Monthly Patterned Seizures

[Myrage]

After an accident in 2000, I started to have abscense seizures.  These were preceeded by an aura.  The seizures have continued to develope into a monthly patterened seizure disorder that follow a precise schedule.  At one point, they would be preceeded by a week of disorientation, memory loss and a general sense of unwell.  Then immediately followed by a week of abscense seizures with as many as 10 per day.  After that week, I would feel great and able to do most things I normally do for two weeks.  Then the whole routine would start over again.
I have sought treatment at a Kansas City Hospital and I am now on medication. I am currently taking 200mg Carbamazepine (generic Tegretol) four times a day.  When I first started taking the medicine, I had a complete remission from the seizures.  Then after six months, the seizures started again.  At first, just waking seizures when I would lay down from time to time.  And now, I am experiencing the disorientation, memory loss and sense of unwell starting around the 10th of each month.  Followed by both waking and absence seizures starting around the 20th and ending around the 25th.
My Doctor has had three EEG's done with two coming back with abnormalities in the right frontal lobe.  They are at a loss as they have never seen anything like this in a seizure disorder.  This has become almost completely dibilitating as I am unable to even complete normal activities during these times.  If anyone has experienced similar seizure activities or heard of, I would appreciate any feed back. More detailed information available upon request.

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

You seem to have a focal seizure disorder (that is, seizures coming from one area of the brain, if your EEGs and symptoms are correct)

Its not clear whether the accident caused some head trauma as it is not unusual to develop focal seizures after varying severities of head trauma

There are other causes of focal epilepsy such as tumors, disorders of inherited or acquired brain development, or vascular malformations. This type of seizures (focal seizures) is very common and can come from any area of the brain. Usually an MRI is done to detect the above causes, but sometimes even the MRI is normal in a significant proportion of cases.

Also, if you are female, we know that seizures can cluster or occur around the menstrual period (this is termed "catamenial' seizures)

For reasons we do not entirely know, a seizure medication can work initially but lose effect later, so this is not unusual either. There are many more seizure medications that could be tried instead. Unfortunately if 2-3 appropriate seizure medications are not helpful, there is only a small chance that more drugs will be helpful. In this situation, the focal seizure area of the brain can be removed surgically with a good chance of success or even cure.

If you wish, you could have a second opinion at the Cleveland Clinic Epilepsy Center where we have extensive experience in treating focal seizures, and evaluating whether surgery is an option. This can be done by making an appointment (1800 CCF CARE) or by econsult (see Cleveland Clinic website, have all you r records available)

Good luck

[Myrage]

I also forgot to add that I am a male, 35, smoker, no drugs (except prescription) or alcohol.  I have read that pattern seizures are usually associated with eplipsy in males experiencing hormone changes or imbalance.  The precedence that sets my case apart from those is that my seizures started occuring after a car wreck in which I had a facial fracture and spinal injuries.  And my seizures have been related to multiple concussions.  I apologize for not including that in the previous statements.  Thank you.