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Conversion disorder (PNES) or Epileptic Seizures
Mon, 07/28/2014 - 16:56 My question is:
¿How can I differentiate an epileptic seizure and a conversion disorder seizure?
Hello,
My wife has generilized seizures almost every month during her period. Also, whenever she gets sick or doesn't get enough sleep, or whenever she feels weak it's probable that she will experience a seizure.
-She loses consciousness during seizures, but she doesn't lose control of her sphincters, seizures last between a few minutes to long periods, it can be easily confused with an epileptic status.
-She is 28 years old and has been having seizures since 2006 (8 years).
-Doctors haven't been able to differentiate between organic seizures (epilepsia) or conversion disorder (pseudo-seizures).
- IRM studies show no anomaly in her head.
- Doctors differ in their EEG interpretation some say that it is normal (no organic reason) and others argue that there is abnormal activity in her left temporal lobe.
-Final diagnosis from doctors is that she may have both kind of seizures. Some of them would have organic reasons and other would be pseudo-seizures.
-She has been prescribed with Levetiracetam, Magnesium Valproate and Topiramate but after using them for more than one year no change has been found in the seizures timing.
- Right now she is being treated with Clonazepam and Citalopram, she has being using them for around one year with no change in seizures timing but with a better quality of life.
-We have studies from 2006 -2014 (EEG and IRM) and we would be glad to share them with other people and doctors to help with diagnosis.
We have been looking for the right diagnosis because seizures keep coming and we want to use the less medication possible in order to improve our quality of life. All her seizures look the same and have the same unleashing mechanism.
I read your post and thought
Submitted by just_joe on Tue, 2014-07-29 - 12:50
I read your post and thought for a few minutes. You posted DOCTYORS differ in their EEGsome say it is normal others say abnormal activity in the left temperal lobe. If the doctors say it shows abnormalities then they might be neurologists since abnormalities for them is seizure activity in that area. You will find other women has seizures around their time of month. You can see posts under women. Now when she is sick or stressed or hasn't had enough sleep those are triggers for many people with epilepsy. I saw the medications she is on and has been on. The later meds have fewer side effects and seem to be helping her. You did not post if her dosage has been raised or lowered recently. If her dosage hasn't been increased or decreased since she started taking them then she might want to talk to her neurologist. In all of my visits Doc askes me questions. "Did you have or how many seizures have you had. Were they like your others or were they different and so forth" Generally I have a question to ask him for every question he askes me. The medications have helped my life style but I still have the same number of seizures should the dosages be increased or desreased? Is this the best medication for the seizures I have been having? Can this medication be coupled with another one to control my seizures better? Are there other procedures that can help control my seizures better? In your wifes case .Do women have seizures during times they have their period? IF she and you want to get control of her seizures always ask questions and get answers. I was having the same number of seizures and I started asking more questions. It took trial and error but the number of seizures has been reduced from 2 a week to 1 every 8-14 days. The length of time in the seizures has also been reduced from 2-5 minutes and 15-45 minutes to get focused (get back to normal. Now those times are 2-5 seconds in the seizure and 5-8 seconds to focus. I will take the latter any day... I would also suggest you get the My Epilepsy Diary. It can be found under the Get Help section/ Watch the video which tells yo uhow to use it. There is a note pad in it so write down things that happened in the seizures and times. If there was something diferent that happened that day write it down. After a while you can look at the notes and by doing that you might see triggers. Like stress. Being sick and others. If you givr the neuro;ogist permission to bring it up he can look atthe graphs and other thing which could help him come up with medications, dosages and priocedures that can help her. I hope this helps and she gets the assistance she needs.