Nova
12-08-05, 01:44 PM
I originally posted this information in the Bipolar medication section, pertaining to the use of the med Topamax, which is now, prescribed for those with Bipo.
It is also used for curbing epileptic seizures.
I have Bipo II w/comorbid ADHD.
I also have temporal lobe epilepsy.
Most of us, on this forum, are quite comfortable and familiar with having Bipo, and ADD/HD.
Very few of us understand epilipsy, let alone the differences between the various forms, it comes in.
I would hope the moderators would place this information in an area, where both the public, and other members, would have easy access to it (0:
After going through a cra*load of various 'brain' tests, the last few days, on top of the past MRIs I have been going through, during the last few months, needless to say...I am drained and a little depressed...not at the results...but just drained from the processes themselves and the continuous 'upping' of my med.
Like my Doc tells me "It's still the same med- don't think about how it's 'upped', just think about it as if you are taking THE med. Period"
300 mgs to now 400 mgs....
The Topomax is for my seizures, and it is also for my Bipo II.
In my case, they are joined like siamese twins attached at the brain.
My brain.
One swoop-in one pill form, 4 times a day, in my case.
Like everything else- I understand how humans can be predisposed to categorizing everything into one 'lump', until it personally affects them..
So I'm including this information because this personally affects me (0: - and now you, also, have the info.
Nova
Temporal Lobe Epilepsy<O:p</O:p
What is it like?
"I get the strangest feeling—most of it can't be put into words. The whole world suddenly seems more real at first. It's as though everything becomes crystal clear. Then I feel as if I'm here but not here, kind of like being in a dream. It's as if I've lived through this exact moment many times before. I hear what people say, but they don't make sense. I know not to talk during the episode, since I just say foolish things. Sometimes I think I'm talking but later people tell me that I didn't say anything. The whole thing lasts a minute or two."
The features of seizures beginning in the temporal lobe can be extremely varied, but certain patterns are common. There may be a mixture of different feelings, emotions, thoughts, and experiences, which may be familiar or completely foreign. In some cases, a series of old memories resurfaces. In others, the person may feel as if everything—including home and family—appears strange. Hallucinations of voices, music, people, smells, or tastes may occur. These features are called “auras” “sensations” or “warnings.” They may last for just a few seconds, or may continue as long as a minute or two.
Experiences during temporal lobe seizures vary in intensity and quality. Sometimes the seizures are so mild that the person barely notices. In other cases, the person may be consumed with fright, intellectual fascination, or even pleasure.
The experiences and sensations that accompany these seizures are often impossible to describe, even for the most eloquent adult. And of course it is even more difficult to get an accurate picture of what children are feeling.
Who gets it?
The two temporal lobes (one on each side of the brain at about the level of the ears) are the most common location for the origin of partial seizures, which start in one localized area, also called a seizure focus. The seizures of temporal lobe epilepsy (TLE) can start at almost any age. Some follow a head injury or an infection that affects the brain, such as menintitis. The cause of others is unknown.
Tell me more
The most common type of seizure in temporal lobe epilepsy is complex partial seizures. Children with TLE most commonly pause in whatever they're doing and do not respond if spoken to. About 40% to 80% of people with TLE also perform repetitive, automatic movements (called automatisms), such as rubbing the hands together.
Three-quarters of people with TLE also have simple partial seizures, in which they remain fully conscious.
Unfortunately, in about 60% of people with TLE, the seizures spread from the temporal lobe to a wider portion of the brain. This process is called secondary generalization. The result is a convulsive grand mal seizure.
After the complex partial seizure or secondarily generalized seizure has ended, patents are often confused for several minutes and then gradually recover.
Temporal lobe seizures usually begin in the deeper portions of the brain's temporal lobe. This area is part of the limbic system, which controls emotions and memory. Some individuals with temporal lobe epilepsy may have problems with memory, especially if seizures have occurred for more than 5 years, but these memory problems are almost never severe.
How is it treated?
For most people, the seizures of TLE can be completely or at least mostly controlled with the medications for partial seizures. Many seizure medicines can be used, either alone or in combination. The choice for adults depends on not only the type of seizure but also on other factors such as whether the person has other disorders or is taking medication for other conditions.
The choice of medicines to treat TLE in young children is much more limited if only the ones approved for children by the U.S. Food and Drug Administration (FDA) are considered. Only Tegretol (carbamazepine) and Dilantin (phenytoin) are approved to be used alone for very young children with partial seizures.
Trileptal (oxcarbazepine) is also approved for children over 4 and Depakote and other valproate medicines are approved for those over 10. Outside the United States, Frisium (clobazam) is used for children over 3 years of age.
