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Medical Forum / Diseases and Disorders / Epilepsy / March 2004

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alien - 15 Mar 2004 09:44 GMT
Hey all i just read the responses to my post. i should go on further from
what i stated. Im 22 now, I am male (not female which was talked about hehe)
a law student, doing well i guess, I dont believe my parents have ever
neglected me, as a child i was taken to doctors and so on, I was taken for
the "episodes" but I never had an EEG (so if anyone was neglecting me, that
is if there really is a problem, it was the doctors not my parents) but the
doctors never seemed too concerned and never refered me to a neurologist.
Ive only ever been to a psychatrist. I do believe I am still having these
"episodes" or whatever they are as I think i had a few today even (like i
will be talking stop in mid sentence and then start again, i feel like im
missing time, is that common or is that a symptom at all? It scares me when
this happens as it happens sometimes while i drive.)

Honestly my parents have done the best they could do, I was always sick as a
child and ive been to countless doctors for all sorts of problems. Im just
perplexed by the posibility now that i might be having seizures of some
sort. Why isnt the depakote stopping them? As for my mood, im still having
manic and depressive episodes so im still cycling, dont know what to do
there. My doc might be adding Neuotin(sp?) to my medication mix.

Honestly, i have great, caring and wonderful parents, i couldnt have asked
for better parents. I feel really bad that some of you feel as if I was
neglected by them as a child as they have never neglected me. And they have
also been through so much themselves (my mother has a heart condition, and
was at an early age (in her twenties, when i was 3 years old) hurt by a
severe work related back injury.

I just wanted to clear things up. Ill let you guys know what my doctor says
and if i do get an EEG or whatever test i might be getting. If my
Psychatrist thinks its nothing to worry about do you guys think i should
persue it further with my local GP?

Chris :)
Bob - 15 Mar 2004 16:07 GMT
> Hey all i just read the responses to my post. i should go on further from
> what i stated. Im 22 now, I am male (not female which was talked about hehe)
[quoted text clipped - 4 lines]
> doctors never seemed too concerned and never refered me to a neurologist.
> Ive only ever been to a psychatrist.

As I said in regard to myself, I went to psychiatrists for many years thinking
that they were the right kind of doctor to be treating the "feelings" that I
had. As a layperson, I had no way of knowing better. You & your parents are now
in the same situation. Let me repeat what I said before - See a Neurologist!

> I do believe I am still having these
> "episodes" or whatever they are as I think i had a few today even (like i
> will be talking stop in mid sentence and then start again, i feel like im
> missing time, is that common or is that a symptom at all? It scares me when
> this happens as it happens sometimes while i drive.)

Those are probably what are called Complex Partial Seizures. You should NOT BE
DRIVING! You may kill somebody with your car during one of your seizures.  It's
happened many times with a condition like yours that is obviously not controlled
by your medications.

> Honestly my parents have done the best they could do, I was always sick as a
> child and ive been to countless doctors for all sorts of problems.

I'm sure your parents have acted in good faith. The doctors have let them down,
but it's not your parents' fault.

> Im just
> perplexed by the posibility now that i might be having seizures of some
> sort. Why isnt the depakote stopping them?

Finding the right medication is always a problem. We've all been through that
process. I've tried many meds that didn't help at all just like many others here
have.

> As for my mood, im still having
> manic and depressive episodes so im still cycling, dont know what to do
> there. My doc might be adding Neuotin(sp?) to my medication mix.

That would be Neurontin, but you are seeeing the wrong doctor. How do I get you
to understand that you need to see a Neurologist?

> Honestly, i have great, caring and wonderful parents, i couldnt have asked
> for better parents. I feel really bad that some of you feel as if I was
> neglected by them as a child as they have never neglected me. And they have
> also been through so much themselves (my mother has a heart condition, and
> was at an early age (in her twenties, when i was 3 years old) hurt by a
> severe work related back injury.

I'm sure you have wonderful parents. There was just a brief misunderstanding
here.

> I just wanted to clear things up. Ill let you guys know what my doctor says
> and if i do get an EEG or whatever test i might be getting. If my
> Psychatrist thinks its nothing to worry about do you guys think i should
> persue it further with my local GP?

You need to see a Neurologist! You should not be treated by a psychiatrist! I
sure wish that I could get that message across to you.

