Types of Seizures

[Chaaya]

For years, I’ve had incidents that I’ve been told are partial seizures that have occurred whenever I take a medication that increases your risk of seizures (wellbutrin, lithium, etc). Stopping the medications or taking an anti-seizure medication has gotten rid of them. Recently, I started having seizures again that started after I went off of  Triliptal (was depleting my sodium). I’m now taking my Lamictal and Tegretol twice a day rather than once a day, and the seizures seem to have stopped. I take these medications because I’m bipolar II.
I have had all of these types of seizures.
Visual changes. Objects change size, color, shape, etc. These usually last less than a minute.
Jamais-vu. I don’t recognize people, places, and objects. These feel different from the visual    changes and can last a few minutes or longer.
Transient epileptic amnesia. I’ve completely forgotten things that I’ve done in the past. I just started having these recently.

My question is not whether or not these are all seizures, but rather can one person have all of these different types of seizures, or do you always have the same type (which would mean that these can’t all be seizures, right)? I had an MRI and EEG years ago and they were normal.

Also, I’m currently on Tegretol and am having really bad muscle pain around my joints from it (anyone else ever have this) and so I’m now going off of it. Am I at risk of withdrawl seizures again even if I taper off of the Tegretol really slow? The Lamictal didn’t control the Triliptal withdrawl seizures and I had to split the dose on the Tegretol as well so I’m worried about what might happen when I finish going off of the Tegretol.

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

First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
   The symptoms that you describe (visual changes, Jamais-Vu and transient epileptic amnesia) can be seen in temporal lobe seizures or could be unrelated.  You have mentioned a normal MRI and EEG years ago, but these do not rule out seizures.  To get a better idea of the nature of the spells, would require catching one of these episodes while having the EEG.  If this is not possible then getting a 2 hour sleep deprived EEG can also be helpful.  Low sodium with trileptal is a common side effect.  Joint/muscle pain with tegretol is a rare side effect and I would recommend a workup to identify other possible causes other that the tegretol.  If you stop the tegretol you should follow a drug level of lamictal to make sure you are therapeutic (have enough in your blood).  If concern for seizures arise after the tegretol is removed then your doctors may consider depakote, which works for seizures and bipolar disorder (however depakote has many side effects as well including increasing the drug levels of lamictal, so this should be done cautiously with professional help).
I hope this has been helpful.

[caregiver222]

The basic problem is to make sure you don't injure yourself or others by a lack of situational awareness during these periods. You have a host of symptoms that should have been reported to the FDA. They have a form on their website. Get a bound book and keep a dily log of your episodes, keeping precise notes on what you are on. You need to find a physician who is really interested in you.

[Buckeye Brickmaker]

I was on Tegretol over 20 years ago to control petit mal seizures and now I'm on Lamictal and Topomax (topamax) and they are controlling the problem very well.  The key thing is to be very careful withdrawing from these meds.  Depending how long you have been on a medication, my experience are that it can take up to six months to get the withdrawl symptoms out of the system.  By the way, although I don't have Bipolar diorder, you might want to consider Topomax (topamax) with the Lamictal.  Both drugs are approved for bipolar and seizure disorder.

[Chaaya]

Actually Topomax (topamax) is what my doctor has suggested I try next. I'm supposed to wait another week until I start it though. I passed out while shopping a couple of weeks ago and one of the bystanders told the paramedics that I had a seizure after I passed out and they wrote in their report that I had a mild seizure. All of my doctors have said that it wasn't a seizure but rather just some twitching which is common when you pass out. Because it was documented as a seizure my doctor thinks that we should document that I don’t have seizures and thinks an EEG should be done after the Carbamazepine, before the Topomax (topamax) and on the Lamictal once a day. Hopefully my most recent partial seizures were just withdrawal seizures from going off of the Triliptal and I won’t have them from going off of the Carbamazepine because my doctor has told me to restrict my driving until after the EEG. My other doctors have already cleared me to drive so I just need a normal EEG. I don’t know what he will say if the EEG isn’t normal since I’ve never had a generalized seizure nor any partial seizures that would affect my driving.