The seizure medicines approved by the FDA to be used as add-ons with one of the medications just mentioned are
·Topamax (topiramate)
·Keppra (levetiracetam)
·Neurontin (gabapentin)
·Lamictal (lamotrigine)
·Zonegran (zonisamide)
·Gabitril (tiagabine)
·phenobarbital
If various seizure medicines have been tried adequately without success, then other treatments may be used. Some people with temporal lobe seizures are candidates for surgery. The operation (called a temporal lobectomy) usually removes only the abnormal part of the temporal lobe, not the entire lobe. Many also benefit from vagus nerve stimulation or the ketogenic diet.
What's the outlook?
The outlook for people with TLE varies greatly, depending on the cause of the seizures. About half of children with TLE outgrow the disorder. Other people, for whom various seizure medicines are unsuccessful, may be evaluated for surgery or other treatments. Many achieve good or complete control of their seizures.
Temporal lobe epilepsy (TLE), now more commonly called complex partial seizure disorder so as to include seizures that originate in the frontal foci, straddles the borderland between psychiatry and neurology. Since the condition may involve gross disorders of thought and emotion, patients with temporal lobe epilepsy frequently come to the attention of psychiatrists. But since symptoms may occur in the absence of generalized grand mal seizures, physicians may often fail to recognize the epileptic origin of the disorder. Indeed, misdiagnosis and failures of diagnosis are common in TLE. Fortunately, the illness is marked by certain "signature" symptoms that can aid in its identification.
<O:p
John Hughlings Jackson observed in the late 1800s that seizures originating in the temporal lobes often result in a "dreamy state" involving vivid memory-like perceptions, sometimes accompanied by déjà vu or jamais vu (interpreting frequently encountered people, places or events as unfamiliar). Jackson wrote of "highly elaborated dream-like states, sometimes called intellectual aura," involving "dreams mixing up with present thoughts," a "double consciousness" and a "feeling of being somewhere else." While the "dreamy state" can occur in isolation, it is often accompanied by fear and a peculiar form of abdominal discomfort associated with loss of contact with surroundings.
<O:p
A person with temporal lobe epilepsy often feels compelled to stare for brief moments at a coffee table in her living room since, as she put it, "It just doesn't look exactly like my coffee table." After a few seconds, the feeling disappears. At no time does she think that the table has actually changed; the only thing that varies is her perception and "interpretation" of it.
The following are the four most common perceptions that occur with TLE:
Auditory illusions accompanied by the perception that sounds were louder or clearer, fainter or more distinct, nearer or farther away;
Visual illusions where things seemed clearer or blurred, nearer or farther away, larger or smaller; fatter or thinner;
Illusions of recognition where present experience seemed familiar, strange, altered or unreal; and
Illusions of emotion consisting of feelings of fear, loneliness, sorrow or disgust.
None of these groups of symptoms are unique to epilepsy. Migraine sufferers regularly experience illusions of sound, sight, taste and smell.
The most commonly encountered illusions of interpretation are those of emotion. Typically, these are sudden in onset and unrelated to conscious experiences or anything in the environment.<O:p></O:p>
Since the feelings can arise de novo without any identifiable precipitant, an incorrect diagnosis of an acute panic attack may be entertained. Almost always, however, the patient will describe additional experiences that will help in the differential diagnosis.
Controversy continues as to the validity of a so-called temporal lobe personality. Certainly, many of the patients tend to be obsessive and over-inclusive in their thinking, often satisfying some or all of the requirements for obsessive-compulsive personality: hyperphogia may be seen in some patients. Their speech and thinking is "viscous" and ponderous with a tendency toward loquacity and the insistence on the elaboration of fine and often tedious distinctions. Outbursts of irritability, are hallmarks of TLE. Other rare presentations include anorexia nervosa (Signer and Benson 1990).
Also ask about generalized seizures, head injuries, concussions, temper tantrums.
Do others complain that the patient often doesn't seem to be listening, appears to be daydreaming or otherwise preoccupied? <O:p</O:p
Often the patients are aware of their lapses, and almost all of them experience some form of memory disturbance, even if nothing more than a vague inability to grasp things with sufficient precision.
In addition to the history, the diagnosis of complex partial seizure disorder can be aided by EEG.
Other diagnostic aids include Magnetic Resonance Imaging (MRI)
Single Photon Emission Computed Tomography (SPECT)
Positron Emission Tomography (PET).
Interictal SPECT of cerebral blood flow is not nearly as helpful as ictal SPECT.
Even more sensitive, although not generally available, is PET imaging of interictal cerebral metabolism.
PET permits greater spatial resolution and versatility.
