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multiple diagnoses

multiple diagnoses

I am a 45 year old female who began to experience symptoms in early winter of 2005 which included spasming, drooping of my left eye and left side of my face.  This was originally believed to Bell's Palsy and then was subsequently diagnosed as Hemifacial spasms.  During the course of the diagnosis process I underwent an MRI and a brain aneurysm was discovered.  The aneurysm was in my right carotid (?) artery and was pressing on my optic nerve and displacing my optic chiasm.  The size was approximately 10 mm.  I underwent a microcoiling and stenting of the aneurysm in fall of 2005.  I was advised that the problems with the left side of my face, which continued intermittently, were not related to the aneurysm.   I recovered well, went on with life and put up with the ongoing facial issues which would come and go, sometimes lasting from a few hours to a few days to a few weeks before subsiding.  Some days my face was good, others bad and I could not detect any pattern, trigger etc... In May 2008 I had a generalized seizure (grand mal) that included loss of consciousness, tongue biting etc... I went to ER by ambulance and a quick CT scan revealed no bleed or aneurysm rupture.  A CT angiogram two days later confirmed that the aneurysm was "well coiled" and while there may have been some residual settling (spacing??) it was stable and not related to my seizure.  I subsequently had an EEG that was definitive for Temporal Lobe Epilepsy on both sides.  At this time my neurologist felt that the facial spasms and eye issues were related to the epilepsy as partial seizures and not Hemifacial spasms.  I have been on Dilantin since May (500 mg) and have not experienced any more major seizures.  I have had partial seizures (I believe) and while not unconscious am aware of my surroundings but unable to respond.  The left side of my face issues continued and Keppra was gradually introduced to gain further control of the facial spasms, with a gradual introduction to 2000 mg.  I also experienced right arm tremors and full body jerking, which was attributed to the epilepsy.  I had a second EEG while I was experiencing facial spasms - the EEG confirmed the epilepsy but did not indicate any more spikes with the facial spasms.  Now the neuro says the facial issues are not related to the Epilepsy - they are hemifacial spasms and recommends botox injection (Dec.)  The Keppra has been reduced to 1000 mg and I do feel better, with less balance issues but it is early still.  There is no correlation between my brain aneurysm, the epilepsy and the facial spasms which is just so confusing for me - I understand (or not) the medical explanations but this seems to be an extreme coincidence of bad health centering around the brain.  Does any of this make sense or am I just going crazy?  Do you have any knowledge of similar diagnoses??
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