> Chris :)

Bob
Julie - 15 Mar 2004 20:47 GMT
Chris, I strongly agree with Bob.  Please see a neurologist and tell your family and
friends that you will not be driving until you have this possible seizure activity
under control.  Please consider your own safety and that of others.

I cringe when I hear on the news that a bus driver had a seizure and caused an
accident.  When people hear these reports they think that no one with epilepsy
should be driving.  But many of us have our seizures under control and we want to
keep our driving privileges.

Please read the second experience on our website, which was submitted by Kathryn
from Massachusetts.  She shared a very valuable experience about driving with
uncontrolled seizures.  http://www.epilepsyidaho.org/experience.htm

I am  truly concerned about your safety.

Concerning your parents care for you when you were younger, they may not have been
aware of what was going on.  I didn't tell my parents about every time I had a
seizure.  I didn't know I was having seizures, I just knew strange things were
happening and I thought I fainted alot.  Don't worry about anyone placing blame.
Focus on taking care of now and your future.

It does sound to me like you are having seizures.  If that is the case, help your
parents to get all the knowledge available so they can be involved in empowering you
to cope with a seizure disorder.

Take care,
Julie Walton, Volunteer Webmaster
Epilepsy Foundation of Idaho
http://www.epilepsyidaho.org

> > Hey all i just read the responses to my post. i should go on further from
> > what i stated. Im 22 now, I am male (not female which was talked about hehe)
[quoted text clipped - 63 lines]
>
> Bob
alien - 16 Mar 2004 05:32 GMT
Thanks heaps i will definatly be seeing a neurologist now.

take care

chris

> Chris, I strongly agree with Bob.  Please see a neurologist and tell your family and
> friends that you will not be driving until you have this possible seizure activity
[quoted text clipped - 93 lines]
> >
> > Bob
mark stamey - 21 Mar 2004 16:38 GMT
Dear Alien

In the epilepsy club a neurologist is like a general practitioner.

They deal with epilepsy and other related disorders.  Despite the roars of
execration I expect from this post, I have found them to be the equivalent
of a country doctor who generalizes in a variety of medical problems
including epilepsy, but do not specialize in the subject.

You may want to consult an "epileptologist".

An epileptologist can address your problem without a lot of false steps. All
they do is treat people with epilepsy. They are specialists.

Some larger hospitals have epilepsy centers within them. You can find them
on line.

You will get relief quicker at a specialist. You may even be driving sooner
than you thought you would be after reading the other posts and listening to
your old doctor.

Good luck.

Stay strong.

Mark

> Thanks heaps i will definatly be seeing a neurologist now.
>
[quoted text clipped - 144 lines]
> > >
> > > Bob
alien - 16 Mar 2004 05:31 GMT
lol you have you have. im 100% going to see a nerulogist.
Im going to book it in tommorrow when i see my psychatrist, if he wont then
i will go to the local GP and get a referal.

> > Hey all i just read the responses to my post. i should go on further from
> > what i stated. Im 22 now, I am male (not female which was talked about hehe)
[quoted text clipped - 63 lines]
>
> Bob
gaross - 15 Mar 2004 17:59 GMT
> I just wanted to clear things up. Ill let you guys know what my doctor says
> and if i do get an EEG or whatever test i might be getting. If my
******************************************
> Psychatrist thinks its nothing to worry about do you guys think i should
****************************
> persue it further with my local GP?
> Chris :)

**G. **  If your Psychiatrist is going to be Treating your Epilepsy, you
should be aware that he's not trained in Neurology, like  Bob said earlier.
  If you had had tests earlier (years ago? or when this started) like EEGs
and MRIs (if they were done back then), they would have identified or
eliminated if the Sensations or Experiences, you were having, were related
to damage which might produce one of the 4-6? main types of seizures.  Also
a Neuro Technician or Neurologist would probably have to interpret the Test
Results of these types of tests.

  As Bob said too, if you have untreated (UNCONTROLLED)  Seizures, you
shouldn't be driving.

  If Insurance companies find out that you caused an accident and HAD
**Uncontrolled Seizures, most jurisdictions your Insurance is Void, and you
could be On the Hook for $100,000+  if a 'Breadwinner' was Killed.  You also
wouldn't do the rest of us much Positive Press if that gets onto the Nightly
News or 'Larry King'.