Only MRI can image the structural changes associated with the underlying epileptic process.
It is also used for curbing epileptic seizures.
I have Bipo II w/comorbid ADHD.
I also have temporal lobe epilepsy.
Most of us, on this forum, are quite comfortable and familiar with having Bipo, and ADD/HD.
Very few of us understand epilipsy, let alone the differences between the various forms, it comes in.
I would hope the moderators would place this information in an area, where both the public, and other members, would have easy access to it (0:
After going through a cra*load of various 'brain' tests, the last few days, on top of the past MRIs I have been going through, during the last few months, needless to say...I am drained and a little depressed...not at the results...but just drained from the processes themselves and the continuous 'upping' of my med.
Like my Doc tells me "It's still the same med- don't think about how it's 'upped', just think about it as if you are taking THE med. Period"
300 mgs to now 400 mgs....
The Topomax is for my seizures, and it is also for my Bipo II.
In my case, they are joined like siamese twins attached at the brain.
My brain.
One swoop-in one pill form, 4 times a day, in my case.
Like everything else- I understand how humans can be predisposed to categorizing everything into one 'lump', until it personally affects them..
So I'm including this information because this personally affects me (0: - and now you, also, have the info.
Nova
Temporal Lobe Epilepsy<O:p</O:p
What is it like?
"I get the strangest feeling—most of it can't be put into words. The whole world suddenly seems more real at first. It's as though everything becomes crystal clear. Then I feel as if I'm here but not here, kind of like being in a dream. It's as if I've lived through this exact moment many times before. I hear what people say, but they don't make sense. I know not to talk during the episode, since I just say foolish things. Sometimes I think I'm talking but later people tell me that I didn't say anything. The whole thing lasts a minute or two."
The features of seizures beginning in the temporal lobe can be extremely varied, but certain patterns are common. There may be a mixture of different feelings, emotions, thoughts, and experiences, which may be familiar or completely foreign. In some cases, a series of old memories resurfaces. In others, the person may feel as if everything—including home and family—appears strange. Hallucinations of voices, music, people, smells, or tastes may occur. These features are called “auras” “sensations” or “warnings.” They may last for just a few seconds, or may continue as long as a minute or two.
Experiences during temporal lobe seizures vary in intensity and quality. Sometimes the seizures are so mild that the person barely notices. In other cases, the person may be consumed with fright, intellectual fascination, or even pleasure.
The experiences and sensations that accompany these seizures are often impossible to describe, even for the most eloquent adult. And of course it is even more difficult to get an accurate picture of what children are feeling.
Who gets it?
The two temporal lobes (one on each side of the brain at about the level of the ears) are the most common location for the origin of partial seizures, which start in one localized area, also called a seizure focus. The seizures of temporal lobe epilepsy (TLE) can start at almost any age. Some follow a head injury or an infection that affects the brain, such as menintitis. The cause of others is unknown.
Tell me more
The most common type of seizure in temporal lobe epilepsy is complex partial seizures. Children with TLE most commonly pause in whatever they're doing and do not respond if spoken to. About 40% to 80% of people with TLE also perform repetitive, automatic movements (called automatisms), such as rubbing the hands together.
Three-quarters of people with TLE also have simple partial seizures, in which they remain fully conscious.
Unfortunately, in about 60% of people with TLE, the seizures spread from the temporal lobe to a wider portion of the brain. This process is called secondary generalization. The result is a convulsive grand mal seizure.
After the complex partial seizure or secondarily generalized seizure has ended, patents are often confused for several minutes and then gradually recover.
Temporal lobe seizures usually begin in the deeper portions of the brain's temporal lobe. This area is part of the limbic system, which controls emotions and memory. Some individuals with temporal lobe epilepsy may have problems with memory, especially if seizures have occurred for more than 5 years, but these memory problems are almost never severe.
How is it treated?
For most people, the seizures of TLE can be completely or at least mostly controlled with the medications for partial seizures. Many seizure medicines can be used, either alone or in combination. The choice for adults depends on not only the type of seizure but also on other factors such as whether the person has other disorders or is taking medication for other conditions.
The choice of medicines to treat TLE in young children is much more limited if only the ones approved for children by the U.S. Food and Drug Administration (FDA) are considered. Only Tegretol (carbamazepine) and Dilantin (phenytoin) are approved to be used alone for very young children with partial seizures.
Trileptal (oxcarbazepine) is also approved for children over 4 and Depakote and other valproate medicines are approved for those over 10. Outside the United States, Frisium (clobazam) is used for children over 3 years of age.
