Hi, yes she has had both and both captured her generalised seizure.
Its a short (30 sec to 1 min) convulsive (usually her right limbs jerk more) seizure. She resolves immediately with no post ictal issues.
A month ago, I videod a few mins of a prolonged event requiring hospitalisation. The neurologist she is seeing now is thinking that maybe more seizures than we are aware are of a psychogenic nature. What I see is a lot of seizures, coupled with some unresponsive agitation.....
She hasnt had an eeg since developing SE and new types of seizures.
psych eval does suggest some anxiety, but not as a disorder. She is just 17, so its a kind of anxious age.
There is no abuse, trauma or anything one would expect from such a severe type of ptsd, no? However, she does work on attachment issues with counsellor and continues with a psychiatrist. She has also had hypnotic therapy over a period of months. I haven't seen any difference......the neurology team made the diagnosis, not the psychiatrist and unfortunately in Ireland we are very short on neuropsychiatrists....
I wonder if I should ask for a lumbar puncture? This is the only test she didn't have and given that she has a history of poor gait, immobility, etc and a grey area nr the thoracic on her spine mri, I wondered if she suffered some kind of cns insult?
Hi Dr Thomas
Thank you for your response.
I think I may have confused you. All of her eeg's show a spike wave denoting epileptic activity! What they havent found is non epileptic seizures on the eeg!
The conversion disorder was borne from drs unable to find a physical reason for her being unable to use her trunk to walk. However, I felt at the time that the loading doses of drug trials which were immediately unsuccessful due to her very low tolerance and suffering extreme side affects. Because the conversion disorder diagnosis was there, drs felt that once she started having more problems at home with seizures, that these prolonged events were probably part of the conversion disorder, hence pnes....her mri was normal in 2012.
What I have been told is 'if Katie is not having a seizure that lasts up to 1 min only and resolves quickly, then this is probably pseudo'!
Im wondering how I can get the proof, is it back to eeg, stripping meds at same time?
Taking on board your advice regarding getting levels done, we will do that.
Unfortunately, Katie has not tolerated the increases required since puberty! Her tolerance levels are off the charts......so med changes are slow and cause low functioning.
She is not a candidate for lobectomy, because the seizures stem perhpas deep from the cortex/frontal lobe. She is not a candidate for ketogen diet because her age complicates this. She left the children's hospital with 'that's all we can do' and entered the adult care with an attitude of 'let's try get the care right'. After 8 months, we are still none the wiser about why / where these new seizure patterns come from.
She would like stem cell treatment and its of importance, if we are to ever go down that route, to tie down this singular or dual diagnosis.