Post-Ictal Freak-Out

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Post-Ictal Freak-Out

Hi Folks,

I’d like to talk about experiences we’ve had after the seizures. Please share what happens to you. To get the ball rolling, here’s my (long) story. I hope it’s entertaining enough for you to continue reading….

I had a pretty sizable concussion in January 2015, about the 7th-9th one of my life (I’m 48, female). I was diagnosed with right temporal lobe epilepsy in March 2016 and went on Keppra.

Keppra: Became irritable to the point I noticed it in July 2016, then had 2 suicide attempts in September and October, changed to Depakote for 3 days late October.

Depakote: Was told I was being given Depakote, but the drugstore gave me Depakote ER (about twice as strong, yet drugstore’s label gave dosages for “straight” Depakote). Experienced supreme mania (up 3 nights straight, really nice seizure as a result). This scared the heck out of me because I was up 3 nights in a row before trying to kill myself both times earlier. Next, I went on Lamictal.

Lamictal: Been on this since late October (now at 100mg 2x/day). It’s okay, but keppra worked better, aside from the suicide attempts. (Other than trying to kill myself, I loved keppra: my brain “felt better” within 15 minutes of taking the stuff. I can’t explain it, but that’s how it felt. But with every suicide attempt, you get better at it, so I thought it best to make a switch.) I’ve had some pretty major seizures while on Lamictal. Here's my most glorious seizure:

- What I guess was status epilepticus in early December (a series of seizures, not one long one). My earliest memory of the sequence was that I was sitting at my computer in the basement. I must have started seizing then, but must have decided to get up. I “guess” this because I ended up 45 degrees to my left vs. my usual path away from my computer—I ended up sitting on the floor in the “well” of a metal desk, banging the left side of my face against the metal desk. I recall thinking, This isn’t good, H., stop this. Eventually, I did, only to begin banging the right side of my face against the desk. Again, I couldn’t stop myself while thinking that it wasn’t good.

After the head banging, I ended up face down on the floor. I tried getting up, on all fours, only to have my arms give out and do a face-plant into the floor. Spent some time here until I struggled up and fell down, only to feel a hard object in my mouth. I thought it was something from the floor (we have an 8-month-old dog and he decimates things), so I spit it out across the room (mustn’t choke on a foreign object, right?). Found out later that it was my front left tooth. Oh well.

Managed to crawl about 8 feet across the floor until giving out. At this point, said puppy came down and began pulling at my right arm. He hates to see me this way; remember thinking, “G., stop pulling my arm.” Remember him growling and giving a massive pull on my arm (only relevant because a few days later, I found that I had a laceration requiring 8 stitches). It hurt A LOT, but when seizing and you have no control over things, you can only note the pain but are helpless to do anything about it (do you know what I mean?).

End seizure event here: babbling incoherently. I can carry on a conversation with another person. They say perfectly normal things, while I reply with nonsense. I’ve read that this is normal for right temporal lobe epilepsy; any one else have this? Had a "conversation" with my mom at this point, and then managed to dial 911 and give them a babble as well.

End result: went to ER because this seizure/s went on for half an hour or more. I managed to call 911, but my mother wanted me to call and put the phone by me while I was on the floor (live with parents). Went to ER and freaked out.

I am truly insane in the ER. Does any one else have this problem? It's really tough because you go there for help, only to fight them.

This is what I call my “post-ictal freak-out.” It’s pretty paranoid-based: I’m scared for my life and want to destroy whoever is around me. Even tried punching a sheriff's deputy in the crotch earlier this week. I feel that they are out to kill me, so I lash out. Considering what has happened to me, it’s pretty sane; however, to the sane people around me, it is abnormal.

I would like to hear about the experiences of others who go crazy in the ER, or experience “post-ictal freak-out” without going to the ER. I’ve come to the conclusion that going to the ER after status epilepticus is not productive because emergency medicine people only see you as a loony tune, not as somebody going through the misery of post-ictal freak-out. I would rather die than be subject to the abject conditions of Grand Rapids Michigan ERs. I know that I treat the ER personnel poorly, but geez oh pete, I cannot control myself. In my post-ictal condition, all I’m concerned about is my survival; I don’t give a poot about their desire to have a smooth shift.

Does any one else experience this hell? Please chime in.
 
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I think this is a safe place to talk about things. Maybe I'm wrong. Nonetheless, I'd like to start a discussion.

What have been your experiences after you've had a bad seizure?
 
