New onset seizure in 30's-now aura

[k-new]

I am a 34y F who had my first grand mal seizure in 6/03 I don't remember anything preceeding up to it. My MRI, CT were neg but my EEG had peaks on both sides of my brain, temporal I belive. I have been on Dilantin 300 qHS, had been fine until last wk when I started noticing a jittery feeling, got home noticed a perm solution smell. I recalled smelling it earlier in the wk. My neuro said it sounded like I was having an aura and is now changing me to Tegretol. When he checked my reflexes he said he could not understand why my right leg responded faster than my left. I guess I am just wondering what is an aura generally like,is the jittery feeling usually assiciated with a side effect of Dilantin vs part of an aura, how long auras last, if they most generally lead to a seizure, if smells are common and if they are always the same smell? I also was told I am old to be having my first seizure w/o a secondary cause and would like to now how much there is out there about hormones and seizures being related, if reflexes are abnorm with this problem, if I'm having auras does that mean I still am having seizure peaks most likely. Should there be any other type of testing to find the cause of my seizure or is most treatment meds for ever?
Thanks

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

An aura is a sensation or a feeling that a patient reports prior to a seizure. They can be visual, auditory, smells, nausea, changes in sensation, de ja vu, or any perceived feeling a patient has before a seizure. Typically auras only last for 5-10 seconds before a seizure. However in patients taking medications they could last longer. Based on the fact that you are having a aura indicates that you have focal seizures (means they are coming from one area), as opposed to generalized. Seizures occur at any age. The MRI you had was most likely a routine MRI, at epilepsy centers, such as the one at the Cleveland Clinic, special sequences can be done, and an abnormality may be found.

Some women notice that their seizures occur at certain times during their menstrual cycle, therefore yes hormones can influence seizures.

In addition to medication some patients can have surgery to try and prevent future seizures. However medications are the first line treatment, and until at least 2-3 good medications have failed surgery would not be considered.

I hope this helps. Good luck

[jan]

Here's a good place to compare notes and gather some good info from others who have epilepsy:

http://neuro-mancer.mgh.harvard.edu/cgi-bin/forumdisplay.cgi?action=topics&forum=Epilepsy&number=33

[dizou]

Hello!
My first grand mal seizure was at 31 in 2000.  No known cause and my doctor missed 8 months of obvious signs of partial simple motor and senory seizures.  I don't always have the exact same aura's.  From extremely sweet smells, alcohol or penny taste, and visually, I have episodes of seeing things in slow motion as if things were moving in a strobe light. These are all examples of temporal lobe aura's as they arise out of the senses such as smell and taste. During a partial simple seizure I experience several minutes of not being able to speak, having loss of short term memory, severe headaches, numbness and tingling in my arms and sometimes legs.  To some extent we all present differently. It is very difficult being diagnosed with adult onset epilepsy with no known cause but absolute EEG abnormalities.  There have been links with hormone "causing" seizures and there is information on the web.  During any aura/seizure there are "spikes and waves" going on in the brain. Understanding EEG's is another thing all together.   We can always hope we won't be on medication forever :) Learning makes understanding much easier.

[k-new]

Thanks Jan, that site was very informative.
dizou, Thanks for the info.

[KyleECoyote]

I had my first grand mal at 33 (5 years ago). It was in my sleep (apparently), and it wasn't until I had one in public that the docs said, "OH okay, that's a seziure." Turns out it's complex-partial seziure disorder with left temporal onset, and it generalizes on occasion just to keep us all on our toes.

What I didn't realize was that I'd been having petite mals since childhood (that feeling wherein everyone in the conversation suddenly begins speaking Chinese--rude of them, I know-- and rising panic at losing control). That was first diagnozed as panic attacks a few years before the grand mal slapped us all in the face and said 'Epilepsy! you morons!"

As far auras are concerned, I can't tell if I get them or not: I lose about an hour of memory preceding each grand mal. My point (I have one, really I do) is that a close questioning of witnesses to your grand mals can sometimes be helpful, to determine if you mention an aura-like feeling before you hit the floor, as in "What's that filthy smell? Whoa! (**goes for the carpet)"

Hope that is at all helpful. (Be advised I'm not making light of anyone's difficulties but my own. Some have denial; I have reflexive joking... whatever gets you through the day, eh?)
Cheers.

[jan]

The chinese seizures sounds like a simple partial seizure, more than an absence seizure.  Maybe you should check it out, esp since you have already been diagnosed with complex partials.  I am diagnosed with complex partial seizures, also and have simple partials to boot.  :o)

[k-new]

thanks, a little humor to things can really help lighten a mood and make you realize you can still step back and laugh.

[Stevieonacid]

I'm 47 and something is changing in my brain big time.  I say brain because it is a set of symptoms which closely resemble symptoms of panic attack, anxiety, phobias, etc., except I honestly am not anxious, phobic, panicky or anything remotely like that.  Ergo, it seems mechanical - physical.  I have seen a neurologist and she initially told me I have BET, benign essential tremor - this from an occasional inability lately to complete certain routine motions - mostly drinking coffee or beverages, and eating.  I get near to taking a sip or a bite from a fork, and this shaking kicks in.  I move my hand back toward the table and it goes away.  Very weird.

It is immeasurably worse if I have a few drinks the night before - but a couple of glasses of wine is OK.  Also, coffee (which I now don't drink) also heightens it immensely.

My other symptom is the one which is really freaking me out.  I am now getting this sensation of a tremor overcoming me when I am talking to people.  It is as if I am going to clench up and fall into some sort of seizure. It has (until yesterday) been a very brief symptom, each time only lasting a second or two.  Yesterday however, I was at lunch with a couple of guys I know and we were just talking.  I was feeling just slightly off from being out with friends from Hong Kong the night before - dinner and about 5 or 6 glasses of wine.  A little too much I know, but no big deal by long time standards.  Anyway I had this sensation overtake me over about 5 minutes which left me shaking with fear.  I was sure that I had very nearly succumbed to something very profound.  It had left me unable to carry on a conversation or eat the other half of my lunch.  I jsut got up and walked away, shakely.  I KNEW I had just come very near to something I had never felt before - like I was just going to fall over in a knot of utterly lost control - again, a purely physical set of sensations - the conversation had been simple, friendly - the setting just a cafeteria.

Now it is happening several times a day, always when I am in conversation.  As I said, I do not have a nervous, panicky, phobic frame of thought, of mind or demeanor.  I am normally confident - a good public speaker - and I am not under any unusual stress.

Anyway, I am venting I guess.  I am going to go back to my neurologist and fill her in on my "near-event" and the trend in this phenomenon worsening.

Any comments or knowledge of similar situations are welcome.

Thanks.