The seizure medicines approved by the FDA to be used as add-ons with one of the medications just mentioned are
·Topamax (topiramate)
·Keppra (levetiracetam)
·Neurontin (gabapentin)
·Lamictal (lamotrigine)
·Zonegran (zonisamide)
·Gabitril (tiagabine)
·phenobarbital
If various seizure medicines have been tried adequately without success, then other treatments may be used. Some people with temporal lobe seizures are candidates for surgery. The operation (called a temporal lobectomy) usually removes only the abnormal part of the temporal lobe, not the entire lobe. Many also benefit from vagus nerve stimulation or the ketogenic diet.
What's the outlook?
The outlook for people with TLE varies greatly, depending on the cause of the seizures. About half of children with TLE outgrow the disorder. Other people, for whom various seizure medicines are unsuccessful, may be evaluated for surgery or other treatments. Many achieve good or complete control of their seizures.
Temporal lobe epilepsy (TLE), now more commonly called complex partial seizure disorder so as to include seizures that originate in the frontal foci, straddles the borderland between psychiatry and neurology. Since the condition may involve gross disorders of thought and emotion, patients with temporal lobe epilepsy frequently come to the attention of psychiatrists. But since symptoms may occur in the absence of generalized grand mal seizures, physicians may often fail to recognize the epileptic origin of the disorder. Indeed, misdiagnosis and failures of diagnosis are common in TLE. Fortunately, the illness is marked by certain "signature" symptoms that can aid in its identification.
<O:p
John Hughlings Jackson observed in the late 1800s that seizures originating in the temporal lobes often result in a "dreamy state" involving vivid memory-like perceptions, sometimes accompanied by déjà vu or jamais vu (interpreting frequently encountered people, places or events as unfamiliar). Jackson wrote of "highly elaborated dream-like states, sometimes called intellectual aura," involving "dreams mixing up with present thoughts," a "double consciousness" and a "feeling of being somewhere else." While the "dreamy state" can occur in isolation, it is often accompanied by fear and a peculiar form of abdominal discomfort associated with loss of contact with surroundings.
<O:p
A person with temporal lobe epilepsy often feels compelled to stare for brief moments at a coffee table in her living room since, as she put it, "It just doesn't look exactly like my coffee table." After a few seconds, the feeling disappears. At no time does she think that the table has actually changed; the only thing that varies is her perception and "interpretation" of it.
The following are the four most common perceptions that occur with TLE:
Auditory illusions accompanied by the perception that sounds were louder or clearer, fainter or more distinct, nearer or farther away;
Visual illusions where things seemed clearer or blurred, nearer or farther away, larger or smaller; fatter or thinner;
Illusions of recognition where present experience seemed familiar, strange, altered or unreal; and
Illusions of emotion consisting of feelings of fear, loneliness, sorrow or disgust.
None of these groups of symptoms are unique to epilepsy. Migraine sufferers regularly experience illusions of sound, sight, taste and smell.
The most commonly encountered illusions of interpretation are those of emotion. Typically, these are sudden in onset and unrelated to conscious experiences or anything in the environment.<O:p></O:p>
Since the feelings can arise de novo without any identifiable precipitant, an incorrect diagnosis of an acute panic attack may be entertained. Almost always, however, the patient will describe additional experiences that will help in the differential diagnosis.
Controversy continues as to the validity of a so-called temporal lobe personality. Certainly, many of the patients tend to be obsessive and over-inclusive in their thinking, often satisfying some or all of the requirements for obsessive-compulsive personality: hyperphogia may be seen in some patients. Their speech and thinking is "viscous" and ponderous with a tendency toward loquacity and the insistence on the elaboration of fine and often tedious distinctions. Outbursts of irritability, are hallmarks of TLE. Other rare presentations include anorexia nervosa (Signer and Benson 1990).
Also ask about generalized seizures, head injuries, concussions, temper tantrums.
Do others complain that the patient often doesn't seem to be listening, appears to be daydreaming or otherwise preoccupied? <O:p</O:p
Often the patients are aware of their lapses, and almost all of them experience some form of memory disturbance, even if nothing more than a vague inability to grasp things with sufficient precision.
In addition to the history, the diagnosis of complex partial seizure disorder can be aided by EEG.
Other diagnostic aids include Magnetic Resonance Imaging (MRI)
Single Photon Emission Computed Tomography (SPECT)
Positron Emission Tomography (PET).
Interictal SPECT of cerebral blood flow is not nearly as helpful as ictal SPECT.
Even more sensitive, although not generally available, is PET imaging of interictal cerebral metabolism.
PET permits greater spatial resolution and versatility.
Only MRI can image the structural changes associated with the underlying epileptic process.