 If you're going to insist having a Bridge Architect repair a Misfiring Car
Engine,  there's no point posting on a Car Maintenance Group.   (Strange
analogy -- apologies to the Porsches and Volkswagens on the Group!! :-<  )
G./
gaross - 15 Mar 2004 19:49 GMT
 Earlier post 'reads' a little more 'brusque' than I intended it...  I
originally had about 4 more paragraphs referring to earlier post I did
(about Saturday?) listing 3-4 Ep. News sites that might have more
information on Seizures, Symptoms and First Aid for each type.

  When I deleted the Longer post (to try for brevity), it lost some of the
Context that I had included in the longer version.   IF you can find the
earlier post that lists 3-4 sites including efa.org  site and First Aid for
Seizures (that described the symptoms of the most common seizure types),
That will give you more information on what the main seizure types Look
like, plus which ones might end with loss of Awareness or (worst case)
Consciousness if they aren't Controlled.
  Those are the types that can lead to problems with Driving, and which
might need a Neurologist to assess if those are your types.    FYI.   G.R./

"gaross" <> wrote in message

> > I just wanted to clear things up. Ill let you guys know what my doctor
says
> > and if i do get an EEG or whatever test i might be getting. If my
> ******************************************
[quoted text clipped - 14 lines]
>    As Bob said too, if you have untreated (UNCONTROLLED)  Seizures, you
> shouldn't be driving.
** removed less related stuff **
> G./
Mary Fisher - 15 Mar 2004 20:50 GMT
>   Earlier post 'reads' a little more 'brusque' than I intended it...

They didn't read 'brusquely' to me - don't worry about it :-)

Mary  I
Daz_n_Pat - 15 Mar 2004 22:02 GMT
i feel like im
> missing time, is that common or is that a symptom at all? It scares me when
> this happens as it happens sometimes while i drive.)
>
> Chris :)

Hi Chris,

As others have already stated, you need to STOP driving.
The legal aspects of driving with seizures aside, trust me it's damned hard
to live with the knowledge that you've killed someone when you knew you
shouldn't have been driving in the first place. That happened to me about
six years ago. At first I couldn't function at all with the knowledge that a
man was dead because of my stupidity....I recently managed to stop crying
and only get very depressed about it now.

Fortunately it was only one man that I hit and not a crowded sidewalk. I
don't think I could have lived with that.

STOP DRIVING.

I know it's hard to stop and involves a lot of dependence on others for
transport, or on the public transport system, but there are FAR worse things
than that. And life does go on.

I'm not, (and neither are the others) trying to be hard or judgemental by
telling you this, just trying to give you the benefit of our knowledge and
keep you and others safe.

All the best to you Chris.

Darryl.

--
To reply, change daryl to darryl in address.

"It's all fun and games till someone loses an eye"
Quote: My Mum
Dave ???? - 16 Mar 2004 01:48 GMT
Howdy!

"Missing time"....

That's an excellent description of what happens when you have a complex
partial seizure.

Your brain becomes disconnected from your MIND for a bit. After it
reconnects you will be able to respond either coherantly or semi-coherently
to anybody around you but you will have absolutely no recollection of
anything between the onset of the seizure and the end of your post ictal
state.

Total disconnection followed by permanant amnesia of a time slot -- that
describes a complex partial!

Not only could you run somebody down... but you could run somebody down and
drive off without even being aware that it happened. (At best, that would be
hit and run!)

Signature

Dave ????
"Noli illigitemi carborundum decendus"

http://www.howdydave.com

>  i feel like im
> > missing time, is that common or is that a symptom at all? It scares me
[quoted text clipped - 35 lines]
> "It's all fun and games till someone loses an eye"
> Quote: My Mum
gaross - 16 Mar 2004 05:34 GMT
> Hey all i just read the responses to my post. i should go on further from
> what i stated. Im 22 now, I am male (not female which was talked about hehe)
[quoted text clipped - 8 lines]
> missing time, is that common or is that a symptom at all? It scares me when
> this happens as it happens sometimes while i drive.)

