Dr. Aida Abaz Quka
Neurology
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Patient's Query
Hello doctor,
Recently my neurologist diagnosed me with complex partial seizure. However, after taking two different medications and increase in doses has not helped. So here is my story: several years back I had been going through an extreme amount of stress. I had some migraines: occasional sharp pain in the frontal lobe. As time went on, I have been having strange episodes from once a month, to once a week and every day now for several years. Symptoms: Dozing off (spacing out) without realizing, lasting two to five minutes when it first started. But now it lasts less than a minute. Staring. Uncontrollable head movement from side to side. Head tilting downward. Feeling numb. Blurry vision. In some ways, I feel paralyzed as in if I want to speak there is a delay. Also, if I want to move there is a delay. I do not know when I go into these episodes but I sometimes know when I come out of it. No abnormality in blood tests, no abnormality in magnetic resonance imaging (MRI). No abnormality in electroencephalogram (EEG) testing as well. My neurologist determined based on my symptoms. I was prescribed Lamotrigine 100 mg daily increased to 200 mg. This did not help. So, I went on Carbamazepine 400 mg daily increased to 800 mg. This did not help either. So, is it actually a seizure or could it be something else? Do I need to continue trying different medications? Please help.
Hello,
Welcome to icliniq.com. Based on the description of these episodes, I agree with your doctor that these episodes seem to be related to complex partial seizures. I would like to directly review your EEG (electroencephalogram) reports if you can upload it. A normal EEG is not surprising in complex partial seizures. On the other hand, you should know that if two anti-epilepsy drugs, in their optimal doses, fail to control seizures, the chances to have success with the third anti-epilepsy drug are: Anyway, considering a normal EEG and normal magnetic resonance imaging (MRI) findings, I would recommend discussing with your specialist on the possibility of performing a prolonged EEG or video EEG in the hospital (up to seven days) or an EEG with sleep deprivation, to have more information on the possible location of the seizures. In such a case, switching to another anti-epilepsy drug could be an option. Another option if there is a focus on EEG, would be discussing with a neurosurgeon on the possibility of a brain surgery, in order to have a better control on seizures (considering pharmacoresistant epilepsy).
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