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Diagnosis and treatment of TEMPORAL LOBE EPILEPSY.

Resolved Question:

Hello. I am male and 19 years of age.

I have been struggling for 2-3 years now and no doctor or med has helped me.

I have a diagnosis of Right Temporal Lobe Epilepsy (Over 10 years)

I have been recently been diagnosed and misdiagnosed with Bipolar 2 Disorder and Depersonalisation within one year, which is now off my medical records.

I have been suffering from:

Bad Memory, short and long term.
Concentration problems
Fatigue
And also this weird sensation, i feel as though everything is constantly very spacey and blurred around me, which gets a lot worse when i concentrate on lets say a computer screen or book for 10-20 mins, i am even finding it hard to write this. It gets to the point where i am un able to function properly even hours afterwards and sometimes effects me the morning after.

I have had my eyes tested recently and they are perfect.

I also went to the doctor and they said my epilepsy is playing up once again, so they put me on Lamotrigine which i have taken for over 2 months now. The Lamotrigine has helped with other problems such as mood changes but not any of the main problems listed above.

I went to my doctor and told him about this and he said i have to "deal with the problems i have now as this is the best its going to get". I don't believe that this is true as i find it hard to just keep a normal lifestyle like this.

Please could you tell me you're thoughts on this? I would like a second opinion.

Thanks.
 

Category: Neurologist, Medical

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Category: Pediatric Neurologist
 19 Doctors Online

Hello.

Thank you for posting your query on DoctorSpring.com.

I have noted your details and agree that these episodes could be complex partial seizures (epilepsy). It is important to know the investigation findings, such as MRI brain-epilepsy protocol and EEG. If you have the results of these tests, please upload them in the follow up.

Lamotrigine is a good drug. However, as per your response, you may need to increase the dose.

Other good medications for this condition are Carbamazepine and Oxcarbazepine.

I am sure you would improve with treatment and lead a good quality of life. You sould discuss with your doctor about an increase in the Lamotrigine dosage or the alternate drugs.

I hope this was helpful. Please do write back if you have further queries.

Best wishes,

Dr. Sudhir Kumar MD (Medicine), DM (Neurology), Senior Consultant Neurologist.


Patient replied :

Thanks for you're reply. They are not episodes, the spaced out feeling is constant all day and never goes away but worsens when i concentrate. Is this possible with seizures? Unfortunatly when my parents split up the documents were lost while moving houses. Would it be neccessary to request another scan although my medical records do state i have Temperal Lobe Epilepsy? Lamotrigine is what i was perscribed when i was younger aswell as Oxcarbazepine but the Oxcarbazepine gave me a poor apitite so i was boosted up on the Lamotrigine and cut out the Oxcarbazepine. I am currently only on 100mg (50mg x 2) a day of Lamotrigine because i lost too much weight at one point and the doctor didnt want to give me too much. I hope that this is the answer as it hold a big restriction on my life at the moment. A year a go while i was employed i had to resign as when i worked sometimes i would daydream for 20 minutes and not get any work done. My boss told me that i needed to resign or i would be fired. I will deffiniately discuss about increasing the dosage.
I have uploaded a document i received in 2004 after my diagnosis and after starting my medication.
Thanks Again.


Thank you for getting back. The additional information was helpful.
I agree that this could still be temporal lobe epilepsy. Increasing the dose of lamotrigine seems to be the best solution at this point. So, please discuss with your doctor about that.
There is no need to repeat the MRI brain and EEG at this stage.
Hope this helps, would be glad to answer any follow-ups.


Dr. Sudhir Kumar
Category: Pediatric Neurologist
Experience: 
Senior Residency, Fellowship: DM, Neurology, CMC, Vellore, 2001
Junior Residency: MD, Internal Medicine, CMC, Vellore, 1998
Medical School: MBBS, Christian Medical College, Vellore, 1995
Dr. Sudhir Kumar and 4 other Medical Specialists are ready to help you

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