Anyway here are some of the symptoms I experience and have experienced with various medications:
> 1) Occasional explosive temper with a lot of autonomic arousal followed by panic anxiety and depression.

"Anger attacks" are common in some kinds of depression. They are occasionally associated with TLE but I think this is very rare.

Treatment approaches for anger attacks include, on the one hand, serotonergic antidepressants (SSRIs, MAOIs, Effexor, etc.), or, on the other, mood stabilisers (lithium, valproate, carbamazepine, etc.). It's hard to predict which will work for whom.

> 2)Constant gastrointestinal problems that seem to worsen and coexist with the mental phenomena.

Ever heard of "irritable bowel syndrome?"

> 3)I like to write a lot (as you can see). I am a technical writer where I work and can type 115 wpm.

I don't think this is pathological.

> 4) I don't get deja vu, I just found out the experience I rarely get is *jamais vu*. An unusual feeling of strangeness in a familiar place.

Me too; it's associated with panic attacks in my case. An alternate word for the experience might be "derealisation."

> 5) Rare mystical experiences-specifically brief intense feelings that God is right there with me (not talking to me or anything-just the *feeling* of presence).

A lot of people have had these, not just epileptics. It's something that has always interested me, although I've never experienced it myself.

> 6) Feelings of changes of scale around me. Everything seeming "bigger" or "smaller". Kind of like getting new eyeglasses. Usually when I change or add a med.

I think this is related to the spacy, unfamiliar, unreal feeling you described above (#4).

> 7) Changes in perception of color intensity with different meds. For some reason Prozac and especially Effexor made colors very very vivid-red almost glowed!

OK, that's just weird. I have no idea what to make of it.

> 8) All SSRI's seem to intensify my ability to hear music in my head (carry a tune around). I can *wakeup* with music playing! I could play music sometimes on Prozac and hear *other* music playing with it that was not there!

I have had something similar happen while on MAOIs, in particular Nardil and Marplan. I don't know what causes it. I've met a couple of other people who experienced this side effect on MAOIs.

> 10)When I was taking Effexor I was frequently smelling things that weren't there. I would be at work and smell something and mention it and noone else could smell it.

It's possible you just have a better sense of smell than most people, although olfactory hallucinations are considered to be very suggestive of TLE.

What kind of smells were they?

> 11) All SSRI's also have this tendency to produce a knee-jerk laughter response to all sorts of stuff.

Sounds like marijuana to me!

> I was off of all AD's for a while and was taking Adderall and that STOPPED and my head was very "quiet"-my mood cycling also stopped.

Lots of people find that stimulants have this effect. I conceptualise it as being able to keep up with your racing thoughts. Whatever the cause, it's common with ADD-spectrum conditions.

Book recommendation: _Dysthymia and the Spectrum of Chronic Depressions_ by Akiskal and Cassano.

> 13)I recently added a low dose of Lithium to my meds and I experienced a couple of episodes where I noticed what looked like a "black hole" in my peripheral vision and it shrank and dissappeared suddenly, very odd.

I think illusions are pretty common with lithium.

Tremor is a common side effect of most ADs.

> 14)I took a single 37.5mg dose of Effexor one time and experienced a full-blown manic episode about an hour after taking it, but it just lasted for an hour or two.

My pdoc says he finds "side-Effexor" to be one of the worse culprits in inducing mania. I had a very serious episode on Effexor XR. Another time, when I tried regular Effexor (immediate-release) 37.5mg, I started shaking violently all over.

> 15)I have had people tell me that my facial expressions seem to change a lot-and I am not really aware of it.

I think that's natural. People communicate a lot through facial expressions, and they aren't always aware that they're doing so.

> 16) When I was a teenager (and now at times) I had a big problem with echolalia (I would repeat out-loud and sometimes unknowingly the last word of every sentence that someone was speaking to me).

I think this is associated with some types of schizophrenia. I don't know much about it, though.

> 17) My mother had generalized nocturnal seizures and my sister had severe dyslexia and temper problems. My dad was temperamental and both his eyes would get to "jiggling" especially when he was upset-to the point where he couldn't hardly drive.

That's called nystagmus (the vibrating eyeball thing). I think that the tendency for epilepsy and ill temperedness in your family may both be contributing to your emotional problems and perceptual quirks.

Sorry I couldn't be of much help. I hope you will check out that book; it includes discussions of the concept of "characterological"/"neurotic"/"atypical" depression, depression associated with ADD, residual and premorbid schizophrenia, etc. I think you might find something in there applicable to you.

A lot of people do have weird perceptual disturbances on ADs. If it's mainly a side effect, I don't think it indicates epilepsy. My suggestion would be to show your list to your pdoc or GP and ask if s/he thinks you could use a referral to a neurologist.





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