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Medical Forum / Diseases and Disorders / Epilepsy / August 2005

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intro -  Bipolar or TLE (long)

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culprit - 02 Aug 2005 01:40 GMT
I've been diagnosed with bipolar disorder for a few years, and i've been
looking at the history of my disorder, and realizing that it reads very much
like the simple partial seizures of TLE.

the beginning:

in my late teens, when experimenting with LSD, i had a full grand mal
seizure at a party.  the power was out, and there were flickering candles
everywhere.  i've always been uncomfortable around flashing, flickering, or
even florescent lighting.

in my 20s, i did a lot of speed, lost a lot of time, and blamed it on the
drugs and lack of sleep.

years later...
i was prescribed Wellbutrin for ADD and depression.  Wellbutrin is
supposedly very safe for people with Bipolar disorder, and very unlikely to
cause a manic episode or any kind of cycling.  it is also known for lowering
the seizure threshold.  while on Wellbutrin, i experienced what is known as
ultra rapid cycling, meaning i had rapid, unexplained mood changes, often
accompanied by changes in perception.  i had what my psychiatrist called
"panic attacks", and my MD called "migraines without the headache".  these
involved feeling very detached from myself.  i felt fear, but not the heart
pounding panicky fear of a panic attack.  i felt as though the ground were
very far away and had to sit down.  i felt paranoid, as though everyone knew
i was unstable.  i also felt that the frequency of the lighting in the store
i was in had caused this.  it happened repeatedly, and always in the same
store.  after months of this, my doctor put me on depakote, as a "mood
stabilizer", to stop the "bipolar" symptoms.  this cleared up all of my
symptoms, but made me very tired and depressed.

skip forward a bit...  i was on paxil for depression and klonopin for
anxiety.  i felt pretty stable, but still had these weird sudden stabbing
headaches in my temporal lobe area.  i've had these since i was a teen
anger, they only last for about a minute, but are incredibly intense.  other
than that, no symptoms.  i now realize that klonopin is also an
anticonvulsant.

skip forward a bit more...  moved to effexor for depression, this works on
norepinephrine and serotonin, and added nortriptyline for chronic pain and
sleep (acts on same chemicals as effexor).  worked for a while, but as we
upped the dose, i began to have the same rapid cycling and weird attacks of
fear and strange perception, especially in places with strange lighting.
doc put me on lamictal for mood cycling and things went back to normal.  i
weaned myself off klonopin at this point.

recently...  switched from effexor to cymbalta for some reason, added
tramadol for pain.  as with any pain killer, started taking more and more of
the stuff. the more tramadol i added, the weirder things got, the more i
cycled and the more i had those weird "attacks" and strange perception
experiences.  found out later that tramadol mixed with antidepressants =
lower seizure threshold.  doc weaned me onto effexor and off cymbalta, with
a period of higher than normal doses of antidepressants in my system  this
made things MUCH worse.  doc also increases lamictal and adds topamax.  i
quit tramadol.  things are finally coming back to normal.

treatment-wise, as well as symptom wise, it sounds like bipolar disorder.
but reading up on simple partial seizures, i'm starting to question that
diagnosis.  is there any way to tell for sure?

-kelly
G.Ross - 02 Aug 2005 04:00 GMT
I'll leave part of below (for me) in case I come across more tomorrow or
later.  Klonopin, lamictal and topamax (sp?) are all used too for control of
some seizure types, although they could be targeted for areas of the brain
where other conditions might arise too.
 I have Temporal Lobe Ep. but haven't used any of those. Others might reply
though if they have over next few days.  Find some posts earlier by Julie
and Howdy Dave.   At end of their posts they both list Websites you should
click to and bookmark.   Julie's is the Idaho main website with links and
general information about Safety and Seizures, First Aid procedures and
other topics.   Dave's is similar based on 10+ years of experience he's had
with his type of seizures, and internet website he's had a long time...
 A site you can look at is the Epilepsy Foundation of America main site at
http://efa.org  . The latter site has a **Medications Glossary.   You can
search down the glossary for each of the pills you've listed below and
earlier, and there's a printable option, if you want a hardcopy for a
particular pill.
  (Most things you've been prescribed you should receive a one page
printout from the Pharmacy at first Prescription filling, listing what the
pills were for, how to use and not use them, etc. Many of the pills might be
compromised by alcohol, some upset stomach remedies and other things.  )
*****
   When they were doing earlier diagnoses did they ever do any EEGs
(Electroencephalograms)  or MRIs (Magnetic Resonance Imaging)  as part of
your treatment?  If they were looking for internal damage or erratic
electric firing,  they'd likely do those for Epilepsy but also some other
brain conditions they were diagnosing.   That's why I thought they may have
done those are part of your earlier treatment.