*** Another thing I thought rereading above (you can Still use the Websites
I posted earlier), a sense of 'lost time' but where you remain conscious
(though 'away' for short periods), might be what are described under Simple
Partial Seizures (which include 'Absences').   Those can vary from brief
(seconds) to longer (5-10 minutes for example).  That's another reason why
those could cause problems with Driving, as well as other things which might
require attentiveness.
   Most of us, for example, use electric kettles that have an Auto-off
Feature, rather than the older style that boil until removed from the stove.
Lots of others also use a Microwave Oven to reheat dinners, or for general
cooking, rather than a stovetop method.  (Many of those safety features are
included under Julie's Idaho website I posted before, under the Tips and
Tricks part, that people have contributed to.)
  That site can be extremely useful, since it'll save you 'reinventing the
wheel' if your symptoms or condition is similar to people who have
contributed to that site.   There are many Safety and Seizures ideas, some
that you might not even have thought of if you're new to this diagnosis.
  I had a problem with short to medium-term memory, so had to develop a way
to make sure I took the pills I use on the schedule prescribed, *but didn't
take *2 doses by mistake, since Either could produce problems I didn't need.
  Others on the group like to swim.  (I swim like a stone!)   For them,
there's information on safety in the water, Plus First Aid for Seizures in
the water.

  Like I said earlier, if you are now prescribed Neurontin?  and didn't get
a writeup from your Pharmacist about possible side effects or conflicts, the
Medications Glossary has most of the common Anti-Ep Drugs (AEDs) listed with
a printable summary page.   (Tegretol, for example, that I use, can be
compromised by both Alcohol and Grapefruit Juice.  Someone not knowing that
could have 'breakthrough seizures'  (my word) and not realize it was a glass
of Grapefruit Juice they had with Breakfast that caused the problem.)
  With Most of the AEDs it's important to follow the schedule that your
Doctor has set for taking it.  Some of them (Tegretol for one) do strange
things if the Dosing rate is interrupted by forgetting some doses, OR by
taking 2 doses by mistake.   Those are the sort of information that's
available on the efa.org site and Julie or Dave's sites.
  Also, if they do Bloodwork to check for medication levels and you're not
using it at the rate the Doctor set, they might Increase your dose if your
Blood Levels are Low on a test, and then you'd end up taking more than the
target dose.   Either extreme can cause unnecessary loss of seizure control.
  Some other things I thought about when I reread your post.  (*I haven't
used Neurontin, but others around here have, if you have specific questions
or problems using it.  Often the Med. type will vary depending on the
Seizure type and which part of the Brain is active during a particular
seizure.   Each medication is designed to take the extremes off the 'spikes'
and stabilize whatever might be triggering the seizures.)

  I guess we'll wait until if they do an EEG etc.  Some people need more
than one, since the EEG only measures erratic electrical signals *if a
seizure happens during the test.  (They have things they do to try trigger a
minor one.)  If they're able to see any erratic electrical activity then
they can more specifically target the newer Meds. for the particular type.
Some people don't show anything, but most of us did the first time.  G./

> I just wanted to clear things up. Ill let you guys know what my doctor says
> and if i do get an EEG or whatever test i might be getting. If my
> Psychatrist thinks its nothing to worry about do you guys think i should
> persue it further with my local GP?
> Chris :)
mark stamey - 21 Mar 2004 16:38 GMT
Hey, G

I asked my epileptologist about the grapefruit hypothesis and he actually
broke out laughing. He said there is nothing wrong with grapefruit juice and
AEDs.

Your posts are some of the more coherant on the newsgroup. I know you didn't
make it up, but the only place I have ever seen grapefruit juice mentioned
in reference to epilepsy is in your posts. Believe me, Friend, I have
searched.

Where did you find that information? I want to be able to tell him where you
found it the next time I see him.

Thanks

Mark

> > Hey all i just read the responses to my post. i should go on further from
> > what i stated. Im 22 now, I am male (not female which was talked about
[quoted text clipped - 73 lines]
> > persue it further with my local GP?
> > Chris :)
Dave ???? - 21 Mar 2004 18:16 GMT
Howdy!

The best neuro that I ever had for my epilepsy just picked up his shingle
and started to specialize in Alzheimers. Guess he was just the best because
he really listened, understood that I was not a moron and treated me like a
whole person!

Personally I don't care how specialized they are -- if they are unwilling to
communicate with me, understand that my IQ isn't 47 and treat me as a person
(not just a patient) then IMO they are just about useless!

As for grapefruit.  That isn't all AEDs (so I've been told) just tegretol
and it's cousins (like triliptal) because of chemical reactions that inhibit
the drugs effectiveness.

Signature

Dave ????
"Noli illigitemi carborundum decendus"

http://www.howdydave.com

> Hey, G
>
[quoted text clipped - 116 lines]
> > > persue it further with my local GP?
> > > Chris :)
gaross - 21 Mar 2004 19:29 GMT
http://www.nfld.net/epilepsy/drugs/carbamazepine.html

 (TELL YOUR DOCTOR that Carbamazepine is the Medical Generic term for
Tegretol).

