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indications of siezure disorder. MRI results

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Hello, I am a woman who will be turning 30 this coming may. Recently I had an mri, I was refered over for indications of siezure disorder. I had my first siezure at the age of twelve which was trigured by the flashing of a strobe light. During that episode I experienced uncontrollable convulsing and when I finished I was crying and extreemely exhausted. through out my teenage years I experienced a total of three others like it. Following I had a silent period where there was nothing or so it seemed. Over the last 5 years I have been experiencing these daja vu like symtoms. I always know when I am going to have them because I get this churning in my stomache either with a feeling of chills or hot flashes then I sometime feel as if I am going to pass out my vision usually is blured or goes black and I have a feeling of fear or familiarity sometimes accompanied with slured speech if I am talking when the onset happens. They usually happen at least once a month, and continue for a period of four days to a week, the first day I might have one and the next day the number increases but then taper back off toward the last day of having them. Sometimes the episode might last 30 seconds or minutes long.I usually feel very exhausted. After these experiences, and most often do not really remember the so called deja vu although I am aware of what I have just experienced. I am having memory problems I get confused easily, I forget things easily and do better learning new things by actually doing them hands on though it is usually after doing it many times, I have been told I accomplish tasks rather slowly, and that sometimes I look like I'm off in china somewhere. I too notice these problems and can become overwhelmed confused and frustrated because of them. One other problem that is now starting to occure is difficulty hearing which others in my home and work place have brought to my attention. And though I too have noticed it seems a bigger problem than I thought. I'm not sure if it is linked to the other issues I am having. I am looking for a new dr. My other dr. Has not really put an effort what so ever into explaining my mri results and so I am looking for a new dr. And answers myself. My mri showed that there were no tumors or lesions detected and that signal seemed normal, however the mri stated the finding mild assymetry in the hippocampus and parahippocampus as well as slight atrophy suggested to right compared to the left. And that clinical correlation is requested. I am not a dr. So I have no clue what any of this suggests or means but I am desperate for any helpful advice or answers. Thank you. -Rosie
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replied March 22nd, 2014
Hoping someone might have some sort of advice, anything helps.
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replied December 3rd, 2014
Hello and Welcome

I appreciate your concern

The seizure /epilepsy episodes which you described are grand mal seizures according to your history and description. The post ictal state i.e the post seizure state can vary in many people and exhaustion accompanying confusion is the most common aftermath. The Dejavu feelings indicate an aura that is commonly associated with disorders of CNS eg also in migraine headaches. Be sure to inform family members or friends when such an aura is evident.

The MRI is an imaging modality. Initially in the workup of a patient an MRI is done to exclude any ischemic or hemorrhagic stroke, tumors or other unusual foci eg abscess etc that can manifest into a full blown epilepsy.

However the above are only space occupying lesions that can present in such a way. There are other causes that also require workup even if the MRI or CT is clear.

EEG, Electrolytes, Blood Glucose, Toxicology screen, ABGs must be done as part of the workup as one cant initiate anti epileptics for extended periods of time without evidence of any pathology or fulfilling guidelines.

Treatment must be started if there is A) an abnormal neurological exam, B) abnormal EEG C) Strong history of seizures D) presented with status epilepticus.

Treatment regimens are many and may be tailored according to your need. Valproic acid is a first line drug. Carbamazepine, ethosuximide etc are considered second line drugs. Your doctor will know more about how to titrate the dose.

You mentioned Seizure free periods. They can only be deemed significant if you have been seizure free for at least two years and your sleep deprivation EEG is negative. If so then there is a low likelihood of recurrence and medications may be tapered accordingly.

Be sure to avoid any heavy machinery work or driving as it can be of great harm if a seizure episode occurs at such a time while you are operating such machinery or while driving.

Hippocampus and parahippocampus are associated with memory and spatial recognition among others. Though memory enhancers aren't proven to be of much benefit you may try gingko biloba in consult with your doctor along with henry Loraine s memory enhancement techniques that teaches visual mnemonics and can help you in this regard.

wishing you best of health


Dr. M.S. Khalil
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