Re: Seizures with memory loss

Posted By CCF Neuro[P] MD, RPS on March 03, 1999 at 18:09:24:

In Reply to: Seizures with memory loss posted by Steve on February 28, 1999 at 14:42:36:






: My daughter(age 17) at the age of 2 had absence seizures, then at about 7 began to have petit mals, and at the age of 12 grand mals.  She was controlled somewhat on depakote, but was changed to Dilantin in November due to the side effects.  Last spring she had a 30 minute seizure that caused her to have both short and long term memory problems.  When she came home she did not recognize anyone but me and didn't recognize her home.  After a few days everything came back.  She had another grand mal in December with no side affects.  Last Thursday she had a 3 1/2 minute grand mal with no complications, however she could not remember anyone other than her immediate family that she lives with, did not know anything about her school, teachers and even could not remember what food was.  She did not know what foods she liked and could not remember what they tasted like.  Her Dilantin level was 13.8.  After five days she began to remember a few people, then the next day would not know who they were.  The next day she could remember them again and began to remember a few more.  Then one week after the seizure everything went blank again, then the next afternoon, 8 days after the seizure everything began to come back.  She still has trouble spelling, can only spell her name very slowly, can read, but having problems writing the letters. Otherwise she seems fine.  I don't believe she is having grand mals in her sleep, as we watch her very closely and have not seen any signs the next morning of one.  Have you ever heard of this and we are wondering where to go from here?  Her neurologist seems to also be stumped and said this was very unusual and even ordered a drug screen just to be sure and rule out anyone slipping her a drug.  (I am certain that has not happened, but we are going to check and be sure to pacify him)  We have an appointment to see him 3-15, but would like to know if you have any information on this.  I can find nothing regarding this, only memory loss for a short time after a seizure.  Thank you, Marilyn Williams




Dear Marilyn:
Sorry to hear about your daughter.  Seizures often cause memory loss, especially when they involve the temporal lobe/hippocampus region.  It sounds like your daughter's epilepsy is not under good control.  Does she still have her absence (aka:petite mal) siezures?  Dilantin does not control these types of seizures well and if she is still having these, this might be the reason for her having the breakthrough generalized seizures.  What medication would depend on what her EEG shows and her clinical seizures are like.  If she has complex absence then a trial of lamictal might be worthy of a try, but since I have not seen her EEG nor done a physical exam, it is impossible to suggest treatment.  Without both, one cannot give specific treatment options.  The memory loss is from her seizures, once you get these under control, this symptom will likely resolve.  To accurately give medications, one has to correlate the EEG to what is happening clinically.  Best of luck.
Sincerely,
CCF Neuro[P] MD




I assume epilepsy has assuredly been diagnosed by more than observational means? If not "proven" to be I might suggest testing for a large number of other causes for seizures; vascular, neuro-chemical, hereditary/genetics.
An EEG done with electrodes on the scalp may not detect deeper electrical abnormalities associated sometimes with frontal lobe seizures.




Dear Marilyn:
The above answer posted is NOT by a physician.
Sincerely,
CCF Neuro[P] MD