Did seizures cause additional brain damage after '93 aneurysm

[JillinPhoenix]

My mother,9-10-46, had a cerebral aneurysm in 93-right frontal lobe. Two weeks later she had a shunt put in due to hydrocephalus. She had months of in & outpatient rehab. The deficits the neurologists said she would have (motivation, short term memory, rigidity) due to the damage done by the bleed, were true. They also told us that any improvement, or worsening, she would have would plateau after about a year-also true.

Two years ago she had 2 grand mal seizures approx 3 months apart. With the first one she did not have any anti-seizure meds in her system-they took her off dilatin one year after her aneurysm since she did not have a seizure the 1st year. The 1st seizure lasted over an hour despite medical help. She did eventually come out of it, spent several days in ICU, and did some therapy as well. She was put on dilatin and was told she’d have to take anti-convulsants the rest of her life. 3 months later she had another seizure, but not as bad as the 1st. After several med changes, she is now on depakote and seems to be doing ok-as far as no seizures.

Is it likely the seizures caused more brain damage?  I ask because I know it is not my imagination-she has worsened neurologically. Her short-term memory is worse than ever, she is highly unmotivated, judgment bad, in a fog most days. Is this normal following a serious seizure even though she had leveled off from the aneurysym? Could it be her seizure meds or pain meds she takes daily for old back injury, or something else? She had a CT few months ago- nothing new was found.They can't do an MRI due to clip type. Thx!

[CCF-Neuro-M.D.-JT]

Unfortunately, memory loss is something that we see commonly in patients who have had prolonged seizure activity as your mother had (over an hour in your post). This is due to lack of oxygen to a place in the brain called the hippocampus that for some reason is especially susceptible to damage from seizures. Although your mother may have clinically plateaued after her inital aneursym clipping and shunt placement, she may now have a new neurological baseline that is somewhat lower than before after such a prolonged seizure. Other things to consider regarding causes of her neurological decline would be levels of depakote that are too high, pain meds as you suggested, or even side effects of the depakote with a normal level. Some patients develop what's called an encephalopathy which is an altered state of mind due to the medication itself. It may be of benefit to try other antiseizure meds such as Keppra, Topomax (topamax), Lamictal, etc... jsut to see if there is any kind of improvement off the depakote. Sorry to hear about your mother's decline, but I wish her all the best.

[JillinPhoenix]

Thank you for the quick reply.  Jill

[Elnetta]

I had a SAH and aneurysm clipping in '96.  Am still having memory loss also confussion, headaches, was fired from my job due to mixing up files (I don't remember doing this).  Neurologist put me on Depakote.  Any comments?  Was I having 'silent seizures'?