does this sound like seizure?

[MikeEMT609]

Hello, Let me begin by giving you Hx of my stepson. He is 16, diagnosed with mild-moderate MR several years ago.
Meds taken are Seraquel, Abilify, Depakote and Zoloft. No Allergies.
Several years ago he started having what his mother and doctors have called 'episodes' where he becomes agitated, combative, yelling, cussing, spitting, trys to hurt himself biting and hitting his head on wall or slapping his face. He usually has to be restrained for his own safety. The 'episode' usually lasts 45 minutes to an hour.
Once the 'episode' ends he starts crying and apologizing for what happened. He then usually falls asleep for a while. I am an EMT, so I strongly believe we are dealing with some sort of seizure activity, and here is why I say this...during the 'episode' he does not respond to ANYTHING you say to him, he justs does what I listed above.
Then when the 'episode' ends he gets very confused sometimes (can we say POST ICHTAL?) for up to an hour.
This happened at a doctors office on Monday, My stepson was fine when we walked in the waiting room, then slowly became agitated and wen't into another major episode in front of the doctor. They say it's behavioral issues and something called IED...and NOT seizure activity.
Another thing I want to add is that a few times in the past he would come in the room and say 'I'm going to get a knife and kill you, my mom, the dogs and myself", then proceed to go to the kitchen and come back with a knife.
Thankfully my stepson is not very strong and fast so I was able to disarm him with no problem.
We tell the doctors everything I have listed here, and the only answer we get is either 'see another doctor' or keep him on his meds and watch him. If the episodes continue we'll up the meds.
If anyone can offer suggestions on what we're dealing with we would appreciate it.

[MikeEMT609]

Thanks for the information. FYI we have been to SEVERAL doctors about this problems, and basically we're getting the runaround. For example, my stepson has a major 'episode' during which he made threats to kill himself, my wife, myself and the dogs. I make a call to the doctor, he was unavailable so we were told 'if you're concerned take him to the ER...and that was a big waste of time. Based on our statement to the triage RN we were brought back to a room, and security was stationed outside the door, which is done when they have a psych patient in the room.
ER doctor comes in, asks questions, says hello to my stepson and says I'm going to order blood work. Then about a hour or two later the doctor comes back and says 'labs normal, I'm referring you to neurology" and we're sent home. NO PSYCH CONSULT?
Several days later we go to the neurologist and he basically says 'not a seizure' and refers us back to the psychitrist .

This brings us to about two weeks ago, we're both (wife and myself) are at work, and I get a phone call from neighbor...Stepson had another episode described as 'facial expresion changed, eyes rolled back and he became violent, threatened to break windows and a fence on their property.
I'm not sure of the duration of the event, but after it ended my neighbor walked my stepson home...and his mom called and told him to take his meds..he was VERY confused for about an hour after the initial episode. After the neighbor helped him with his meds he fell asleep. I called the pscyhitrist and told him was happened and he said "THAT SOUNDS LIKE SEIZURE ACTIVITY", then refers us to another neurologist where the last episode happened in front of the doctor...and he basically said the same thing as the others...'doesn't look like a seizure'.
We did have an EEG done that day...after the episode was over and my stepson was back to normal.
People have suggested trying to get an EEG when he has an episode, but that's impossible as you can't predict when one will happen. He sometimes goes months without having an episode, then he'll have them several times a week.
As for the history and phyisical, I gave you all the information I have on him.
I can tell you he's highly functional and is able to stay home for several hours by himself, is able to prepare his own meals and do his laundry...but when it comes to simple things he claims to need help "clean my glasses" or "fix my watch band (he moves the part that holds the strap down toward the watch, and expects me to fix it)" even though he knows how to do both things. That's not related to episodes, just little things he does. Is this OCD, is he stuck, I don't know

[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 from you and your stepson, 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 is difficult to say if these are seizures or not. It would be recommended that your stepson be evaluated by a pediatric neurologist. He may be a candidate for a prolonged video EEG. It would be very helpful to capture one of these events on video as well as EEG and see there is any seizure activity. Also, the time between the events would be helpful as well for any interictal (between seizure) activity. These may be related to seizures, but they may also be behavioral.

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