Psychogenic Non-epileptic seizures vs EP

[No Shame]

I will be doing a 3-hour video EEG on Tuesday, and wonder if it will just come back abnormal again with no real identifying spikes. After 5 abnormals, and still no diagnosis, i am considering the alternatives ONCE again. And probably because my last Epileptologist was so wishy-washy and no one has actively observed a seizure (except maybe a simple one on a few occasions), i again feel like i am a crazy person And often i feel removed or disassociated, so i wonder if i have a disassociation disorder, or psychogenic non-epilepetic seizures and figure that's probably why my last doc was pushing me to complete the 5-day video EEG versus the 2-day ambulatory, which i completed and there were pre-seizure events about 1x per hr during sleep, which the docs just blew off because i felt crappy all day--not just during my sleep. My therapist who i have seen regularly for the last 2 years insists i have a neurological disorder, not a mental one. I am soo confused and filled with some sort of self-loathing especially because i can't seem to snap out of it so to speak. So, are my seizures epileptic in origin..that's the real question. EEG's can produce false positives and show up abnormal in soo much of the regular population. And i have symptoms of disassociation disorder, but then again, it could be simple seizures.

I guess my question is really-has anyone else had this discussion with doctors about non-ep. seizures and does the EEG tests really rule this out? Thank you for responding as i try to get well, physically and emotionally.

[Zoe]

I will be doing a 3-hour video EEG on Tuesday, and wonder if it will just come back abnormal again with no real identifying spikes. After 5 abnormals, and still no diagnosis, i am considering the alternatives ONCE again. And probably because my last Epileptologist was so wishy-washy and no one has actively observed a seizure (except maybe a simple one on a few occasions), i again feel like i am a crazy person And often i feel removed or disassociated, so i wonder if i have a disassociation disorder, or psychogenic non-epilepetic seizures and figure that's probably why my last doc was pushing me to complete the 5-day video EEG versus the 2-day ambulatory, which i completed and there were pre-seizure events about 1x per hr during sleep, which the docs just blew off because i felt crappy all day--not just during my sleep. My therapist who i have seen regularly for the last 2 years insists i have a neurological disorder, not a mental one. I am soo confused and filled with some sort of self-loathing especially because i can't seem to snap out of it so to speak. So, are my seizures epileptic in origin..that's the real question. EEG's can produce false positives and show up abnormal in soo much of the regular population. And i have symptoms of disassociation disorder, but then again, it could be simple seizures.

I guess my question is really-has anyone else had this discussion with doctors about non-ep. seizures and does the EEG tests really rule this out? Thank you for responding as i try to get well, physically and emotionally.

I suggest you do more checking around if your neurologist is not helping you. The diagnosis of epilepsy is wrong about as often as it is "right". There are many many causes of seizures ( epileptic and nonepileptic) so you may have a long row to hoe to find what's causing yours.
The EEG can't rule out anything and misreading the EEG is one the most common causes of misdiagnosis. Heart disorders may look like epilepsy on an EEG. These can trigger seizures and seizures can trigger heart spells. Try a google search on "migraines" seizures" "misdiagnosed" and you'll see these too may cause seizures. Many of these other conditions that cause seizures also affect behavior.
If your tests come back as nonepileptic seizures it doesn't mean they're just "mental." Do a lot of reading and searching and trust in your own gut instincts to guide you. Below are a few links for you to explore:

Internal Medicine Medical News about refractory temporal lobe ...Hippocampal sclerosis in refractory temporal lobe epilepsy is associated with gluten sensitivity. Journal of Neurology, Neurosurgery, and Psychiatry ...
http://www.mdlinx.com/internalmdlinx...le.cfm/2628864

http://www.worldcat.org/oclc/56956444
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Misdiagnosis of Epilepsy - WrongDiagnosis.comBasilar artery migraine - BAM is often misdiagnosed as epilepsy; ... Epilepsy misdiagnosed as schizophrenia: The book "Preventing Misdiagnosis of Women" ...

