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Partial seizures for a patient with Epilepsy - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Epilepsy
Answered by

General & Family Physician
Practicing since : 2009
Answered : 681 Questions
User :   Hi, i am an allready known epileptic with complex partial and tonic clonic seizures. recently upon waking i have been experiencing odd things, when i look at things everything goes small and i have twitching in my right thumb and then hand. it last for about a minute or so, i was just wondering if this could be a seizure?
Doctor :   Hi
User :   hi
Doctor :   give me a couple of mins to read your query.
User :   ok
Doctor :   did you feel any blurring of vision?
Doctor :   what were the other symptoms?
Doctor :   apart from the things you mentioned?
User :   no, everything is just like out of proportion and small
User :   its hard to explain, at the same time my right thumb twitches and then my whole hand
Doctor :   ok, after the episode did you have any headache, loss of consciousness, etc?
User :   no loss of consciousness, a little bit dazed afterwards but not for long
Doctor :   Ok
Doctor :   have you had similar episodes of the same type before ? apart from the epilepsy you mentioned.
User :   i have had them on and off for a while, its exactly the same everytime which was made me wonder
Doctor :   ok
User :   its not scary, i dont feel anxious or anything... its just weird...and annoying
Doctor :   generally a simple partial seizure may preesent in similar ways
Doctor :   probably lasting for as less as 30 seconds also.
Doctor :   any changes you felt with the mouth , any twitching in the face?
User :   top lip feels like it is but i havent looked in the mirror or anything
Doctor :   ok
Doctor :   this could be a seizure, but we may not be able to exactly come to a conclusion
Doctor :   generally they start with warning symptoms
Doctor :   as in visual disturbances, a headache , tremors, etc.
Doctor :   sometimes loss of conciousness or going blank for few seconds.
Doctor :   are you on any medications?
User :   yeah
User :   keppra
Doctor :   ok
Doctor :   have you seen your doctor after getting these episodes?
User :   not yet, i dont want to bother them if its just nothing
Doctor :   I feel you may need to bring this to the doctor,s notice next time.
Doctor :   generally these seizures may manifest widely, sometimes with a minor twitching as well
Doctor :   in your case as you have had similar episodes , we need to evaluate this.
Doctor :   do you associate it with eye problems always?
User :   how do you mean?
Doctor :   I meant whenever you get the twitch , do you always feel the things around appear smaller?
Doctor :   or was this the first time.
User :   yeah i know its gonna twitch because everything goes small first
Doctor :   Ok
Doctor :   I cannot exclude the possibility that this could be a seizure.
Doctor :   since you have a history of seizures.
Doctor :   twitching of the hands may indicate a seizure episode.
Doctor :   are you there with me?
User :   yeah
Doctor :   before this episode, when did you have the last episode of seizures?
User :   what the other seizures?
Doctor :   yes.
User :   theyve never really stopped
Doctor :   ok
Doctor :   when was your last consultation for the same with your doctor?
User :   i see an epilepsy nurse every 3 months, and the consultant every 6 months
Doctor :   I think you will need a review on the current medications .
User :   i dont wanna bring it up coz i have had non epileptic seizures in the past too... and if they are going to just say its non epileptic then i have wasted their time
Doctor :   I feel these are seizure episodes
Doctor :   we need to get the blood levels of the present medicine.
Doctor :   as well as do an EEG, to conclude correctly
Doctor :   If the serum levels are low, you need to increase the dose of the medicine.
User :   im allready on the highest doese though? i dont think i can go any higher
Doctor :   if there is evidence of abnormal activity on EEG, you will need other medicines in addition.
Doctor :   Ok
Doctor :   Then we may have to add second drug
Doctor :   are you there with me?
User :   yep
Doctor :   I hope you followed my suggestion.
User :   yes, i think i will mention it to my epilepsy nurse tomorrow
Doctor :   to summarize, I feel you need a second drug to control the seizures , I recommend that you review the medication with your doctor or nurse.
User :   okay, so do you think the odd things i have been experiencing may be another type of seizure?
Doctor :   It may be the manifestation of the same type of seizure or another one as well.
User :   ok
Doctor :   I hope I answered all your questions.
Doctor :   Are there any more questions that I can help you with?
User :   no thankyou very much for your time
Doctor :   pleasure here.
Doctor :   thanks for consulting me.
Doctor :   Bye for now.

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