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Six overlooked conditions of Epilepsy

MLREPIL (Large)Six overlooked conditions of Epilepsy

 Lee W. Outlaw III, PhD

As I begin the new section of Drtruthman Christian Counseling and Opinion dedicated to Epilepsy titled, “Epilepsy in plain sight”, I will attempt to address areas of this neurological condition which are usually obvious but often neglected in general epilepsy diagnosis and discussion.

These associate conditions include:

  1. Heightened emotions
  2. Decreased touch sensitivity (aka ”Depakote dropsy”)
  3. Increased or decreased libido
  4. Verbal rambling
  5. Momentary memory loss
  6. OCS ( a type of OCD)

Crying man

Heightened emotions

Very few epileptics ever talk about this subject with either their support team or their neurologist; especially men. It usually happens while watching a movie or television program and you find yourself suddenly caught up in the movie and become either extremely angry or crying like a baby with usually more of the latter.

This Pseudobulbar affect (or more commonly known as PBA), or emotional incontinence, is a type of emotional disturbance characterized by uncontrollable episodes of crying and/or laughing, or other emotional displays. PBA occurs as secondary to an existing neurologic disorder or brain injury. Although more commonly associated with Parkinson, MS and stroke victims, PBA has become increasingly reported among epileptics; possibly because of new epilepsy medications or simply because patients haven’t always reported the condition.

These uncontrollable episodes of crying and/or laughing, or other emotional displays seem to happen at the most inopportune times.  It happens at family events, church, patriotic events and even for no reason at all. I have found myself sometime blubbering like a baby just hearing someone pray or me giving the family Thanksgiving blessing or my favorite sports team winning.

There doesn’t have to be any rhyme or reason for these heightened emotions occurring.

I do know this; I am a genetic, grand general epileptic. I was born with epilepsy and I can have any kind of seizure at any time but my problem with heightened emotions didn’t start until I was put on anti-seizure medication in 1999 and I have been on three different medications.

It depends on your anti-seizure medication as to the extent of the increase in your emotions being heightened but from the epileptics I have professionally counseled over the years it seems to happen to all of us as epileptics.

It doesn’t have to be just anger or sorrowful emotions either; it can also be manic emotion such as uncontrollable laughter, frivolity and whimsical behavior.

At this point, you have to be careful should you decide to report this to your neurologist, GP or Psychotherapist; the reason being that heightened manic emotions can also mask epilepsy in some psychotic disorders such as certain types of Bipolar disorder and schizophrenia.

With regard to schizophrenia there are two common sub-types which would seem to mimic The Pseudobulbar affect:  1) neophrenia; a deranged neurosis or psychosis which has often been associated with early onset schizophrenia where an individual finds everything funny and laughs sometimes uncontrollably and 2) hebephrenia; a syndrome characterized by shallow and inappropriate giggling (or laughing), and silly regressive behavior and mannerisms; this has now been renamed disorganized schizophrenia.

Another important fact to remember is that most ant-seizure medications are also used for controlling certain types of Bipolar and schizophrenic behavior.  As a result, there is some indication that the conditions these medications help to control in bipolar disorder and schizophrenia might actually have the reverse effect on epileptics causing medical and mental health professionals to overlook the epilepsy connection and jump right to the neurotic and psychotic diagnostic categories.

Even though it can be a somewhat frightening thought to have your epilepsy re-diagnosed as a psychological disorder, it is still always best to consult your neurologist with concerns about heightened emotions. It might be as simple as changing your medication dosage or even changing your anti-seizure medication completely.

But once again, with regard to the information provided, choose your words carefully.

Closely associated with an epileptic’s heightened emotions is the second condition of Decreased touch sensitivity (aka ”Depakote dropsy”) which will be discussed in the next article of “Epilepsy in plain sight”.

© 2018 Lee W. Outlaw III, PhD

I am an Epileptic

 

Having been one all my life, it is sometimes easy to overlook the fact that I am indeed an epileptic.