Hi Hydrogyrum

I've had epilepsy most of my life, took tonic clonics from 9 months until I was 3 then was 21 years seizure free. My seizures returned in 2002 when I was 24 & I had surgery in 2011 when I was 33.

Obviously I dont remember anything about my seizures as a baby/toddler but all I know is I had tonic clonics on regular basis until they stopped when I was 3.

As for adult hood they came back out of the blue one Sunday in May 2002, before my surgery I only had 3 tonic clonics which landed me in hospital (2002, 2004 & 2008 ), otherwise my seizures were simple / complex partials. I didn't act crazy in the ER after a tonic clonic that I know off.
The only things i do remember is the day my seizures returned I had a tonic clonic in the ER & vomited all over myself & I think I tried to get my gown off.
Then another time I had a tonic clonic at work & was taken to hospital, all i was worried about was getting back to work to get my work done lol.

I've been on 7 meds all up since 2002 & out of those meds 2 meds affected my moods Neurontin (which took from Nov 2009 - Nov 2010) & Vimpat (which I took from Feb 2015 - May 2015). I'm currently on Tegretol, Keppra & Zonegran & don't have too many side effects with this combination. I had also tried Lamictal & Topamax before my surgery

In regards to people reading your posts but no comments you will have people respond but as we are from all over the world we have different time zones so some people may be in bed or some may have quickly popped on to read posts & not had chance to reply.
 
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After a seizure I have a headache, extreme fatigue, intense pain for a few minutes, soaked in sweat, sometimes a 5 second memory, inability to talk or understand speech, and some other stuff I cannot think of right now.

I do not recall ever having a freak out and I have never been to the ER for a seizure.
 
After a tonic clonic I usually feel sick, end up vomiting, have a killer headache & want to sleep.
 
CQ, I wrote a nice reply to you but the system deleted it. I'll try to replicate it here.

I didn't have seizures as an infant or child. I got them because of too many concussions of my brain. I hate my brain.

I had a seizure in Dec. 2015 when I was admitted to hospital after a seizure, but the doctor didn't have the EEG on at the time. If he had, we wouldn't be having this conversation.

I vomit a lot. As of now, I vomit so much that I don't give it any credence. In fact, I've started to enjoy it. I like to up-chuck whatever I've eaten. Vomiting means nothing to me.

At 48, and as an earner of a master's degree, I'd like to think that I could contribute to society. I've tried--believe me, I've tried. My attempts since my concussion and epilepsy indicate to me that I am a dependent on society rather than a contributor.

I posted in the afternoon (my time), logged out, and then logged back in in the evening. Nobody posted. I posted to myself. When I close my eyes, this is the person I communicate with: myself. The Internet is wordwide; is it bigger than myself? I should hope so.
 
Hi Hyrdogyrum,

I'm so sorry to hear of your experiences with a post ictal freak out. I've heard of this happening to people before. And as most of us know, you can also get Keppra rage, mood swings, depression, and suicidal thoughts. I'm very sorry for your freak out. That utterly sucks.

My worst post-ictal states have included completely losing my vision, crawling around the floor after a grand mal (didn't go to hospital as I'm an idiot), and developing a verbal tick lately. Other than that, I get the usual states (I'm mainly focal seizures).

I've had seizures all my life, but man they just knock the shit out of you.
 
1. Is your neuro aware of your tendency to post-seizure psychosis? If so, he/she should make sure that it's in your record and available for ER personnel. It's also treatable, usually with a benzodiazepine (such as valium) taken on a short-term basis when the psychosis begins. It's possible that you could have be prescribed a small amount as a "rescue medication" available to take at home.

2. Any time someone has status epilepticus they should be taken to the ER. You should make sure friends and family understand what this is: http://www.epilepsy.com/learn/impact/seizure-emergencies/status-epilepticus.

3. You and your neuro should discuss tweaking or changing your seizure medication. There are many meds out there to try, one of them may be a better a fit in terms of seizure control and side effects. Sometimes a combination of two meds does the trick. The "medication merry-go-round" is no fun, but it can pay off with better quality of life.
 
My post-ictal phase depends on the type of seizure I have. With absence seizures, right after, I have a migraine. My migraines have lasted several hours to several days. After having a tonic clonic, I have brain zaps, left-sided neuropathy, nausea and the need for an abnormal amount of sleep. This can last up to a week.