http://www.wrongdiagnosis.com/e/epilepsy/misdiag.htm


Abdominal epilepsy misdiagnosed as psychogenic pain.Abdominal epilepsy misdiagnosed as psychogenic pain. P. D. Singhi and S. Kaur. Department of Pediatrics, Postgraduate Institute of Medical Education and ...
http://www.pubmedcentral.nih.gov/art...?artid=2428499

Cardiac-related symptoms often misdiagnosed as epilepsyBritish researchers performed simple, noninvasive cardiac testing on patients with apparent epilepsy, many of whom were receiving anticonvulsant medication, ...
http://www.theheart.org/article/296309.do

Epilepsy and Intellectual Disabilities - Google Books Resultby Vee P. Prasher, Michael (Michael P.) Kerr ... - 2008 - Medical - 232 pages
Sleep Disorders Misdiagnosed as Epilepsy Several sleep syndromes cause confusion with epilepsy: • Narcolepsy is a disorder of rapid eye movement (REM) sleep ...
books.google.com/books?isbn=1848002580...

The Differential Diagnosis of EpilepsyEpilepsy and Intellectual Disabilities, .... one generation of a family being misdiagnosed as having epilepsy. ...... Zuberi SM, Eunson LH, Spauschus A, et al. (1999) A novel mutation in the human voltage ...
http://www.springerlink.com/index/mh41870755723586.pdf

Hope this helps!

[Bernard]

See also previous discussions about PNES

[No Shame]

I appreciate your feedback and will look at the links you suggested.

[RobinN]

my daughters were diagnosed as psychogenic non-epileptic seizures by one teaching hospital after a 20 min appt. EEGs and a video EEG did not rule out any thing. Thankfully she has a therapist like your that said there was a physical cause and supports me in the quest to find the cause. I have since learned how undetected blood sugar levels can cause seizures and emotional imbalances. In addition to periods of amnesia and hormonal imbalances.

[Zoe]

As you are reading keep in mind that feeling dissociated (one of my major symptoms when I still had seizures) may also have physical causes, such as poor sleep, or hyperventilation.

[No Shame]

I've been tested physically for everything under the sun-diabetes, hypoglycemia, hyperthyroidism, wore the heart holten monitor, vasovagal syncope, stomach problems, vision, sleep disorders...you name it, and its been ruled out. I am frightened that a mental illness lurks behind my symptoms, and since coming to this community, i have found it helpful to consider that aspect as well. I am not currently medicated, yet everything seems surreal, as if i am underwater, and Keppra didnt help, and anti-anxiety meds havent helped. I don't know what to think anymore. So, i will plunge forward into the next EEG, and then talk to my therapist about possible links to past trauma. I have no doubt i am experiencing seizure states--i just don't know why...and that i am sure is a common sentiment shared by many here! Why why why???

Thanks for your input-it helps tremendously!

[lovelygirl]

I too have been tested for everything under the sun it seems, i am going in for an ambulatory eeg for 3 days soon as to try and say whether it is non epileptic or epileptic seizures. I have also been to see a homeopath who says it is a virus in my brain associated with a really bad flu i had five years ago so trying homeopathy on top of taking 25 mg of lamotrigine, which has reduced the number of collapses so less bruises but still lots of detachments with reality and poor memory, no memory of events when they happen. I just want to know what is wrong with me and how to fix it and get back to normal no matter what the diagnosis is

I hope you find out what is wrong with you soon, i know how frustrating not knowing can be!! Best of luck Eleanor

[RobinN]

Fish oil in treatment of psychosis is a hot new research topic.

Many scientists are very impressed by what they’re discovering. And you're going to be excited too.

Medline Plus online encyclopedia defines psychosis as a “loss of contact with reality. This typically includes delusions (false ideas about what’s taking place or who one is) and hallucinations (seeing or hearing things which aren’t there).”

Included in the general definition of psychosis are bipolar disorder, depression, schizophrenia, dementia, hallucinations, extreme excitement, unfounded fears, abnormal emotions, illusions, delusions and confusion.

If some of these descriptions hit home for you, don’t run out for a diagnosis just yet. Remember that psychosis is consistent and often has some chronic expression.