I am on medication and live a fairly normal life. I do most everything that non-epileptic people do; in fact after eleven years and seven attorneys attempting to get this “Grand General Epileptic” disability, the state and federal governments denied such because they declared that I was a “functional epileptic”.

“Functional epileptic”, is there really such a thing? That’s a topic for another discussion.

None the less, most epileptics will tell you it’s not necessarily the seizure that’s the great concern but everything leading up to and afterwards such as pre and post seizure auras that are truly debilitating and hinder the ability to “be normal”.  

For the non-epileptic, it’s important to note that epileptic auras are for most, more dreaded than the seizure itself and like a seizure they can occur unexpectedly at any time with or without medication with no reason as to the cause.  

One thing for certain is that there is nothing fun about an aura. They can last from a few minutes to hours or even days. The average aura time for most epileptics I know is about 15 minutes. My average aura last 24 hours but I have experienced a pre-seizure aura which lasted 2 days and a post-seizure aura which lasted almost a week.

Auras are terrible. They can be mild to migraine headaches, the proverbial “seeing stars”, visualizing “saintly” like glows or halos around people, visualization can take on a yellowish hue as well as experiencing  strange sounds and odors.

But the worst aura experience of all for most epileptics is dissociation; the feeling of uncertainty of where you are or what many epileptics describe as a sensation of being in multiple places at the same time. Some have suggested it is like you’re here but also somewhere else. The bottom line is if you haven’t experienced it, you simply can’t understand.

The aura often causes an epileptic to lose momentary thought, focus and concentration.

Some research now suggests that due to their debilitating effect on the epileptic, these auras are actually partial seizures. Regardless of what these auras are, they can certainly slow a person down, delay or even force a change or cancellation to plans.

It is important to note here that some epileptics never experience an aura.

In addition to the auras and seizures, there is also the emotional trauma sitting in the epileptics unconscious mind constantly asking the question, “Will I have a seizure today”? And “If I have a seizure today, what kind will it be”?  

Those questions usually give rise to more questions which give rise to more questions such as, “Since I feel kind of strange today, should I go out in public and chance having a seizure away from home”? If you drive, “Should I try to drive today and possibly have an accident or even hurt or kill someone”?

“I’m feeling constantly sleepy, do I need sleep or am I trying to pass out and seize” and “if I take a little nap, will I have a sleep or wakeup seizure”? “Should I go to the ER or should I call my neurologist or am I just being silly and paranoid”?

Although life for everyone is filled with uncertainties, for the epileptic these uncertainties become magnified.

For this epileptic, the past month had gone very well; between my medications of Depakote and CBD oil I was stable and feeling great. I had gone to church, out to eat, a birthday party or two and even driving during day light hours. Being an epileptic simply wasn’t on my radar and didn’t seem to matter.

Then suddenly out of nowhere last Saturday, I experienced the worst aura since 2008. My hands and arms shaking, visualization suddenly yellowed, found myself staring for long moments into space, then the dreaded feeling of disassociation; the feeling of being in two separate places at once.

The feeling was horrible and quite frightening. The last time I had an aura that intense was prior to a “Grand Mal” seizure while driving in 2008. There was nobody hurt and no damage except to my van which was totaled. Thank God a police officer witnessed the entire thing and called the paramedics who took me to the ER immediately.

That recent Saturday aura suddenly brought me back to reality reminding me that I am an epileptic.

Then this very morning, with plans in process, my day is interrupted by having a moderate morning wakeup seizure with a traumatic follow up post-seizure aura destroying both my plans for the day and possibly my future.

It is totally debilitating, destructive and often humiliating (as it was for me today), this thing we call epilepsy.

But once again, I am an epileptic and as most neurologists tell us, we can have a seizure at any moment of any day; unfortunately for some repeatedly throughout the day.

Cancelled plans and appointments, inability to keep commitments, feelings of inadequacies and indecisiveness, frustration and associated depression; all associated with epilepsy.

Take the meds as prescribed, get eight hours sleep, try and avoid naps and seizure causing meds and still a seizure and/or an aura is possible.

I can never forget I am an epileptic.

© 2017 Lee W. Outlaw III, PhD