   When you describe below where I put some ***s that 'I weaned myself off
klonopin at this point', did you mean the Doctor told you the rate and how
to do that?  or did you do that on your own?    I wondered, as some of the
pills we use for seizures, it's better to have the Doctor tell us how fast
and how to phase out a pill, as some can produce negative reactions if
they're stopped quicker than a set rate. (I've had some where phasing them
out was done over 4-6 weeks for example.)

    Although several of the pills you have mentioned are used for TLE or
other seizure types,  some others (than those I listed above) are not, so
far as I know.   How the pills work to control certain brain functions,
might make them useful for treating both my TLE and the type of conditions
you are diagnosed with.   So even if they're used by both of us, doesn't
necessarily mean you have TLE.     Why not have a look at that efa  Pill
Glossary, scroll down or type in the Pill name, and click 'enter' or
'search' ??  I forget what the button is called, but it's obvious at the
search location.  That will tell you first what the pills you are using are
for.
     (If you have trouble finding some pill links and are near the
Drugstore you get your prescriptions you can ask them if they were supposed
to give you that one-page I mentioned above for each pill.  ALL the
prescriptions I've had since 1993, came with instructions for each one.)

   Your last question at end, if you click to Julie's Idaho Website at end
of her posts, then go to First Aid for Seizures page,  the main Seizure
types are described by symptoms a person exhibits during a seizure.   See if
any match what you were having.   I think only the Simple Partial type will
you be at all Aware during the seizure or know what you do during it.   The
other ones, you would normally need someone who sees your seizure to tell
you what you did during it, since most of us aren't aware what we are doing
during the stronger ones.  I think only the Simple Partial (you mentioned),
do we come out of, without losing consciousness.  If you're not passing out,
it's unlikely? you would be having the stronger ones?  But I'm not a Doctor.
G./

> I've been diagnosed with bipolar disorder for a few years, and i've been
> looking at the history of my disorder, and realizing that it reads very
[quoted text clipped - 5 lines]
> everywhere.  i've always been uncomfortable around flashing, flickering,
> or even florescent lighting.
***** Those can affect some seizure types, as the frequency is different
that a normal light bulb.  Soime of us are especially affected, if we're
sensitive, to a tube that's near to wearing out.  Strobing lights affect
some of us the same way. /

> in my 20s, i did a lot of speed, lost a lot of time, and blamed it on the
> drugs and lack of sleep.
[quoted text clipped - 18 lines]
>
> skip forward a bit...  i was on paxil for depression and klonopin for
*************
> anxiety.  i felt pretty stable, but still had these weird sudden stabbing
> headaches in my temporal lobe area.  i've had these since i was a teen
[quoted text clipped - 9 lines]
> lighting. doc put me on lamictal for mood cycling and things went back to
> normal.  i
*******************************
> weaned myself off klonopin at this point.
***************************************
> recently...  switched from effexor to cymbalta for some reason, added
> tramadol for pain.  as with any pain killer, started taking more and more
[quoted text clipped - 5 lines]
> this made things MUCH worse.  doc also increases lamictal and adds
> topamax.  i
***********************************************************
> quit tramadol.  things are finally coming back to normal.
>
> treatment-wise, as well as symptom wise, it sounds like bipolar disorder.
> but reading up on simple partial seizures, i'm starting to question that
> diagnosis.  is there any way to tell for sure?
> -kelly
Robert A. Fink, M. D. - 04 Aug 2005 22:24 GMT
>treatment-wise, as well as symptom wise, it sounds like bipolar disorder.
>but reading up on simple partial seizures, i'm starting to question that
>diagnosis.  is there any way to tell for sure?
>
>-kelly

Kelly,

Sounds like too much treatment and not enough diagnosis.  You need to
have a good workup by a neurologist, including studies such as
electroencephalogram, CT or MRI scans, and other studies as indicated.

Your symptoms could represent a convulsive disorder, or some other
neurological condition, as well as bipolar disorder.  You need a good
specialist.

Best,

Bob

Robert A. Fink, M. D.
Neurological Surgery
2500 Milvia Street  Suite 222
Berkeley, CA  94704-2636  USA
510-849-2555

**********************************
NOTE:  The material above is not "medical
advice".  Medical advice can only be
given after an in-person contact between
doctor and patient.
**********************************
 
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