Psychosis can be brought on by illegal or prescription drugs, excess alcohol or anything else that causes the brain to function incorrectly, such as a stroke or Alzheimer’s Disease.

Some people think nutrition has nothing to do with psychosis. But that’s like saying you could live on junk food and still have a long happy healthy life. And we all know that’s not possible.

So, what does the research say?

Recent and on-going scientific studies have found major health benefits with fish oil in treatment of psychosis, including bipolar and depression. Here are just a few of those findings.

Research reported in the Journal of Affective Disorders found that, “Major depressed subjects showed significantly lower total omega 3 polyunsaturated fatty acids…than minor depressed subjects and healthy controls.” (Vol. 26, No. 38, 35-46)

Translation: more dietary fish oil fatty acids equals less depression.

Another study done on subjects with major depressive disorders published in the American Journal of Psychiatry concluded that, “Highly significant benefits of the addition of the omega-3 fatty acid compared with placebo were found by week 3 of treatment.” (Vol. 159:477-479)

Translation: fish oil provides huge health benefits in just 3 weeks.

A study at Harvard University published in the Archives of General Psychiatry found, “Omega 3 fatty acids were well tolerated and improved the short-term course of illness in this preliminary study of patients with bipolar disorder.” (Vol. 56 No. 5)

Translation: Bipolar disorder patients taking fish oil improved.

More research reported in the American Journal of Psychiatry, concluded, “The results of this study suggest that EPA may be a safe and effective form of monotherapy for women with moderately severe borderline personality disorder.” (Vol. 160:167-169)

Translation: Fish oil helps women with severe personality disorder.

Researchers in the psychiatry department at the UK University of Sheffield reported in the Journal of Affective Disorders that, “The findings [of their study] raise the possibility that depressive symptoms may be alleviated by omega 3 PUFA [polyunsaturated fatty acid] supplementation.” (Vol. 48(2-3):149-55)

Translation: Good quality fish oil supplements work for depression.

That's the overview – short, sweet and to the point. This research should make your decision about fish oil treatment of psychosis or even minor depression an easy one.

The fish oil health benefits speak for themselves – naturally.

http://ezinearticles.com/?Fish-Oil-i...osis&id=393536

http://www.doctoryourself.com/hoffer_psychosis.html

http://www.scribd.com/doc/2575198/Fi...ogical-illness

[No Shame]

That raises an excellent question Robin, does our brain chemistry cause physical symptoms (i.e. depression, anxiety, etc) or are we dealing with those mental moods due to our poor health?

Eleanor-I had a 2-day ambulatory EEG which showed some brain wave disturbance only during sleep. Recently, I went to another epileptologist who said i do not have epilepsy. My primary care physician is testing me for Lyme Disease. My friend's 5-year old son had a post-infectious virus that landed him in the hospital for a week--he couldnt walk, talk, and had to relearn how to do simple tasks. But that closely followed his flu/chicken pox or whatever he had contracted in the 1st place (not five years later). Viruses/Bacteria that are known to attack the brain: syphillis, herpes 1 (same that causes cold sores), Lyme Disease, and of course there's meningitis and staph infections. And like 1000 other types, which i am finding i have to narrow it down as the patient, to request select tests. Good luck with the EEG, hopefully it will bring answers.

[Cint]

does our brain chemistry cause physical symptoms (i.e. depression, anxiety, etc) or are we dealing with those mental moods due to our poor health?


.

Psychoneuroendocrine aspects of temporolimbic epilepsy. Part I. Brain, reproductive steroids, and emotions.

Herzog AG.

Harvard Neuroendocrine Unit, Beth Israel Deaconess Medical Center, Department of Neurology, Harvard Medical School, Boston, MA, USA.

