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Neurology (Expert Forum)
Seizers
Answered by
CCFNeuroMD JT, MD - Neurology/Epilepsy, Neurology/General
Cleveland - OH
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury
Seizers
by sass27, Nov 10, 2007 08:32AM
Just last week November 2007, i had a seizer in my sleep again, besides my first seizer all of them seem to happen when i am sleeping and i don't know at all until i wake up.....but this one was different.....i have notice that i have atleast 3 to 5 headaches a day that are hard to get ride off and i am feeling wired electric zaps is what it seems like shoting all around my head and when i know to be at night i feel alot of presure being releived from my head. I went to see my Neurologist and he would not do any test on me.....what should i do from here? how should i get help?
Doctor's Answer
by CCFNeuroMD JT, MD, Nov 15, 2007 05:46AM
, Nov 15, 2007 05:46AM
To: sass27
Dear sass27~
I am happy to address the questions that you pose, although it is important that you recognize that my impression is based entirely on the information you have provided in your posting and is by no means a substitute for an office visit with a neurologist. Diagnosis is contingent on detailed history and physical exam and as such, the following information should be considered solely for educational purposes.
Foremost, a little bit of history about your seizures- ie. how old you are, what seizures are like, how long they last, their frequency, when they first started, etc. would be key points that would enable me to better address your question. Seizures may occur in the context of a larger neurological problem as well as in isolated epilepsy syndromes. Here's just a little background information: Seizures occur when there is an abnormal synchronization of electrical discharges pf the neurons in the brain. The clinical appearance of the seizure is often reflective of the place in the brain where the seizure is occurring. About 9% of all individuals will experience a single seizure at one point in their life. About 1-3% of the population will have more than one unprovoked seizure and will thus be classified as epileptic. Around 60-70% of epileptics are well-controlled on antiepileptic medications.
As I suggested above, there are a vast number of reasons why people have seizures. Other neurologic problems that may present with seizures include a mass (such as tumor or abscess) within the brain, meningitis/encephalitis, trauma, problems with metabolism, or malformation in the actual brain tissue itself which may have occurred during brain development. The most common adult seizure subtype is classified as a complex partial seizure. These types of seizure generally involve a behavioral arrest with some staring, stereotyped behaviors called automatisms, and a period of confusion following the seizure. At times, the seizure may become "secondarily generalized" thereby leading to a full-blown tonic-clonic seizure. Urinary incontinence and tongue biting may occur as well. Some of the more common automatisms include lip-smacking, hand movements, and tongue-thrusting. Patients may or may not describe an aura, ie. some sort of characteristic feeling that they are about to have a seizure. Some common auras include an unsettling rising feeling in the stomach, tingling in a part of the body, visual changes, or ringing in the ears.
One important note is that other diagnoses can be mistaken as seizure. Believe it or not, stress can cause symptoms that are difficult to differentiate from seizures and migraine headaches can also cause similar features. Given that you have these "electrical zap" headaches, I think that it would be most important for you to see a neurologist who can better determine through a n exam and thorough history what these headaches are. At that time, the neurologist may choose to obtain an MRI to make sure there is no structural reason for your symptoms. In addition, an EEG can be done to evaluate the spells you are experiencing in the nighttime. Because your nocturnal seizures, a sleep-deprived EEG or admission to an epilepsy monitoring unit may be helpful in clinching the diagnosis. At any rate, I urge you to see a neurologist- either a headache specialist or epileptologist would be ideal, although I think a general neurologist is a good place to start. Thank you very much for your question, and best of luck.
I am happy to address the questions that you pose, although it is important that you recognize that my impression is based entirely on the information you have provided in your posting and is by no means a substitute for an office visit with a neurologist. Diagnosis is contingent on detailed history and physical exam and as such, the following information should be considered solely for educational purposes.
Foremost, a little bit of history about your seizures- ie. how old you are, what seizures are like, how long they last, their frequency, when they first started, etc. would be key points that would enable me to better address your question. Seizures may occur in the context of a larger neurological problem as well as in isolated epilepsy syndromes. Here's just a little background information: Seizures occur when there is an abnormal synchronization of electrical discharges pf the neurons in the brain. The clinical appearance of the seizure is often reflective of the place in the brain where the seizure is occurring. About 9% of all individuals will experience a single seizure at one point in their life. About 1-3% of the population will have more than one unprovoked seizure and will thus be classified as epileptic. Around 60-70% of epileptics are well-controlled on antiepileptic medications.
As I suggested above, there are a vast number of reasons why people have seizures. Other neurologic problems that may present with seizures include a mass (such as tumor or abscess) within the brain, meningitis/encephalitis, trauma, problems with metabolism, or malformation in the actual brain tissue itself which may have occurred during brain development. The most common adult seizure subtype is classified as a complex partial seizure. These types of seizure generally involve a behavioral arrest with some staring, stereotyped behaviors called automatisms, and a period of confusion following the seizure. At times, the seizure may become "secondarily generalized" thereby leading to a full-blown tonic-clonic seizure. Urinary incontinence and tongue biting may occur as well. Some of the more common automatisms include lip-smacking, hand movements, and tongue-thrusting. Patients may or may not describe an aura, ie. some sort of characteristic feeling that they are about to have a seizure. Some common auras include an unsettling rising feeling in the stomach, tingling in a part of the body, visual changes, or ringing in the ears.
One important note is that other diagnoses can be mistaken as seizure. Believe it or not, stress can cause symptoms that are difficult to differentiate from seizures and migraine headaches can also cause similar features. Given that you have these "electrical zap" headaches, I think that it would be most important for you to see a neurologist who can better determine through a n exam and thorough history what these headaches are. At that time, the neurologist may choose to obtain an MRI to make sure there is no structural reason for your symptoms. In addition, an EEG can be done to evaluate the spells you are experiencing in the nighttime. Because your nocturnal seizures, a sleep-deprived EEG or admission to an epilepsy monitoring unit may be helpful in clinching the diagnosis. At any rate, I urge you to see a neurologist- either a headache specialist or epileptologist would be ideal, although I think a general neurologist is a good place to start. Thank you very much for your question, and best of luck.
To make a long story short, we ended up going through a lot of test with several neurologist. He was diagnosed with Narcolepsy. The docs were able to put him on medication to help with the problem, but it did not resolve the problem totally. I think he is about to go through a medicine change again because the meds are no longer therapeutic.
I hope someone answers you soon. I'm not a doctor but I encourage you to find one (a neurologist) that will listen. You may have to make a number of phone calls and tell them your symptoms before you go in. Tell them you want test. Over the years the doctors did several sleep studies and have conduct several MRI's and completed numerous blood test. He's monitored consistently.