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Loss of consciousness, de ja vu & auditory hallucinations, difficulty in memory. MRI showed generalized brain atrophy. What now?

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I am a 29 year old female with 17 year history of loss of consciousness, de ja vu & dreamy states preceeded by auditory hallucinations. EEG is normal and MRI showed generalized brain atrophy. Recently I am experiencing difficulties in memory and choosing the right words. What do I have?
Posted Sun, 15 Jul 2012 in Brain and Spine
 
 
Answered by Dr. Pratap Sanchetee 3 hours later
Hi,
Thanks for writing in.

I have gone through the history provided by you as above. We need to look for partial complex seizure disorder in your case.

1. I would suggest that a Repeat EEG study, long record EEG and sleep (after sleep deprivation for 8-10 hours) EEG may be prescribed by your epileptologist considering the clinical situation.

2. Considering generalised atrophy in brain, memory impairment and speech problem, we should look for nutritional and toxic reasons. I would need a history of your dietary habits and addictions(if any). If needed, blood is to be tested for complete blood count, peripheral smear study, sugar, creatinine, thyroid functions, vit B12 and other studies may be done. Please consult your epileptologist/Neurologist for the same.

Awaiting your reply
Regards
Dr. Pratap
Above answer was peer-reviewed by
 
Follow-up: Loss of consciousness, de ja vu & auditory hallucinations, difficulty in memory. MRI showed generalized brain atrophy. What now? 25 minutes later
Well 1 neurologist says it is temporal lob epilepsy & started me on keppra, but my other neurologist tells me he is not sure, my psychiatrist says it is not seizures but u still have 2 consult a neurologist.

Am not abusing alcohol or drugs, but I had a difficult birth & was blue for few half a minute after birth. I've done all these tests and they came back normal. I underwent a neuropsychometric assessment which confirmed memory deficits and dysphasia with spatial orientation and left right issues. Am confused as to my diagnosis.

Thanx 4 ur help
 
 
Answered by Dr. Pratap Sanchetee 20 hours later
Dear,

Thanks for writing back.

When I suggested partial complex seizure disorder, it meant neurologist about uncertainty in diagnosis. This can be resolved by observing you or of video recording during attack along with EEG recording (video recording EEG). Since attacks are infrequent, it may be difficult to time it for recording. Thus I would suggest for

1. Repeat EEG study, long record EEG and sleep (after sleep deprivation for 8-10 hours) EEG may be prescribed by your epileptologist considering the clinical situation.

      2. If needed, blood is to be tested for complete blood count, peripheral smear study, sugar, creatinine, thyroid functions, vit B12 and other studies may be done. Please consult your epileptologist/Neurologist for the same.

I wish you speedy recovery.

Regards,
Above answer was peer-reviewed by
 
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