HomeAnswersNeurologyseizure disorderI was diagnosed with an abscess at the end of my septum. Can this cause seizures?

Can seizures cause an aura before they occur?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Hitesh Kumar

Medically reviewed by

iCliniq medical review team

Published At January 16, 2023
Reviewed AtJanuary 19, 2023

Patient's Query

Hello doctor,

I am a 35-year-old female. I have had seizures since my childhood. EEG was taken five years back, and I have been taking tablets Depakote, Keppra, Lamotrigine, and Topamax for the past five years. Seizures were under control without a breakthrough. But I fainted five days back and got admitted to a hospital. I got hurt on my forehead while fainting. I developed double vision, seizures, dizziness, headache, and extreme fatigue. The doctor confirmed that there was no bleeding in the brain, but the symptoms continued. I developed tonic-clonic seizures the next day, and an MRI with contrast was performed on that day. The doctor diagnosed an abscess at the end of my septum. I had three episodes of seizures on that day and the following day. I could not remember anything when I had seizures. The nurses told me that I could not answer simple questions and that each seizure lasted about two to three minutes.

During discharge, I was informed that I have nonepileptic seizures. I do not have any traumatic experiences, psychiatric disorders, anxiety, and depression. But, I developed sinus tachycardia three months back, and I am taking a tablet propranolol for it. I do not have heart failure, but I still have tachycardia, and my doctor asked me to visit this week to start Ivabradine. I also have complaints such as epilepsy, PCOS, asthma, migraines, and a TIA. I am on tablets Oxcarbazepine, Gabapentin, Propranolol, Lipitor, vitamin D, vitamin B-12, Magnesium, Aimovig, Potassium chloride oral solution, Pioglitazone or Metformin, Saxenda, Levonorgestrel, and Ethinyl estradiol. I also laboratory tests such as CBC, CMP, lactic acid, copper, TSH, and vitamin B1. The copper level and vitamin B1 are high, and the TSH value is low. I am still experiencing the symptoms such as double vision, dizziness, extreme fatigue, headache, and constant sensitivity to light. I had another seizure yesterday. I want to know if the abscess at the end of the septum is causing those seizures.

Please help.

Answered by Dr. Hitesh Kumar

Hello,

Welcome to icliniq.com.

I understand your concern.

I would like to know some details about your present symptoms and the seizures you had since childhood. Kindly answer the following questions.

1. Have you had any different feelings or sensations just before and during those previous seizures?

2. How has been the frequency of those seizures since childhood?

3. Are recent seizures similar to the previous ones?

4. Are you taking medications for asthma?

5. Is the presence of brain abscess a new finding? Or is it present since childhood?

6. How has your previous MRI (magnetic resonance imaging) brain been?

7. Currently, you are on only one antiepileptic tablet, Oxcarbazepine? or are you taking tablets Depakote (Divalproex Sodium), Keppra (Levetiracetam), Lamotrigine (antiepileptic drug), and Oxcarbazepine?

I also suggest you do a long-term video EEG (electroencephalogram) monitoring.

Kindly follow up with the reports.

Thank you.

Patient's Query

Hello doctor,

Thank you for your reply.

I never had an aura before, but It would feel like deja vu. My mom has told me that I usually fidgeted or smacked my lips and would not respond to her. I do not remember anything about the seizures. I was first diagnosed at six months, and they were frequent until the age of 11. EEGs tested positive for seizures. It was not there for 10 years after. At 21 years old, my mom witnessed it again, so I consulted a new neurologist. EEG was performed, and I had one during the test. Then the tablet Keppra was prescribed. Since I had seizures a few more times, the tablet Topamax was prescribed. I did not remember anything and could not function on that medication. So the tablet Lamotrigine was given, and I have been taking this tablet for several years. I started noticing flu-like symptoms and swelling in the neck. The doctor told me that I was having a black box reaction. He asked me to stop the tablet Lamotrigine and switch to tablet Depakote. That worked for some time, but I started having breakthroughs. I had about five episodes in that year, before three years. So, I switched to the tablet Oxcarbazepine, and I did not experience even a single episode since then, for the whole three years.

The new ones that started are completely different. They have an aura of flashing lights. I can sense it before it occurs, but I do not remember anything after that. The nurse told me that first I would first tense up, extend my arms forward, then shake and jerk, and I would drool and clamp down. It would last for about two to three minutes, and then she said I could not answer any questions. Then I will able to nod my head as a response, then slowly come out of it. These are her words, but I do not remember anything. The hospital notes say that they were tonic-clonic seizures. I am taking an Albuterol inhaler for asthma, but my asthma has been dormant, so I have not used it for a while.

I fainted because I cut my wrist with the box cutter while cutting the boxes and got hurt my forehead. A brain MRI was performed. It stated that no acute intracranial amount and abnormal enhancement in the cervical spine are present, but an abnormal appearance of the nasal septum is noted. But, my recent scan stated that there is a peripherally enhancing fluid collection within the nasal septum, with a normal appearance of the brain, and fluid collection with peripheral enhancement in the nasal septum that is suggestive of an abscess. Now, I am taking the tablets Oxcarbazepine 300 mg twice daily and Gabapentin 600 mg thrice a day.

Thank you.

Answered by Dr. Hitesh Kumar

Hello,

Welcome back to icliniq.com.

I understand your concern.

According to your description, previous events suggest a possibility of complex partial seizures. But now, it is a different phenomenon, which can be occipital seizures (a focal seizure with secondary generalization).

Kindly answer the following questions:

1. Do you get any tongue bites during the event?

2. Do you have urinary incontinence during the event?

3. Do you get any physical injury during the event or bleeding from a body site due to injury during the event?

A nasal septum abscess will not lead to seizures. However, I suggest you perform long-term video EEG monitoring, consult your cardiologist, and discuss the tablet Propranolol (beta-blocker). As it can exaggerate asthma in some patients.

I hope this has helped you out.

Thank you.

Patient's Query

Hello doctor,

Thank you for your reply.

I did not bite my tongue during the second seizure. I do not always bite the tongue, but it happens sometimes. But I had this during childhood. I do not have urinary incontinence for the past few years, but I had it during childhood. I have also had several injuries during childhood, during the episodes. My cardiologist told me that he would be starting Ivabradine this week.

Thank you.

Answered by Dr. Hitesh Kumar

Hello,

Welcome back to icliniq.com.

I understand your concern.

The previous episode, associated with tongue bite and bodily injury, favor the possibility of true seizures. The new one cannot be predicted clearly, but it can be a focal occipital seizure with secondary generalization.

I hope this has helped you out.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Hitesh Kumar
Dr. Hitesh Kumar

Neurology

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