Bipolar I and Epilepsy

[Carol11]

I've been diagnosed with Bipolar I/psychotic features for a number of years. Thankfully, I've also been stable on meds for a number of years as well. A few weeks ago, for lack of a better descriptor, my brain seems to have exploded, and I was diagnosed with Photosensitive Occipital Lobe Epilepsy. I have complex partial seizures. My eyes flutter, I freeze in place, can not speak, my face twitches and my eyebrows do some crazy things. I am fully conscious during these seizures but am unable to respond to my environment. They last 30 seconds to a minute and generally cluster. I have literally had hundreds in one day.
I have been photosensitive ever since I had meningitis 9 years ago. I was definitely bipolar before the meningitis but managed to coast along unmedicated. Less than a year after meningitis, I ended up hospitalized in the psych ward.
I had some possible seizure like events over the years but they were minor and very infrequent so I never worried about them. Then everything went haywire in mid-July. I am still trying to mentally come to terms with having epilepsy. I felt like bipolar I was enough to deal with. Now this. Just curious if anyone else suffered from both conditions.
Additionally, I have ADHD, restless legs syndrome, a near permanent migraine, and Celiac's disease.
Also- has anyone else had meningitis? Did they find themselves with major neurological problems afterwards or did it exacerbate existing ones?
I had fungal meningitis. I lived in a top floor apartment with a horribly leaking roof that was infested with mold.

 

[Cint]

I felt like bipolar I was enough to deal with. Now this. Just curious if anyone else suffered from both conditions.

Welcome Carol,

I suffer from temporal lobe epilepsy and have had CP and TC seizures. Tried nearly every med that was available and had surgery. It was after brain surgery that I plummeted into a deep, deep depression and ever since have terrible mood swings. One dr. did say I'm bi-polar. But the thing is, mood swings DO co-exist with TLE.

Additionally, I have ADHD, restless legs syndrome, a near permanent migraine, and Celiac's disease.

Several others here on CWE have Celiac's disease. I do get migraines.

Also- has anyone else had meningitis? Did they find themselves with major neurological problems afterwards or did it exacerbate existing ones?
I had fungal meningitis. I lived in a top floor apartment with a horribly leaking roof that was infested with mold.

I never had meningitis, encephalitis or suffered a head injury before my seizures began. But others here on CWE have. Maybe they will chime in and answer your questions.

 

[masterjen]

Hi, Carol and welcome to CWE!

I don't share all of your issues, but I do have celiac, seizures and migraines along with a few other neurological issues as well such as dystonia (can be misdiagnosed by non-neurologists in some cases as restless leg syndrome).

How long ago were you diagnosed with celiac? How are you doing on the GF diet?

Looking forward to seeing you around the forums!

 

[resaebiunne]

Just curious if anyone else suffered from both conditions.

I was diagnosed with epilepsy when I was 12 years old (so about 18 years ago). Just over a year ago I wound up in the emergency room because I was having hallucinations. I was never diagnosed with bipolar, per say, but the ER psychiatrist believed that my hallucinations were closer to bipolar feature than schizophrenia. My regular psychiatrist diagnosed me with psychotic disorder NOS and I've been on an antipsychotic medication ever since.

Typically I have a focal seizure where my head just shakes for a second and that's that. Then, very recently, after I moved from Austin to St. Pete, FL, I started having generalized, tonic-clonic seizures and wound up in the hospital. After my most recent and severe generalized seizure, I would have to say I was definitely psychotic following the event. While I was in the hospital getting fixed up (I broke my shoulder among other things), they put me on Abilify in addition to my existing medication (Saphris), and started me on Keppra since I was not on any anti-seizure medication. It's hard to say whether the psychosis was from the seizure or was part of my psychotic disorder acting up, but the result was the same, very severe hallucinations. Up until that point, I have never had visual hallucinations of that magnitude.

I was just reading a medical paper the other day about schizophrenia and epilepsy, and apparently there is some correlation between the two disorders. Antipsychotic medications are well known for lowering the seizure threshold of the brain and so when combined with epilepsy, can make for quite a complicated treatment profile.

I have never had encephalitis or meningitis. I also can't say I've had any severe head injuries other than falling off my bike when I was younger and requiring stiches just above my eye brow. This accident would've been a few years before I was diagnosed with epilepsy.

