Yvonne,

Thank you for taking the time and effort to be detailed, clear yet concise
about so complex a topic.  You illuminated my ignorance regarding matters
epileptic.

Until I read your (and Bobby's) explanations I would have thought young
Zachary to be "in love" or realizing the "full magnitude of pending
adulthood."   I would be yakking uselessly about being male, struggling with
unrealized dreams, insecurities, and unrequited testosterone attacks.  ;-)

Robin, being a good, caring, and intelligent mother, now seems headed in the
better advised and proper direction.  I hope Zach will be on effective
medication and in better mind and body soon.

S.


----- Original Message -----
From: "Yvonne Craig" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, October 04, 2000 12:58 PM
Subject: Re: CP - Cured ? (Steve)


> 10/03/00 12:21PM "I. S. Margolis" wrote:
>
> <<<<Please help me understand.  Am I "correct" inferring from your =
> statement
> that temporal lobe epilepsy may not always manifest grand or petite =
> seizures
> yet still be present or active enough to mimic psychotic-like
symptoms?>>>>=
>
>
> Although there is usually a history of observable seizures these may be =
> quite different than standard grand or petit mal seizures. The seizure may
=
> manifest itself as a complex-partial seizure and be characterized as =
> repepitive, meaningless actions (walking in a circle, opening and closing
=
> a drawer repeatedly, facial grimacing, etc.). Or lots of variations of =
> this. Sometimes the seizure activity is not apparent to the naked eye - =
> only seen in specialized tests like EEGs (picks up electrical activity in
=
> the brain much like an EKG/ECG picks up electrical activity in the heart).
=
> The seizure activity can happen during sleep. Because it is not always =
> what people typically think of as seizures, temporal lobe epilepsy is a =
> bit trickier to diagnose sometimes.=20
>
> <<<<<Would you illuminate" your phrase "post-ictal" phase? >>>>=20
>
> Sorry for the jargon slip. :-)  Post-ictal is the name for the post =
> seizure period. Each person and each seizure type varies in the specifics
=
> of this. Petit mal or absence seizures usually have a very short phase - =
> some people just come out of the seizure and resume whatever they were =
> doing. After a grand mal seizure, for example, a person may be very =
> confused or extremely tired and have to "sleep it off" for a few minutes =
> or several hours. Often a person with temporal lobe seizures may have an =
> extended period of just not being themselves. Feelings of paranoia and =
> delusions can occur. If these are the symptoms that present in the patient
=
> it is not uncommon for the assumption to be that this is a psychiatric =
> problem rather than neurological.
> Especially if the patient didn't have any obvious seizure activity in the
=
> first place. This is rare, but I've seen enough patients in my 15 years =
> with atypical presentations of seizure disorders misdiagnosed initially as
=
> schizophrenia or psychotic depression that I always keep it in the back of
=
> my mind. Especially with a sudden onset of symptoms.
>
>  <<<<<And what is the likelihood of remission/recurrence?>>>>
>
> Again this varies a lot from person to person. I haven't worked directly =
> in Neuropsych for a few years so I'm not up on all the latest meds and =
> treatments. Usually people are put on meds for a while, monitored and =
> after a period of being free of seizures are gradually weaned off the =
> drugs. Then you see if they remain free of seizure activity. A lot of time
=
> it is trial and error to find what works for the individual. Some people =
> have multiple seizures(could be in the 100s) per day - some have 1 or 2 =
> over their lifetimes. Seizure control can vary a lot too.
>
> <<<<Thank you for making me aware of the more likely gradualness of =
> psychosis.  ;-)   >>>>>
>
> Were you worried? Hehehe There's an old joke that if you're worried that =
> you're going crazy, you're not! :-)
>
> It's not that psychosis never has an "overnight" onset, it's just not the
=
> norm. Usually if it is very sudden, I tend to think of acute stress =
> reaction, post-traumatic stress disorder, or an organic problem (something
=
> neurological, like seizures, or physical, like a thyroid problem).
>
> Hope this helps!
>
> Yvonne
>
>