Seizure, Migrane or mental disorder

[TLR]

Thank you for taking the time to answer my question.

I am 27 years old and have had what was termed as migranes since the age of 7 at which time I did in fact have a concussion due to a head injury.  We have always been told that the two were not connected in any way.  Over the years I have had various symptoms that occur along with the migrane, speech problems, numbness in various parts of my body.  Over Christmas this year I was hospitalized after having a very strange episode.   I had had a migrane for 7 weeks (everyday) prior to the episode I do not remember anything that happened during that time my husband said that I was mumbling incoherent things punching him, having hallucinations visual as well as auditory. I was placed in the psychiatric ward and onc shrink said I had pshycotic depression (without speaking to me as I was unconcious for a whole day)  the next shrink who talked to me said that I had not mental problems what so ever and said the problem was physical and released me.  Two days later I was again admitted had another episode while I was there and told by one doctr that I had some other mental problem, then another shrink said no that it was physical ordered an EEG, when my GP received the results he simply said thathe didn't understand it. I asked if I should see a neurologist he said maybe in the future.

The results of the EEG are as follows:
-moderate amount of bilaterally synchronous paroxysmal slow wave activity in the delta and theta between 2-5Hz in a generalized fashion maximal over both frontocentrotemporal regions.
-occaisional intermittent slow wave activity in the lower theta frequency band over each frontocentrotemporal area questionable left side prodominance.
- background activity consisted of a not well regulated 8-10Hz alpha over both parietoccipital and posterior temporal regions
-hyperventilation increased abnormality 1
-intermittent photic stimulation evoked a moderate driving response over both occipital region

at the end it says that this could have been caused by a head injury.

Could you please tell me what all this means and point me in the right direction for the next step? Do I see a shrink or a neurologist? My family doctor is useless and I can't get a new one.

Thank you in advance

Tammy

[CCF Neuro[P]-M.D.-RPS]

Dear Tammy:

Sorry that you are having problems.  It is difficult to tell you alot about what the EEG was read as, one really needs to see the EEG.  But, here are some thoughts, hyperventillation changes are not abnormal if they are generalized (sounds like yours were generalized).  The background activity sounds normal.  There is some slowing which is not normal.  Slowing during the awake state is a sign of cerebral dysfunction.  That portion of your EEG sounds abnormal.

What can this be?  It might be seizure activity, one does not necessarily know for sure unless an EEG can be done during the spell (the best way, but often not possible).  You might have had a cerebral event such as stroke etc, but it doesn't sound like it.  We have seen patients with an event of encephalopathy with a metabolic disorder and another with a mitochondrial disorder.  A work up of the latter two possibilities needs to take place having some knowledge of metabolic disorders.  

I would see a neurologist first, someone who is aware of these type of disorders.

Sincerely,

CCF Neuro MD

[DENISE]

NEUROTIN IS A VERY GOOD MEDICINE FOR EPILESY I HAVE BEEN ON IT FOR A LITTLE WHILE NOW AND MY SEIZURES HAVE DECREASED. I HOPE THAT IT STAYS WORKING FOR ME. I HAVE TRIED DILANTIN-DEPOKOTE-AND NONE OF THEM SEEMED TO HELP.THE DEPOKOTE PUT ME IN A COMA FOR THREE MONTHS.IT ALMOST KILLED ME.THANKS VERY MUCH.
                                            MICHELLE