 

[Cint]

I was diagnosed with epilepsy when I was 12 years old (so about 18 years ago). Just over a year ago I wound up in the emergency room because I was having hallucinations. I was never diagnosed with bipolar, per say, but the ER psychiatrist believed that my hallucinations were closer to bipolar feature than schizophrenia. My regular psychiatrist diagnosed me with psychotic disorder NOS and I've been on an antipsychotic medication ever since.

I would be VERY careful of the anti-psychotic drugs. I was also diagnosed with Bi-polar disorder and put on an anti-psychotic drug, but it brought on Type 1 Diabetes. The thing I want to point out desperately to those who suffer from Temporal Lobe Epilepsy, especially, is that we often times due suffer from hallucinations because of the seizures/epilepsy, not from a schizo/bi-polar issue. My neuropsychiatrist said eventually that I suffer from Interictal Dysphoric Disorder. That is why I wish there were more neuropsychiatrists around for folks like us. Fortunately, before I moved and developed diabetes, I was seeing a neuropsychiatrist. Look here for more info on E and hallucinations:

http://www.epilepsy.com/learn/impac...and-behavior-101/mood-and-personality-changes

Typically I have a focal seizure where my head just shakes for a second and that's that. Then, very recently, after I moved from Austin to St. Pete, FL, I started having generalized, tonic-clonic seizures and wound up in the hospital. After my most recent and severe generalized seizure, I would have to say I was definitely psychotic following the event. While I was in the hospital getting fixed up (I broke my shoulder among other things), they put me on Abilify in addition to my existing medication (Saphris), and started me on Keppra since I was not on any anti-seizure medication. It's hard to say whether the psychosis was from the seizure or was part of my psychotic disorder acting up, but the result was the same, very severe hallucinations. Up until that point, I have never had visual hallucinations of that magnitude.

More than likely it was due to the severe seizure. I've had a few hallucinations, but only right before the seizure, part of the "aura".

I was just reading a medical paper the other day about schizophrenia and epilepsy, and apparently there is some correlation between the two disorders. Antipsychotic medications are well known for lowering the seizure threshold of the brain and so when combined with epilepsy, can make for quite a complicated treatment profile.

There is some correlation, and I do know that those anti-psychotics due lower the seizure threshold as well as cause lots of other problems as well!! My docs do say I am a complicated patient. BE very CAREFUL when starting any new meds!!!

 

[resaebiunne]

Your best bet is to make sure that you have a good neurologist and psychiatrist and make sure that they are both aware of your medical issues and the medications you take. I am sure that my recent hospital stay included some sort of evaluation of the medications I was taking and their interactions together. I am positive that in this sort of evaluation and scenario, the doctors would not have put me on Keppra if there would've been some sort of interaction with the Saphris (or other medications that I take). The sort of care that you need in this case is called coordinated care where the doctors will actually confer with each other and interact. The other option that I suppose could be an option would be to see a neuropsychiatrist who is comfortable taking the role of both specialists.

Also, I think it's worth mentioning that one should not just assume if you have E that hallucinations or auras (or any psychotic symptoms) are necessarily caused by seizure activity. It is quite possible to have psychosis and E together and have two separate disorders causing the symptoms, which is exactly what we are discussing here.

 

[Carol11]

8 years on a gluten free diet. My entire family has Celiac's

 

[masterjen]

8 years on a gluten free diet. My entire family has Celiac's

Does entire family refer to cousins, aunts, uncles, etc. or just you parents and any siblings you have? Do doctors think the seizures are due to sclerotic lesions in the brain caused by celiac disease?

 

[Carol11]

