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Archive for the ‘Epilepsy’ Category

Unrecognized Seizure Signals


 
Epilepsy is certainly a disorder of mystery and unpredictability as any epileptic will tell you.

 After ten years being grand mal seizure free, just one day after this past Christmas I found myself waking up in an ambulance from a grand mal seizure in route to the hospital where I encountered a second seizure only three hours later. This has been the worst seizure ever and roughest recovery. After coming home from the hospital, I slept for nearly 3 days and remember almost nothing.

 Although unknown to me until I was fifty-seven years old, I was born an epileptic and had experienced seizures all my life; in fact my grandfather was an epileptic as was his grandfather and his grandfather before him and who knows how far back.

 For those of us older such as me, we grew up in a time when epilepsy had many labels and taboos even linked to mental disorders and demonic possession. As a result, your family or even family doctor might not pursue any detailed medical investigation. In my case, my parents and I were told it was just part of growing up; or so I had always been told. But shortly before my father died, he confided in me that our family doctor had suspected I might have epilepsy but to quote my father, he told “old Doc Holden, there was no way his son was crazy”.

 My father also, didn’t understand that what he witnessed so often in his father as what was called “fits” was actually epileptic seizures as well.

 Although I don’t blame my parents for my epilepsy, it’s very sad to think what just a little more knowledge and information might have done to help me today.

 Since having my first full blown grand mal seizure in 2001, I have made every effort to learn everything I could about epilepsy and how to recognize and avoid the proverbial “seizure triggers” and how to prevent them.

 As most epileptics know the two basics to control and prevention are, 1) take all your meds as prescribed and 2) get at least eight hours sleep every night. In most cases, if an epileptic follows this regiment of treatment the chances of having a seizure are greatly reduced.

 Unfortunately Epilepsy is a neurological disorder and not a disease resulting in the reality that at present there is no cure. The best that can be done at present is the prescribing of a variety of medication, electronic stimulators and surgery. As such the bad news every epileptic receives once diagnosed is “epilepsy is for life”; so your neurologist will instruct you in how to recognize the possibility or the signs of an upcoming seizure.

 Most epileptics are well aware of the most obvious sign of a possible seizure which is the dreaded “aura”. For most of us, we hate the aura worse than the seizure. The seizure strikes and is usually over in just a few minutes but the aura is totally debilitating and can last from a few minutes to several days. Like it or not, the aura is usually a sign of a potential seizure.

 The aura is difficult to describe; especially to non-epileptics.  The average aura time for most epileptics I know is about 15 minutes. My average aura last 24 hours but I have experienced a pre-seizure aura which lasted 2 days and a post-seizure aura which lasted almost a week.

Auras are terrible. They can be mild to migraine headaches, the proverbial “seeing stars”, visualizing “saintly” like glows or halos around people, visualization can take on a yellowish hue as well as the experience of strange sounds and odors.

But the worst aura experience of all for most epileptics is disassociation; the feeling of uncertainty of where you are or what many epileptics describe as the sensation of feeling like you’re in more than one place at a given moment. Some have described it as feeling like you’re here but also somewhere else. Some have likened the experience to a type of “déjàvu”.

The aura often causes an epileptic to lose momentary thought, focus and concentration.

Some research now suggests that due to their debilitating effect on the epileptic, these auras are actually partial seizures. Regardless of what these auras are, they can certainly slow a person down, delay or even force a change or cancellation to plans.

It is important to note that although some epileptics never experience an aura, those that do have different aura experiences. One such experience is “mood change”.

Mood change (which is usually a side effect of anti-seizure medication and not epilepsy) itself is often a signal or precursor to a major seizure. Of great importance is the “Unrecognizable Mood Change”. It might be subtle or it might be drastic. It might not be recognizable to the epileptic patient at all but very noticeable to everyone else. The mood change can begin weeks before the seizure.

As a lifelong epileptic and Christian psychologist I was well aware that mood changes could be a part of epilepsy but as a lifelong epileptic I had never seen myself as having mood changes.  Recently however, my reaction to what I interpreted as a bad smelling slice of ham was actually seen by family members as both irrational and mean spirited. The bottom line is others saw the mood change but I didn’t. In addition my family informed me that over the past forty years I had many similar experiences. 