There was one time that I was pulling up to my driveway, I had a minor seizure and right after, "something" told me that if I got out the car and went into the house, someone was going to get me. So, I pulled into the garage and sat there for a few minutes until a mustered enough courage to go inside. My heart was practically beating outside of my chest as I went from room-to-room and closet-to-closet to make sure no one was there.
 
I've been on several different meds through the years, especially when I was first diagnosed with epilepsy, trying to find ones that helped. I'd been on one (I'm sorry but I don't remember what it was) that I just couldn't eat anything, food just made me sick. My mom practically had to force feed me to eat dry toast and saltine crackers but I'd want to throw them up. I'd lost over 15lbs in 2 weeks and wouldn't get out of bed basically because I couldn't move. We called my neuro and told him what was going on and he took me off of it immortally. After that I started eating again and things pretty much went back to normal.

Eleven people read this, but nobody responded. The count down continues....

If there's a new post on here I'll read it but if I can't relate to it or have any advice to give then I don't post anything. I'm sure others are this way too which was probably why you didn't have any replies.
 
Thank you to all who've posted.

Nakamova, no, my neuro isn't aware of my post-seizure psychosis. Well, I guess she is aware of it now, but before now, no. I have kept it quiet becuause it's quite shameful. I am very angry right now about what has happened to me (brain injury, epilepsy, et al.). In my experience, ER staff like to pretend they're in control, when in fact they are not. They must learn to respond.

In1, to me it sounds that you were psychotic when you had to check all the rooms, closets, etc. in your house before entering. Believe me, I understand. I have this feeling when I'm confronted with sheriff's deputies and EMR folks. I know they're there to help me, but I still need to protect myself from whomever will "hurt" me. I carry this attitude into the ER.

PS I'm twisted when psycho. I try to hurt people. I tried to punch a deputy in the crotch--that was my goal in life at the time. Unfortuately, he caught my fist in mid-air.
 
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Hi hydrogyrum,

I also have right temporal lobe epilepsy and a few yrs. ago after a concussion my family Dr. put me on Neurontin to help me out with the headaches I was having but that led to absence status seizures which was a nightmare.
I would be out of it for 30 min. to 2 hrs. and during this time I couldn't control my body at all or what I was saying. I was trying to speak to my husband but the words wouldn't come out of my mouth, also I had muscle spasms around my mouth and my arms would jerk around like crazy and I couldn't control a darn thing. I finally got ahold of my Epileptologist and I found out that Neurontin can sometimes trigger seizures for a person that had a seizure and for those that have E. it can make it worse in some cases. There was even a special on NBC Dateline about this a few yrs. ago. I've been on over 10 different seizure meds in the past 45 yrs. I've had seizure and I later found out I was drug resistant so my Epileptologist put me on CBD (medical marijuana) this past summer and I am amazed on how good it works. I've had the least amount of seizures this past yr. than I have ever had since I started keeping track of my seizures back in 1989. Here's wishing you only the best and May God Bless You!

Sue
 
Let me reply to a number of your replies. Believe me, I'm happy you've replied.

After a seizure, either I go to sleep for 4-6 hours, or I go "black out" and cannot remember my actions. According to my parents, I flail about and swear up a storm (the f-word in particular).

If I black out, swear, and cannot remember 30-45 minutes, I am also affected physically. When I come to, I cannot control my body until I get into a safe place (the sofa). At this point, I usually become very hungry.

I haven't reported this crap to my neurological NP. It's too shameful, and apparently, I had this problem before I began seeing her (my parents/witnesses didn't tell me about my behavior then).

I was at the point where food made me sick or I couldn't taste it. I also threw it up (mentioned this earlier).

Once, I couldn't find my way to the Secretary of State's office, despite the fact that I knew the route for the last 25 years.. Spent around 30-45 minutes before finding my way. How many events do you tell your practioner?

Tired of all this. Today, had my Lamictal upped by the neurological NP before being referred to a better Level 4 neurological unit at a different hospital. Am holding hope that they learn something more about my situation. Thank you to all that responded!
 
After a seizure I'll usually fall asleep for a few hours. I'm just so tired that I can't stay awake. Many times after a seizure I might forget things that have happened a few minutes to days before it. My memory is very bad in general. I don't drive but I'll have problems remembering how to get places or telling people how to get there, even if it's trying to tell someone how to get to my house. Lately I've been having problems remembering what simple words are. When I went to a fast food restaurant recently I wanted to see if I could get onion rings instead of french fries but I just could not remember the word french fries. I stood there trying to describe what they were and she had to figure it out.