I feel fairly certain I have the two disorders separately. When I am psychotic, I hear voices, I do not have any visual hallucinations. I have had visual hallucinations which I call "visions" since I was 13. I get a funny feeling that I am going to see something, I close my eyes and I wait and it's like watching a movie. In recent years, I have had visual hallucinations when my eyes were open brought on by glaring lights/light contrast. I have never been in any sort of altered mental state when I have them and I always know what I'm seeing is not real. At first my neurologist thought I might be having migraine auras but these visual hallucinations have in no way been associated with the onset of a migraine. Rather, a seizure type event has occurred. I do not get auras with my migraines, I just know that I'm going to get one. That said, I have had some for which I had zero warning whatsoever. They occurred so suddenly I felt as if I were struck by lightning. Usually, when walking into a store brightly lit by fluorescent lights.
My neurologist also specializes in psychiatry so he's aware of all me meds. Insofar as anti-psychotics, I'm on Latuda. I've been on it for 3 years. None of my meds have changed in 3 years so I don't think that the seizures are brought on by my medication.
My neurologist gave me Keppra. That lasted 4 days. It kept the seizures at bay for the first two days and my permanent headache was completely gone. It was amazing. When I looked in the mirror, I noticed that I looked different because my face wasn't tensed in pain. Unfortunately, Keppra made my bipolar rapid cycle and I alternated between mania and deep depression every hour. I tried to put up with it but I couldn't so I had to stop taking it. My mood was stable prior to trying the Keppra and returned to normal in 1 1/2 days.
I am currently on Zonegran. My seizures calmed down on their own prior to me starting it so I don't know if it works or not. It's just been a few days. So far, it gives me insomnia and blurred vision. I still have a headache although the headache has a slightly different quality to it and fluorescent lights and screens make my eyes feel like they belong to two different brains. I am writing this post on a Mac with Retina display and I am still having a lot of trouble. Generally the left eye feels messed up but this time it's the right.
I have been on anticonvulsants before for bipolar, restlessness and migraines. All to no avail. I've tried depakote, lamictal, neurontin and topamax in addition to keppra and zonegran.
Antipsychotics I've been on are seroquel, risperdal, abilify, saphris and now latuda. Seroquel worked pretty well but latuda is much better and no weight gain.
My current meds are: adderall, lithium, latuda, zonegran, levothyroxine. As needed I take ativan, xanax and imitrex.
I have to go fill a prescription for clonidine tomorrow. That's the latest attempt at a sleeping pill. Nothing works and I often stay up for 3 days straight in the summer, then sleep 3-4 hours and up for another 3 days.
I feel like a walking pharmacy.

 

[Carol11]

Does entire family refer to cousins, aunts, uncles, etc. or just you parents and any siblings you have? Do doctors think the seizures are due to sclerotic lesions in the brain caused by celiac disease?

I just started having seizures mid-July and just got diagnosed so I'm not that far into the process. I did have an MRI done last summer because I have elevated prolactin. The only thing that showed up was a cavernous malformation in my right frontal lobe. That has nothing to do with the occipital lobe where my seizures are located so I have no idea.

My mother, father, brother and sister all have Celiac's.

 

[masterjen]

In my family I am the only one with Celiac. I have other neurological problems besides seizures, but in my case as well it is felt the celiac is not connected because 5 1/2 years of a gluten free diet has not improved the neurological symptoms.

 

[Nakamova]

Hi Carol --

There have been a few CWE threads about bipolar and epilepsy that you might want to check out:
http://www.coping-with-epilepsy.com/forums/f23/epilepsy-link-bipolar-7304/
http://www.coping-with-epilepsy.com/forums/f23/connection-bipolar-epilepsy-549/
http://www.coping-with-epilepsy.com/forums/f23/new-psychiatrist-mild-bipolar-epilepsy-18953/
http://www.coping-with-epilepsy.com/forums/f20/epilepsy-bipolar-12029/

You might find this post about a nutritional link to bipolar interesting as well:
http://www.coping-with-epilepsy.com...tors-bipolar-disorder-often-overlooked-12700/ The article cited mentions that Omega3s, magnesium, and low sugar can sometimes help with minimizing bipolar symptoms. Those dietary factors have also helped some folks with migraine, seizures, and restless leg. If you work with a dietitian in relation to your celiac disease, you might ask about adding foods that might help. In my case, I've found that a magnesium supplement has helped with mild restless leg, and I know another member found that her migraines went away when she started taking ionic magnesium.

Some seizure medications such as Lamictal are prescribed for both epilepsy and bipolar one, so you may want to discuss taking it with your neurologist if you aren't on anti-seizure meds already. If you are taking ADHD medication that may need adjusting as well, since stimulants can sometimes lower seizure threshold.

Meningitis can definitely trigger or exacerbate neurological symptoms, including headaches and seizure disorders. Do you know which type of fungus was involved?