Re: episodic nausea, preceded by an aura

Posted By CCF neuro MD MM on December 07, 1998 at 16:32:35:

In Reply to: episodic nausea, preceded by an aura posted by Matthew on December 06, 1998 at 20:39:50:






I had submitted to this forum previously on November 7, 1998.  The reason why I am submitting once again has to do with new insights on my behalf as well as a few more questions.  I will briefly give a description of my symptoms, for more in depth information I would suggest for those unfamiliar with my past entries to look in the archives under the same name and date I listed above.  I have episodes in which I experience intense nausea, very slow thinking, overwhelming fatigue with occasional blurred vision and slurred speech all of which are preceded by an aura.  The aura is difficult to describe other than by saying a strange feeling comes over me in which I feel like I'm reliving or reinacting a previous experience.  For the past few years the frequency of these episodes has been so low (or at least so less intense) in comparison to when I had not taken anticonvulsant medication that I would say I average one noticable episode per month.  I have never had an E.E.G. during one of these spells, only in between.   There are two new insights I would like to disclose.  The first is that I have been successfully off of Prilosec for ten days now.  The second has to do with what was first mentioned in my previous entry.  I had said how I experienced convulsions as an infant, which was correct, but I was mistaken in saying that they were related to asthma attacks.  I had just found out a few days ago that most if not all of these convulsions happened before I was ever diagnosed with asthma.  I was also told that each time I was taken to the hospital the doctor(s) said they were unsure of the cause and mentioned a possible viral infection.  My first question is is what I have read pertaining to convulsions in infants and children true in that they can cause possible later neurological problems?  The reason I ask is because several years ago when this was mentioned to a doctor he said that the convulsions I experienced as an infant would have nothing to do with a possibility of me having epilepsy at present.  My second question is in regards to the description of my symptoms.  Do my symptoms warrant consideration for any other disorder as much as a type of epilepsy?  Please do not be intimidated, for I am not asking for a diagnosis.  I asked that question because many doctors so far have not taken either me or my condition seriously.  I have found out through personal experience that it is much easier to place an individual into the gray area of mental disorder then to fit them into the black and white areas of general medicine where there is little acceptance of any ambiguity.  I want to go to my doctor with a balance of both assertiveness in expression and an openess in understanding, and  I don't believe it wrong to hope the same of him.  The last thing I would like to mention is that the only medications that have worked to any degree to treat my symptoms have been anticonvulsants (Dilantin, Tegretol, Depakote, and at present Klonopin) which to at first glance may seem a clear indicator of possible epilepsy, but there are two problems.  First, many of these medications are also used to treat certain psychiatric disorders.  Second, each one of these medications has been prescribed by a psychiatrist who felt that my condition was organically based.  Thank you for your patience.



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Thank you for the additional information.
I am usually reluctant to contradict another physician when discussing a
patient I have never seen but febrile seizures in infance are on of the
modst common background factors leading to temporal lobe epilepsy in
adulthood.
Temporal lobe epilepsy is classically associated with an
aura describe as " deja- vu" exactly as you describe, it may the progress
to altered awaremess, nausea, or generalized convulsions.
This sounds like a very good history for temporal lobe seizures to me,
accompanied by the history of seizures in childhood  ( especially if they
occurred in the context of high fevers ) and the response to
anti-epileptic drugs makes a very convincing case.
With this history you should have an MRI scan of the brain using a
temporal lobe protocol which visualized the area typically inviolved
in this type of epilepsy and prolonged EEG monitoring.
The Clebveland Clinic has one of the largest epilepsy centers in the US,
dealing with this problem by both medication and surgery.
If you wish to be evaluated here the number to call for appointments
is ( 216 ) 444 5559.