The temporolimbic structures of the brain that subserve emotional representation are highly epileptogenic and play an important role in the modulation of hormonal secretion and mediation of hormonal feedback. Estrogen is highly epileptogenic and exerts energizing and antidepressant effects. Excessive estrogen influence produces anxiety, agitation, irritability, and lability. It can promote the development of anxiety manifestations (e.g., panic, phobias, and obsessive-compulsive disorder). Progesterone and its metabolites inhibit kindling and seizure activity. They have potent anxiolytic effects, possibly by virtue of their GABAergic activity. Excessive progesterone influence produces sedation and depression. Testosterone has two major metabolites: estradiol, which can exacerbate seizures, and dihydrotestosterone, which blocks NMDA-type glutamate transmission and may be responsible for antiseizure effects. Testosterone has energizing effects and increases sexual desire in both men and women. In excess, however, it may promote aggressive, impulsive, and hypersexual behavior. Hormonal effects tend to be exaggerated or idiosyncratic in the setting of an abnormal or anomalous temporolimbic substrate, especially temporolimbic epilepsy. This may reflect altered neuronal responsivity to hormonal exposure perhaps by virtue of changes in the number of dendritic spines and receptors.

[lovelygirl]

Ok, well to clear up how the virus may be involved is due to the fact i started collapsing about a month later after i had the flu i didn't really stop for, i had a very specific headache which i can only describe as a cone through my head with the point above my right eye and as it intensified i knew i was going to blackout and i would go pale and faint but unable to get up for about 20 mins and could tell in the morning if i was going to have these episodes, they eventually were diagnosed as vasovagal. fainting and reduced to one or two a month with no medication with the odd few weeks where i was constantly on the floor. In august i just started collapsing no headaches no warning, suffering confusion, poor memory my brain just not up to complex tasks, struggle to do an easy sudoku, was a PhD chemist, also i have crap concentration. The homeopath claims that the virus was causing the old symptoms and is now running riot, but at least i do not get headaches anymore

[RobinN]

Metabolism of estrogens occurs in several areas of the body, however the main ones are liver and gastrointestinal tissues.

Neurofeedback - Rebecca's Story

Lovelygirl-
Virus, I have learned, remain in the body for .... quite some time.
This is being talked about in the ASD community, which include many neurological disorder. I have read that it can migrate to the brain. There is a connection it seems, between heavy metals in the system and the body holding on to viruses. Not sure how or why, but there is a lot of discussion and evidence of this.

[Zoe]

Neurofeedback - Rebecca's Story

Lovelygirl-
Virus, I have learned, remain in the body for .... quite some time.
This is being talked about in the ASD community, which include many neurological disorder. I have read that it can migrate to the brain. There is a connection it seems, between heavy metals in the system and the body holding on to viruses. Not sure how or why, but there is a lot of discussion and evidence of this.

And not just viruses. The same goes for gluten sensitivity that is unrecognized and untreated. Seizures, "epileptic" or otherwise, along with behavioral disorders may represent the damage being done to the brain by the sensitivity to gluten. The study below focuses on the behavioral disorders.
It's one more reason to be skeptical when a doctor says its all in the mind.



Psychosomatics 43:331-334, August 2002
© 2002 The Academy of Psychosomatic Medicine

Case Report
Untreated Celiac Disease and Development of Mental Disorders in Children and Adolescents
The full text of this study is available online:
http://psy.psychiatryonline.org/cgi/.../full/43/4/331

[No Shame]

I work with lead-poisoned children in my community, and believe that our bodies retain heavy metals due to low calcium and Vitamin D, which lead mimics calcium in the body, and is deposited in bones, and can have serious impact on neurological functioning. If your immune system is depressed or not functioning properly, your body will not find its homeostatic balance with viral infections. Sleep and good nutrition, as well as ruling out deficiencies in vitamins can be helpful. Also, there are chemical agents we can take to strip the body of heavy metals, but they are akin to chemotherapy and shouldnt be used without identifying high levels of metal through lab tests. Our kids tolerate it pretty well, but then again, they are sick to begin with and are good little troopers.

[lovelygirl]

Heavy metals may have some presence on my case as i was doing research in chemistry working with most of the metals in the period table with lots of nasty solvents. I shall mention it again to the consultant? what sort of tests would they need to do? I mainly worked with nickel, palladium, platinum, iridium, rhodium and ruthenium as complexes i made myself. That is one of my main worries is i did it to myself whether it was the chemistry or just the stress of the Phd.