neurological basis for depersonalization and derealization

[Rob2008]

how can you tell if longstanding, chronic depersonalization and derealization has an actual neurological basis, when a brain MRI and routine blood tests have already proven normal?    I have read that occipital-temporal dysfunction, for example...can be the culprit

[Neuro Forum]

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 your doctor.

Depersonalization and derealization are terms used to describe a state of detachment from reality and a sensation that the surrounding world is somehow not real or that the person experiencing these symptoms is not connected to it.

These terms are predominantly used in the description of states related to psychiatric/psychological disorders. Several theories exist as to the nature of these states. The majority revolve around a theory that there is dysfunction in certain areas of the brain or connections between brain areas, such as the limbic system, temporal lobes, and other brain areas. A dysfunction in these areas would not (and in fact usually does not) appear on MRI or other tests, because it is a problem with nerve transmission (a chemical problem) or connectivity rather than a structural problem large. Some functional imaging studies, which can test brain activiation, blood flow, or metabolism may show abnormalities, but these are most often done in the research setting and are not routinely available.

There is not definitive medical treatment for depersonalization and derealization however antidepressants such as SSRIs (prozac, lexapro, celexa, paxil, zoloft etc) and benzodiazepines (used for anxiety, such as valium, klonopin, ativan) have been used with some success in some patients. Counseling by a psychologist may also be helpful in some cases.

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

[Satori1952]

I have partial seizures and experienced what you are talking about. My seizure activity is in the left temporal lobe. I am on 900 mg of Trileptal a day and now seldom have these spells. Have you had an EKG to see if you may have seizure activity? My MRI and routine blood tests were also normal. It was also found that I have severe central sleep apnea, which made the seizures worse. A CPAP helped with this problem.
Sherry

[Rob2008]

also is there a medication that you know of that has proven helpful