The bottom line is if you haven’t experienced an epileptic aura, you simply can’t understand but you can try and be observant of the epileptic in your life.

If the epileptic in your life begins demonstrating unusual or a sudden change in behavior, be certain to make them aware of those changes in a very caring and constructive way. You might ask if they have taken all their meds on time or ask how they’re feeling.

If you’re an epileptic, listen to those around you, they might see things happening in you that you don’t see in yourself and if you listen carefully you might prevent a seizure or even save your life.

Let others help you recognize the unrecognizable signals in you.

© 2019 Lee W. Outlaw III, PhD

 

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Just when you thought it was safe

Epilepsy in Plain Sight

Just when you thought it was safe

A personal epilepsy experience by Dr. Lee Outlaw

I am taking a short break from my six part Epilepsy series, “Six often overlooked associated conditions of Epilepsy” to write a special piece on my most recent experience as an epileptic.

I want every epileptic to know that I am not just a Christian Counselor and Psychologist; I am a real life epileptic. Although, my epilepsy is controlled fairly well, like you, I have my epileptic moments and just when I thought it was safe…, EPILEPSY reared its ugly head.

I was driving home (yes I drive) from a meeting feeling perfectly fine when suddenly out of nowhere I was hit with the ugly fist of a full blown Epileptic aura; not a seizure mind you but the next worst thing. I had taken my morning dosage of Depakote and CBD and had gotten my full 8 hours sleep. Apart from the slight stress of the drive itself, there was absolutely nothing to trigger an aura.

It was a very frustrating experience. Although I had had minor auras, this was the first major aura in ten years and that aura led to a major Grand Mal seizure; needless to say I was scared.

The aura was so intense, I had to pull over onto the frontage road from the freeway and eventually I pulled into a convenience store and purchased a diet cola. I finally felt I had walked the aura off well enough that I had control and drove on home; unfortunately the aura wasn’t over.

As I reached my home, I became extremely tired (every epileptic knows that severe tired feeling) and I practically fell out of my van. I made it inside the house and collapsed into my recliner where I remained fading in and out of consciousness for the next eight hours. I had no doubt as to what was happening so I finally took an extra dose of Depakote and ultimately made it to bed.

I woke up Saturday morning and felt some better but I knew things still weren’t right. As usual I took my Depakote and later CBD. I had a light breakfast but the aura remained; not as bad as the previous day but it was bad.

For those of you who might have never experienced an intense epileptic aura, here is what I (and many others) experienced:

It was as though I became semi-conscious, walking around in a hazy light yellow (some experience other colors but mine has always been yellow) fog (unable to focus or concentrate) intermittent déjàvu, weird smells (I smelled cigarette and cigar smoke even though no one in my home smokes and nobody is allowed to smoke in the house) and a thousand crickets in my head (some claim to hear strange sounds or music)(tinnitus/ringing in my ears). I also experienced a light head ache.

As a psychologist I need to point out here that someone experiencing a stroke can have a similar pre-stroke experience. Unless you have had an intense aura and discussed it with your neurologist (even if you are an epileptic) and have such an experience as I have described, you should call 911 immediately; it could be the difference between life and death.

Every epileptic’s aura experience is different but that was my most recent.

I continued to take my Depakote and CBD throughout the day and even an extra half dose of Depakote in the afternoon as my neurologist had previously directed when I experience an intense aura.

The aura seemed to decrease throughout the afternoon until I went to bed that evening.

Around 4:30 am Sunday morning, it happened, I had a “night (Nocturnal) seizure”; I woke up consciously shaking having bitten both my right side tongue and upper and lower lips. My tongue was bitten severely and outer lower lip bite actually bled.

The good news as most of us as epileptics know is that after the night seizure I am feeling much better and am nearly back to normal.

Keep in mind, increasing numbers of neurologist and researchers believe the epileptic aura is actually a simple partial seizure. Regardless, the aura for most of us as epileptics is a horrible experience.

I thank God for a good neurology team, support team which includes my family, great anti-seizure meds and prayer.

I am also thankful for the U.S. Congress having legalized CBD oil in all 50 states and the Texas State Legislature having legalized Low THC/CBD Cannabinol for use by Epileptics. I believe sincerely, had I not been taking CBD, my aura and seizure would have been much greater.

