simple partials or PNES ? please help

[johnp007]

Hello, i am 45yr old male in a good health (well, sort of). For the last 10 yrs I have been suffering from seizure-like spells. This is how they manifest - out of nowhere (no triggers, usually when I am relaxed), I have a weird sensation in my head - hard to describe so I am not going to try. It takes just a moment, a few seconds at most. People around me do not notice - even if I am in the middle of a conversation. This "attack" is followed by a confusion, memory impairment, and general uneasiness that can last from a couple of hours to a couple of days. The frequency of these spells is about 2/month, it varies though.

I have seen by my estimate 20 doctors - some of them very good - and went through a plethora of tests (MRI, 2xEEG, you name it, i tried it). All tests came back negative. The most common diagnosis has been anxiety and/or some mild depression. I tried many medications from SSRI/SNRI to anticonvulsants (Topamax, Depakote, Lamictal) and have not observe any real improvement. Now, I agree that I have anxiety, I even accept that the cognitive impairment that follows can be caused by anxiety or some mood disorder. I just dont buy that anxiety is responsible for the sudden attacks - they are certainly not panic attacks.

What could those spells be ? If they were simple partial seizures, would I not see any improvements from anticonvulsants ? Or is it more likely I have psychogenic non-epileptic seizures ? If so, how do I treat them ? I recently started seeing a psychologist it's just I don't know what to focus on; I didn't suffer any PTSD or anything like that.

Any advise will be much appreciated. Thank you.

[momof3boys]

I have simple partial seizures. But in march of this year, I had my first video EEG and after doing that, my dr could see off the EEG that I did infact have seizure activity, but wanted me to see a psych dr to see if it was possible I was also having Non Epileptic seizures too. Prior to having my video EEG, I was having complex partial seizures and grand mal seizures. Ive had epilepsy my whole life. I was dx'd with Epilepsy at 18 months old, but was having seizures before, just small ones, that my parents at the time didnt realize were actually seizures, til I had a huge grand mal seizure. But after having the video EEG, my dr could see that I wasnt having the complex partial seizures or the grand mal seizures anymore. He did say I could have grown out of them, over the years, but he wanted to see if what he was seeing on the Video were in fact seizures from epilepsy, even though he could see seizure activity on the EEG too. After taking me off of Carbatrol and keppra, and only putting me back on Keppra, after being released from the hospital from the video EEG, I did go to see a psych dr and after evaluating my history with seizures, and seeing that the Keppra was controlling the seizures, and I wasnt having any seizures since in the hospital (I was taken off all medications during my video EEG) she said if they were infact non-epileptic seizures, the Keppra would not prevent them from coming. Seeing that the Keppra was controlling the seizures, she said that based off my video EEG results, they were infact epileptic seizures that i was having during my video EEG. Its been 7 months since Ive had my video EEG, and Ive had one time where I didnt have alot of sleep and had a seizure during my sleep. But other than that, the Keppra XR has been controlling my seizures very well.

If youre seeing a psych dr, I would focus on how the medications you have tried or are trying for seizures, are helping, try to keep track of when these spells occur, what they feel like, what youre doing at the time, etc. It will give the dr a good idea if its something epilepsy related, or if its coming on due to anxiety, etc.

[Cardones]

Anxiety is hugely powerful. Do not dismiss it as just something doctors say when they can't think of anything else.

These spells could easily be anxiety simply because anxiety makes you hypersensitive to any weird sensation in your body that other people would barely notice or just dismiss as a funny feeling. They become a point of concern for you and so you are constantly scanning for the next occurence so when it occurs it is a much bigger event for you than other people.

If you have had 20 doctors and all the tests tell you the same thing I would listen to what they are telling you. Relax and concentrate on improving your anxiety rather than worrying about neurological disorders!