  Scroll down about 55% of the way, to  Below title? -->  "How should I
take carbamazepine".

  If you want a Printable version, they don't have Page Breaks nicely laid
out like Julie etc. do, you might have to Forward Inline to yourself, then
Edit out all the Trash before it's sent, except source and Text I described
above that was needed, to get to specific information on Tegretol.

  I doubt he'd come up from Rolling on the Floor.    How hard is it for you
to get a Referral to a Trained Doctor??

  I'm frightened that *I have to do his Research for him.  How much would
he bill ME for that hour I spent?

  I don't know why that's not on the EFA Main site under Medications.  That
was back in 1999 that I found that (in my case) and This  took *me 50
minutes to search out,   while your Dr. is rolling on the Floor Laughing.

  You should consider finding a Doctor who knows what he's doing.   G.R. /
******************************************************************

> Hey, G
>
[quoted text clipped - 14 lines]
> >****** Took out older unrelated stuff ***
> >    Like I said earlier, if you are now prescribed Neurontin?  and didn't
get
> > a writeup from your Pharmacist about possible side effects or conflicts,
the
> > Medications Glossary has most of the common Anti-Ep Drugs (AEDs) listed
with
> > a printable summary page.

 (Tegretol, for example, that I use, can be
> > compromised by both Alcohol and ****Grapefruit Juice. *****  Someone not
knowing that
> > could have 'breakthrough seizures'  (my word) and not realize it was a
glass
> > of Grapefruit Juice they had with Breakfast that caused the problem.)
> >    With Most of the AEDs it's important to follow the schedule that your
[quoted text clipped - 3 lines]
> > available on the efa.org site and Julie or Dave's sites.
> >    Also, if they do Bloodwork to check for medication levels and you're
not
> > using it at the rate the Doctor set, they might Increase your dose if your
> > Blood Levels are Low on a test, and then you'd end up taking more than the
> > target dose.   Either extreme can cause unnecessary loss of seizure
control.
> >    Some other things I thought about when I reread your post.  (*I haven't
> > used Neurontin, but others around here have, if you have specific
questions
> > or problems using it.  Often the Med. type will vary depending on the
> > Seizure type and which part of the Brain is active during a particular
> > seizure.   Each medication is designed to take the extremes off the
'spikes'
> > and stabilize whatever might be triggering the seizures.)    G./
turbinado - 21 Mar 2004 22:29 GMT
When I get my Tegretol at the pharmacy, the patient info sheet they give me
says to avoid grapefruit and grapefruit juice. I believe it is only Tegretol
that interacts with it, not other AEDs.

> Hey, G
>
[quoted text clipped - 116 lines]
> > > persue it further with my local GP?
> > > Chris :)
Pablo - 21 Mar 2004 23:44 GMT
g'day mark,
strangely enough it was my pharmacist who told me to avoid grapefruit juice
while taking tegretol. she also said it will effect some high blood pressure
medications. i think i'll bow to her judgement.
most doctor's only know basic information about medications, although i
would expect a specialist to have more knowledge in that field, particularly
those which pertain to his/her field.
pablo
> Hey, G
>
[quoted text clipped - 13 lines]
>
> Mark
Klenow - 22 Mar 2004 02:53 GMT
There doesn't seem to be much research on the effects of grapefruit juice
interaction with anti-epileptic drugs, however one paper did find that
grapefuit juice does lead to increased blood levels of Tegretol, perhaps by
inhibit the enzyme which breaks down Tegretol (CYP 3A4), although they
didn't specifically look at this.  The product information from Novartis
does say that CYP 3A4 inhibitors may increase Tegretol blood levels and they
list several drugs which may do this.  They don't specifically mention
grapefruit juice but it's probably a good idea not to ingest anything which
may alter Tegretol levels.

http://www.pharma.us.novartis.com/product/pi/pdf/tegretol.pdf

I think pharmacists probably get a lot more training in drug interactions
and mechanisms than doctors do.  I know that at our medical school that's
certainly the case with respect to epilepsy and anti-epileptic drugs (AEDs),
since I've been running their epilepsy and AED laboratory.  :-)

> g'day mark,
> strangely enough it was my pharmacist who told me to avoid grapefruit juice
[quoted text clipped - 24 lines]
> >
> > Mark

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