For all epileptics and non-epileptics alike, please remember that epilepsy is not a disease (although since 2014, many researchers have disagreed); it is a neurological disorder. At present there is no known cure and epilepsy does not get better (although most of us agree it is becoming easier to control); it is always there. But with proper care and support it is possible to live a relatively normal life.

May God bless every epileptic and their families and may God give wisdom to epileptic researchers as they seek a cure.

© 2018 Lee W. Outlaw III, PhD

 

 

Six overlooked conditions of Epilepsy

MLREPIL (Large)Six overlooked conditions of Epilepsy

 Lee W. Outlaw III, PhD

As I begin the new section of Drtruthman Christian Counseling and Opinion dedicated to Epilepsy titled, “Epilepsy in plain sight”, I will attempt to address areas of this neurological condition which are usually obvious but often neglected in general epilepsy diagnosis and discussion.

These associate conditions include:

  1. Heightened emotions
  2. Decreased touch sensitivity (aka ”Depakote dropsy”)
  3. Increased or decreased libido
  4. Verbal rambling
  5. Momentary memory loss
  6. OCS ( a type of OCD)

Crying man

Heightened emotions

Very few epileptics ever talk about this subject with either their support team or their neurologist; especially men. It usually happens while watching a movie or television program and you find yourself suddenly caught up in the movie and become either extremely angry or crying like a baby with usually more of the latter.

This Pseudobulbar affect (or more commonly known as PBA), or emotional incontinence, is a type of emotional disturbance characterized by uncontrollable episodes of crying and/or laughing, or other emotional displays. PBA occurs as secondary to an existing neurologic disorder or brain injury. Although more commonly associated with Parkinson, MS and stroke victims, PBA has become increasingly reported among epileptics; possibly because of new epilepsy medications or simply because patients haven’t always reported the condition.

These uncontrollable episodes of crying and/or laughing, or other emotional displays seem to happen at the most inopportune times.  It happens at family events, church, patriotic events and even for no reason at all. I have found myself sometime blubbering like a baby just hearing someone pray or me giving the family Thanksgiving blessing or my favorite sports team winning.

There doesn’t have to be any rhyme or reason for these heightened emotions occurring.

I do know this; I am a genetic, grand general epileptic. I was born with epilepsy and I can have any kind of seizure at any time but my problem with heightened emotions didn’t start until I was put on anti-seizure medication in 1999 and I have been on three different medications.

It depends on your anti-seizure medication as to the extent of the increase in your emotions being heightened but from the epileptics I have professionally counseled over the years it seems to happen to all of us as epileptics.

It doesn’t have to be just anger or sorrowful emotions either; it can also be manic emotion such as uncontrollable laughter, frivolity and whimsical behavior.

At this point, you have to be careful should you decide to report this to your neurologist, GP or Psychotherapist; the reason being that heightened manic emotions can also mask epilepsy in some psychotic disorders such as certain types of Bipolar disorder and schizophrenia.

With regard to schizophrenia there are two common sub-types which would seem to mimic The Pseudobulbar affect:  1) neophrenia; a deranged neurosis or psychosis which has often been associated with early onset schizophrenia where an individual finds everything funny and laughs sometimes uncontrollably and 2) hebephrenia; a syndrome characterized by shallow and inappropriate giggling (or laughing), and silly regressive behavior and mannerisms; this has now been renamed disorganized schizophrenia.

Another important fact to remember is that most ant-seizure medications are also used for controlling certain types of Bipolar and schizophrenic behavior.  As a result, there is some indication that the conditions these medications help to control in bipolar disorder and schizophrenia might actually have the reverse effect on epileptics causing medical and mental health professionals to overlook the epilepsy connection and jump right to the neurotic and psychotic diagnostic categories.

Even though it can be a somewhat frightening thought to have your epilepsy re-diagnosed as a psychological disorder, it is still always best to consult your neurologist with concerns about heightened emotions. It might be as simple as changing your medication dosage or even changing your anti-seizure medication completely.

But once again, with regard to the information provided, choose your words carefully.

Closely associated with an epileptic’s heightened emotions is the second condition of Decreased touch sensitivity (aka ”Depakote dropsy”) which will be discussed in the next article of “Epilepsy in plain sight”.

© 2018 Lee W. Outlaw III, PhD