Don't be ashamed to tell your neuro, you're not the only one out there who has these problems, if you read on here you'll see how many others deal with these things too. I keep a seizure diary and make sure I write down anything out of the ordinary that's happening so I make sure I tell him. Changes in your meds or something else could help it. When I've had problems with things in the past my neuro has had to make changes in my meds. The first change might help/work but usually when we work around we find something that does. I know it can be VERY frustrating at times.

At first I used to see my neuro NP every few visits but started having a TON of problems with her, I could spend all day telling you about them. After my last visit with her I blew up and told them at the office if I didn't see my actual neuro every visit then I was going to start seeing another neuro. Since I haven't seen her things have gotten better. My neuro listen more to what I have to say and asks questions about what is going on. The changes that he's made in my meds through the years have helped much better than anything that the NP ever did.
 
I've seen a neurologist NP who was quite nice but who treated me as though I was just another money-maker for her. I do not know who her overseeing doctor was. I guess this situation is based on a) her desire to appear professional to her peers, and b) my failure to communicate my urgency.

My neurology NP recently increased my lamictal from 100mg twice a day to 125/twice daily, to go to 150/twice daily. In my experience, lamictal is as effective as taking sugar pills, maple sticks, or dog's poop. Or standing in the middle of the road when a semi is approaching.

Looking over my seizure diary, I see that often I have seizures 10-20 minutes into a dinner. This is "new evidence" to me and should be shared with whomever takes care of me next. This evidence suggests to me that maybe my diet is causing my seizures, and that my meds can do nothing to prevent seizures. Right now, there are no clear ties between my diet and my meds.

I hate marijuana because it's illegal as a recreative drug. However, its strengths have been shown to all as a medical boon. I voted "yes" to instilling marijuana as a medical drug in Michigan a few years ago, am dissatisfied with how the legal fuckholes in Michigan are dealing with it, but now think that marijuana might help me out immensely.

Sorry that this rambles. If you want to reply to something, copy-and-paste what I said and then give your response. I love this site and want to hear more.
 
Well. Thank you, valeriedl for your reply. in a few ways, you seem to be in the same boat as i.

in general, my experience with nurse practitioners has been great. Because they've been nurses, they've experienced a great deal with their patients. But maybe a few of them are ambitious to succeed and forget their experience--question mark.me not know.

excuse my incorrect punctuation, but my keyboard isn't working correctly.

my np kicked me out from her practice recently because i went on a tirate via email against her after a seizure. btw, witnesses say that i swear most violently after a seizure, so she's experiencing the same thing. it's just that she couldn't deal with the realities of epilepsy.

i am having a ton of problems with this epilepsy shit. i was only diagnosed this past march 2016. i'm having a ton of seizures on lamictal; i will keep taking it, but i don't hold out much hope. lamictal is my third aed drug. i know it's hit or miss with aeds, but geez it's my life in the balance here.
 
Many people are treated as if drunk when coming out of sz if you explain it then she of all people should understand.Big article on British fb page it seems many been lugged off to hospital wake up to alcohol liasen nurse or flung in cell for night even tho got medic alert chain on
 
i am having a ton of problems with this epilepsy shit. i was only diagnosed this past march 2016. i'm having a ton of seizures on lamictal; i will keep taking it, but i don't hold out much hope. lamictal is my third aed drug. i know it's hit or miss with aeds, but geez it's my life in the balance here.

When I was first diagnosed with epilepsy I was having at least 10 seizures a month. I tried a ton of different meds, dosages and combinations but nothing was really doing much help. After about 4 years of doing this my neuro suggested I try a VNS, vagus nerve simulator. It's helped a ton. I'm only having about 4 seizures a month now and they aren't nearly as bad as the seizures I was having before I got it. I am still having to take meds along with it though but the amount of meds I'm taking now is nothing like what I was taking before I got it.
 
After the last TC I had I was very adamant that I wasn't going to get in the ambulance. I'm pretty "able" after a seizure so since I came around as the ambulance arrived I was able to walk, but didn't want to go. Every time the paramedics tried to do something to me, like check vitals or whatever, I would resist. Every time they tried to clip something on me or put a needle in me I'd pull it out. I remember the oxygen thing they put on your finger, really did not like that for some reason so I threw that to the ground. I guess I just turn into a massive grump.
 
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