Nocturnals and partials

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Mekellay

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Hello from Toronto! (I apologize for the length)

Figured I would introduce myself and ask all of your opinions since I haven't told my neurologist about them all (I have my reasons).

History: No family history of any epilepsy. Prior to May 2013, I had no history of anything medical but possibly have anxiety/depression but being stubborn, don't seek treatment. I work in the medical field and having a diagnosis might hinder my job

Starting around June, I started having "deja-vu" episodes. Just little moments when someone would say/do something or I'd recognize something that my brain is saying "IMPORTANT, YOU KNOW THIS" but when I try to think about it, my brain goes dead. I can't remember where, why, who, anything. As soon as it starts, I slow my breathing and take deep slow breaths, I can't talk or I say unrelated words while staring off. Most of the time I get a weird smile/smirk and try and come out of it. Once it does I have either a headache, exhaustion or confusion but it doesn't last long.

Those episodes weren't too concerning and I chalked them up to anxiety attacks since stress has been building since May.

The last week in August, I woke up at about 4:30am to 2 paramedics and my gf looking at me as I groggily focused and began talking. I had had a 90 sec seizure, punching, kicking, biting, choking, then was post-ictal and unresponsive for 20 mins. BGL was 3.6, hospital did blood work, CT and MRI and all were clear. So I was sent home and told to see a neuro.

Saw a neuro and she said it was probably a solo episode. She wasn't too concerned about the "deja vu episodes" and said since I'm stressed, that they were probably just anxiety related. She requested an MRI, CT and EEG, all were clear and I haven't heard back from her since.

Since August the deja-vu episodes have still happened. Some days I get them about 20 times a day, other times I go a week without any.

2 weeks ago, I had another tonic-clonic at 3am. My gf didn't call 911 (I told her I didn't want her to, again, job issue, and she filmed it, timed it and made sure I was breathing once it was done) but took great care of me. Once again, 20 mins to come out of it and then she kept me awake for an hour before letting me sleep again.

I haven't told the neuro about the second seizure but talking to some people, they think the episodes are partial seizures and the fact that both seizures were nocturnal, that I should tell the neuro and hopefully it won't affect my job.

So I guess what I'm asking is, any idea what's going on or why? What I can do to prevent them happening again? Should I bring up the episodes to the neuro again so she can reconsider them as seizures? Anyone work in Ontario in healthcare and know if seizure diagnosis will affect a job?
 
Hi and welcome! In a nutshell, it seems as though you have developed a seizure disorder and need to see a neurologist ASAP and probably get started on some meds. Having clear brain scans and normal labs doesn't mean that you don't have epilepsy. I know that many of us here, including me, have idiopathic epilepsy. I have only had, I think, four tonic clonic seizures, three of which happened while I was asleep, but I have had thousands of partial seizures, with no definite etiology.
In any case, this is far too serious a matter for you not to address it. If you were to have a tc seizure while driving or working with a patient (if you do direct patient care) you could hurt or kill someone. Even the "deja vu" episodes, which sound like partial seizures, could cause you to have an accident or make a serious mistake. I hope it doesn't have too big an impact on your job, but you really need to get this sorted out. Good luck with it all and keep us posted on how it goes!
 
Hi, welcome!

I would definitely let the Neurologist know that you've had another seizure. Please don't risk greater injury on a possibility of this information getting to your employer.

Everyone is different, but to not treat could lead to attendance or performance issues at work over time. Best to get a professional opinion.

Also, I'd much rather be in the position of "following doctor's treatment plan" if it ever came to having to fight for my job.
 
Hi Mekellay, welcome to CWE!

I agree with the others -- you need to seek treatment, at the very least because untreated seizures have a tendency to escalate. As your brain "gets used to" seizing, your seizures can become longer and more frequent, and they can change in nature. I understand not wanting to seek treatment but the longer you don't, the more likely that things will progress in the wrong direction.

And there is a very real risk that you could have a daytime tonic-clonic and cause injury to yourself or others. Even with impaired awareness or only partial loss of consciousness, you could have an accident.

I know the fact that there's no family history and you are otherwise in good health makes it feel like the seizures aren't serious and/or will go away on their own. But my seizures came out of nowhere when I was 35. I've always been extremely healthy, and there's no family history for me either. So don't let that hold you back from seeing the neurologist and discussing treatment.

In the meantime, keep a symptom diary (if you aren't already). It can help you identify (and perhaps avoid) secondary triggers that may be playing a role in bringing on the seizures. The #1 trigger is fatigue, but there are many other things that can lower seizure threshold, and triggers can change over time. Some sample triggers: Low blood sugar, dehydration, metabolic imbalance, nutritional deficiency, food sensitivities (e.g. MSG, aspartame, caffeine, gluten, etc.), illness/infection, flashing/fluorescent lights, and good old emotional stress. Any ways that you can be proactive and moderate in your lifestyle can potentially help to minimize seizures. Some people have found that adopting a low-carb or gluten-free diet has helped. For more tips and information, see: http://www.coping-with-epilepsy.com/forums/f22/proactive-prescription-epilepsy-1254/

Best,
Nakamova
 
It sounds to me that your having seizures .You should tell your doc about all of your seizures.You need to see a neurologist like Arnie said be put on meds. You do need take care of yourself and you don't want to injure yourself at work.
 
Welcome Mekelley,
I know how you feel. I was in the same position as you. I worked in the school system and would also have "deja vu" episodes. One night I also awoke to EMS in my bedroom. My husband had called. I did see a neurologist, tests, meds.... No reasons found. MY DIAGNOSIS: lack of sleep, severe stress, horomones. That was 2008. Today, my husband is deceased, moved closer to kids and trying hard to get enough sleep and not worry. (easier said then done) I'm on 1000 mgs of Keppra daily but going to see my neurologist on Mon. to see if I can get it reduced. Haven't had an episode since 2008. My main concern is driving. Here in Florida, if you have a seizure (and they find out) they will take your drivers license. I CAN'T let that happen. So we are in a catch 22. To tell or not to tell?
Everyone has to decide for themselves their best course of action.
Good Luck to you!
M
 
Hey Mekellay,

That sounds like me in high school. I hadn't had a tonic clonic seizure until I was about 24.

It sounds like you may be having simple partial seizures. What you explain is very similar to what I feel during one. I am controlled now, but the worst part is, you could be going into a complex partial without even knowing it. That is dangerous if you are doing anything like driving.

You should talk to a neurologist about this ASAP to find out what is going on.

Its one thing to have a "deja vu" feeling, but I'm betting the "deja vu" you are talking about is a different animal all together.

The smirk, the "hard breath" or what I do yawn. :) It all sounds familiar. A good sign I'm having a simple partial is when I can't speak right. I'll mumble words that aren't real. I try, but the right words just don't come out.

Talk to the doctor about all of that.

Best of luck and welcome.
 
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