Treatment for Temoral Lobe Epilepsy using Lamictal

  This is a follow up to a previous post ("Persistent Symptoms of Unkown
  Cause"; CCF response on November 18, 1998).  At that time I was diagnosed
  as having Bi-Polar disorder.  I had my doubts about this diagnosis, and had
  serious concerns about the symptoms described in my previous post.  Today
  (December 8, 1998), I received a second opinions from a "Neurobehavioral"
  physician (Neuropsychiatry?), who disputed the Bi-Polar diagnosis.  His
  diagnosis was Temporal Lobe Epilepsy.  He based his reasoning on a variety
  of questions which elicited my symptoms without me volunteering them
  beforehand.  (Did I have unusual smells?  Yes, Ammonia.  Did I have unusual
  tastes?  Yes, metallic tastes.  Did I have noticable hear irregularies?
  Yes.  Did I have breathing difficulties?  Yes.  Did I have perceptual
  (vision) changes?  Yes.  Did I have periods of confusion?  Yes.)
  This doctor put together both my physical and my mental symptoms (which
  include depression; suicidal ideation and suicide attempts; worthlessness
  and guilt; increased sleeping; physical depression; euphoria; increased
  libido; excessive spending; and decreased need for sleep--with paranoia
  interspersed in both "depression" and "hypomania"), and attributed them to
  this particular type of epilepsy.  He backed up his reasoning with textbook
  excerpts (which listed almost all of the symptoms I described, and what he
  said seems logical and believable to me.
  I am a bit skeptical, however, that six years of psychiatric treatment by
  around nine or ten clinicians can be labelled "misdiagnosis" by 30 minutes
  of questioning.  My first question, then, is:  have there been any cases in
  your center's clinical experience which support this doctor's opinion that
  epileptic conditions can present as psychiatric (is it possible that I was
  misdiagnosed for this long?  My next question is:  is using lamictal alone
  an effective and appropriate treatment for what this doctor described?
  My last question is:  how safe is lamictal (I am aware of the rash
  associated with the drug)?
  Currently I take no medication (except Claritin).  Previously, I was taking
  Depakote and Zyprexa (and have been off them for approximately two weeks).
  Thank you for your attention to this post. --Matt
      
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Dear Matt,
This is a continuation of my previous posting
We here at the Cleveland Clinic has a world class Epilepsy Center,
and if you would like to get a second opinion regarding the diagnosis of Temporal Lobe Epilepsy, and you live near OH please don't hesitate to call for more information. This is an important issue, so I think the diagnosis needs to be .confirmed. The number to call is 1-800-CCF CARE, you may  want to check with your insurance company as well.