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Old 04-04-2010, 11:32 AM
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Question The Role of Fatigue in Epilepsy


Hi, all.

I've been keeping a journal to try and sort out cause-and-effect relationships between environmental and internal factors, and my seizures. Tiredness or fatigue has been a tangled issue I'm having trouble figuring out.

Sometimes fatigue comes after my seizures, and I just want to sleep all day.
Almost always lack of sleep is a trigger and results in more frequent or worse seizures.

Yesterday I had an experience with fatigue that confused me - I don't think I had a seizure yesterday, but you never know because all day I had that "something's wrong" feeling that comes with my auras, and I was exhausted beyond description. I was so tired that I could feel it down in my bones. It felt like the exhaustion had hit my lungs and they didn't want to work making it very hard to breathe. I was unusually irritable, too. (And of course my family just saw me as the biggest grump ever, not pre-ictal!)

Then that night:
  • In the evening I had one AIWS seizure (alice in wonderland syndrome - the tv appearing big then small then big then small)
  • In the middle of the night between 2:00 a.m. and 4:00 a.m. I had 3 fear seizures. Ugh, a tough night.

It's morning and I still don't feel right. The terror goes away when the seizure goes away, but it makes me shakey and fragile feeling for awhile afterwards. But I am no longer bone-numbingly exhausted. That is gone.

So can fatigue be an aura predicting seizures, as well? Or was the deep fatigue a seizure all on its own? Or maybe I had a seizure and didn't recognize it? (sometimes I don't because of all the years of training myself to try to ignore them and just keep going!)

The exhaustion wasn't due to a bad night's sleep the night before - I had slept great that night. Also, I'm ramping up on Lamictal, currently on a very low dose. Could that have something to do with it?

When does fatigue hit you?
  • Before (seizure trigger)?
  • Before (aura/warning)?
  • During?
  • After?
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Old 04-04-2010, 11:47 AM
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That's an interesting question, and I'm curious to hear people's answers.

In my partner's case, he can get extreme fatigue after an episodes of staring or eyelid fluttering, so I would guess in those cases it's a post-ictal fatigue. Sometimes the fatigue just hits without anything noticeable preceding it, so maybe it's a type of seizure for him as well? I'm still not totally sure about that.
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Old 04-04-2010, 11:54 AM
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I found that as I tapered onto Lamictal I had very restless sleep, so even though I would "sleep all night long," it wasn't satisfying sleep. Don't know whether that's the case for you.

For me, fatigue has definitely been a trigger, often coupled with low blood sugar. Once I had an infection as well, which was both making me fatigued AND lowering my seizure threshold, so hard to separate out triggers in that case. So to the extent that fatigue can be a sign of other physiological stresses it could indeed be a pre-seizure warning sign. I don't tend to get auras, so nor sure about intense fatigue as an aura. Perhaps it depends on where in the brain your seizures originate, and what form your auras usually take.

Post-ictal fatigue is a given. I have tonic-clonics, where the strain on the brain and body aside, the lack of appetite/dehydration afterwards probably prolongs the fatigue.
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Old 04-04-2010, 12:58 PM
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I've found that it's days when I feel awake, alert & energetic that I'm most likely to have the strongest seizures.

I've wondered if it's connected to my meds (maybe a lack of absorption) since the Tegretol often makes me feel sleepy & spaced out
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Old 04-05-2010, 12:27 AM
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i find that the less sleep i get, the more seizures i tend to have, and also, i allways just sleep for hours and hours after a seizure and my auras come whenever im awake and about to have a seizure, but all i feel is scared and the room seems semi-distorted.
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Old 04-05-2010, 06:41 AM
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For me, sometimes I become fatigued before the seizure- I have complex partials.. so I am not real sure if its an aura causing the sleepiness. I feel it under my eyes and my eyes become more sensitive to light.
When the aura starts, I start feeling weirdo, geting a fear/funny feeling in my stomach and it travels into my troat then my head and then its kinda like I'm in a dream- sounds change and sometimes I walk around or pick at random things..

Sometimes after a seizure, actually almost always I get sleepy and sleep about 20min but then I can't sleep at all after than. My brain is almost aggitated or something- making it hard to settle down.

Intereseting topic-
Take care
Crystal
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Old 04-05-2010, 07:06 AM
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Fatigue could be a symptom that something else is off balance in the system - low potassium levels, hypoglecymia/blood sugar, etc.
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Old 04-06-2010, 11:11 AM
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Originally Posted by Endless View Post:

Then that night:
In the evening I had one AIWS seizure (alice in wonderland syndrome - the tv appearing big then small then big then small)
Question: I've been doing the "AIWS" thing since I was a kid, never linked it to being a seizure. Just wondering is this concidered a kind of seizure? I've only had documented T/C's since I was 18.
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Old 04-06-2010, 11:45 AM
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According to my neurologist, yep, it's a type of seizure. But ask yours, too. Norm posted a link to an AIWS site in another post. If I find it I'll edit and add it.

Ha! Found it! Alice In Wonderland Syndrome

I'm laughing a bit at how these puzzled me for years before my epilepsy diagnosis. Things would seem huge then normal then huge then normal. I couldn't figure it out! When I told my doc she thought I was a nut. Even the first neurologist I went to thought I was a nut. My epileptologist knew right away what it was.

Last edited by Endless; 04-06-2010 at 11:47 AM.
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