anbuend wrote:
I'm befuddled by the amount of people who said that having their brains scanned with the scan showing up a certain way showed they didn't have seizures. A structural scan doesn't rule out seizures, it just is possible that it shows a visible reason someone might be having seizures (or things that look like them), and that's important to be ruled out. An EEG doesn't rule out seizures, unless you're having the sort of seizures an EEG should be able to pick up on, right at the time you're having the EEG, and the EEG doesn't pick up on it. EEGs only pick up on certain kinds of seizures, and they sometimes can show patterns of activity that occur because of seizures (but that are not seizure activity itself) when seizures are not happening, but some people have seizures without that pattern of activity. And some kinds of seizures are simply not possible to pick up on by EEG.
That's why the next move if a person is having seizures, is to try to figure out if what is being reported sounds like a known form of seizure, and then to attempt anti-seizure medications (particularly kinds that work on that kind of seizure) to see if it helps. That's how they figured out I have complex-partial seizures. (And I also have abnormal patterns of brain activity in a region it's common to have that sort of seizure in, but deeper in the brain than an EEG generally picks up on.) Treating it with anti-convulsants that are generally good for that kind of seizure does work, therefore it's probably that kind of seizure. (And also, another bit of evidence is that on drugs that lower the seizure threshold I start getting atonic seizures and myoclonic seizures very easily.) I've never had a seizure at the same time as having an EEG, so there's no other way they could really know.
It's also unknown whether pseudoseizures are really for emotional reasons or not. I've never been considered to be having pseudoseizures, but from what I've seen of the research, they simply don't know what causes them, and a lot of people with genuine epilepsy also have pseudoseizures along with it. It could be that some other mechanism of the brain or the rest of the body explains them that they don't understand yet, and that's what I've read in places that don't simply put it down to "emotional reasons". It's been my experience that people who are not all that competent in medicine will use "emotional reasons" as a cover for "I don't know," since "I don't know" is a blow to some doctors' egos, and "emotional reasons" will get a patient to go away. A competent doctor will just say "I don't know" and list a number of possible reasons if they know of any, and look into them or consult someone who does know.
i have intractible epilepsy...
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