temporal lobe epilepsy

Okay so my complaints have long surrounded feeling derealization from mild to severe 24/7 all the time.....it's hard to describe but it more or less feels like I'm going around **literally** like I'm breathing nitrous oxide gas from the dentist 24/7.     I have other symptoms that usually show up when my symptoms are at their worse,  such as a peculiar numb-ish sensation in my nose/mouth area,  heavy "jello" arms and legs, as well as urinating over and over and over followed by a relief of the severest symptoms.    

So my psychiatrist that I've been seeing a year or so says I'm an "unusual specimen" and I guess I am but he says to me I think you could have TLE temporal lobe epilepsy and is giving me Tegretol,  which I'm not tolerating well at 200 mg.    The odd thing is, I had an EEG done and brain MRI done a couple years ago and it showed up as normal even though I was experiencing my chronic symptoms during the EEG.    Could this still be TLE even though it's a 24/7 thing?    Your thoughts otherwise about what is wrong with me ??  Thanks.  I'm a 32 yr old male.

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

It would be quite odd to have your symptoms 24/7 and be epilepsy of this sort. It would be recommended that you follow up with a neurologist who specializes in epilepsy. You may benefit from a prolonged EEG (24 hours or greater). A short EEG may miss epileptiform abnormalities particularly if your symptoms are not present or typical during the recording. It is most likely that you are having symptoms from your underlying psychiatric disorder. For example, anxiety is a psychological and physiological condition that can present in various ways. They include heart palpitations, muscle tension, fatigue, nausea, chest pain, sensory changes in the extremities/face/etc, shortness of breath, headaches, and GI symptoms such as diarrhea to name a few. Anxiety can also be accompanied with panic attacks such as a feeling of impending doom or death.

Regarding the tegretol, there are other medications that are available if you are truly not tolerating the medicine. You should discuss this with your psychiatrist.

You should continue discussing your symptoms with your psychiatrist. You may also benefit from a referral to a neurologist.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.