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Suggest treatment for seizure activity after TBI

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Posted on Mon, 18 Jan 2016
Question: I have TBI caused by a life threatening fall 14 feet face first onto a wood floor below. After two years and 14 surgeries later, we realized I had brain damage with multiple symptoms. (Could not have an MRI due to a metal stapes in my R ear) Eventually, I started to have seizures (non-Epileptic) diagnosed by the Seizure Center in XXXXXXX I am currently taking 10 mg Diazepam under the tongue to stop the seizure. Occasionally, a second pill is needed to stop it and has to be put under by tongue by someone else. How long would it take for this dissolvable pill to react with my system?

Diazepam is all that seems to be able to stop my seizures.... I really haven't tried anything else... Not many Drs or specialists seem to understand how to deal with seizures unless they are epileptic....
doctor
Answered by Dr. Erion Spaho (1 hour later)
Brief Answer:
Diazepam oral dispersion tablet takes 10 minutes to act.

Detailed Answer:
Hello and thanks for using HCM.

I have read your question and understand your concerns.

If the 10 mg tablet of Diazepam that you use to control nonepileptic seizures is a formulation known as oral dispersion tablet, it takes approximately 10 minutes from putting it under the tongue till start of therapeutic effect.

Common formulation tablet of Diazepam takes up to 40 minutes to start the therapeutic effects.

It is true that nonepileptic seizures are often misdiagnosed and taken for psychiatric disorders.

If the diagnosis is right, the most effective treatment modality about nonepileptic seizures today with positive results in stopping nonepileptic seizures in around 60% is cognitive behavioral therapy informed psychotherapy together with the use of sertraline.

Hope you found the answer helpful.

I remain at your disposal for further questions and clarifications.

Greetings.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Erion Spaho (4 hours later)
Thank you so much for your answer. Now, I am a little confused because my husband just told me that he asked the pharmacist when he went to pick up my diazepam 10 mg prescription, if it was 0DT and the pharmacist said no. However, I have been taking this for three years for my seizures and when I put the first pill under my tongue at the first sign of a seizure, it does dissolve extremely quickly. Sometimes my seizure can go away in under 15 minutes and sometimes it won't go away and can get worse, so in 20 to 30 minutes, I need to have someone else put the second pill under my tongue to dissolve and then the seizure will finally quit within 15 minutes after that dose. The longest that I have had to wait for my second pill has been almost an hour and a half when the emergency room did not know how to handle my seizure and had to wait for my husband to come pick me up and take me home to give me the 2nd pill himself. (At that time I only carried one pill with me. But now I carried two.). So many doctors and emergency room technicians do not understand seizures and less there epileptic and are at a loss as to how to treat them. But my questions: 1.) is there an ODT diazepam 10 mg pill available. 2.) is it possible that the pill I have been taking is dissolving quickly enough under my tongue to affect my seizure in under 15 minutes as it appears to have done a few times? I can usually tell if it is going to work or not within 10 minutes but I cannot communicate very well at all during the seizure even though I can hear most of what is going on around me. The problem is that some people are not believing that the pill is affecting my seizure that quickly and that is acting like a placebo. And that upsets me greatly because I am terrified through my seizures and I can feel his medication is working or not and I would do anything I could to stop them if I could. The problem is that some people are not believing that the pill is affecting my seizure that quickly and that it is acting like a placebo. And that upsets me greatly because I am terrified through my seizures and I can feel if the medication is going to help with just one pill or not and I would do anything I could to stop them if I could. I desperately want to stop these. Question 3.) do you know of any place in the knighted states it is stating the fact of Trumatic brain damage and seizures in correlation? I know there have been many many other people with similar issues especially with so many PTSD veterans. My injury is a form of PTSD as well. I was extremely blessed to be able to live through it but now I feel maybe not so blessed because nobody seems to understand what I am going through nor do they believe that it is not just psychological. I know I have brain damage and many have admitted that. Any help or device in this area that you could provide or that your colleagues may know about my conditions would be extremely appreciated. Thank you so much.

I just reread my comments from last night and realized how poorly they were written. That is just another symptom of my brain damage as I wrote them later in the day. I am including a fixed copy. Please excuse the original.

Thank you so much for your answer. Now, I am a little confused because my husband just told me that he asked the pharmacist when he went to pick up my diazepam 10 mg prescription, if it was ODT and the pharmacist said no. However, I have been taking this for three years for my seizures and when I put the first pill under my tongue at the first sign of a seizure, it does dissolve extremely quickly. Sometimes my seizure can go away in under 15 minutes and sometimes it won't go away and can get worse, so in 20 to 30 minutes, I need to have someone else put the second pill under my tongue to dissolve and then the seizure will finally quit usually within 15 minutes after that dose. The longest that I have had to wait for my second pill has been almost an hour and a half when the emergency room did not know how to handle my seizure and had to wait for my husband to come pick me up and take me home to give me the 2nd pill himself. (At that time I only carried one pill with me. But now I carried two.). So many doctors and emergency room personnel do not understand seizures unless they are epileptic and are at a loss as to how to treat them.

My questions:
1.) Is there an ODT diazepam 10 mg pill available?

2.) Is it possible that the pill I have been taking is dissolving quickly enough under my tongue to affect my seizure in under 15 minutes as it appears to have done a few times? I can usually tell if it is going to work or not within 10 minutes but I cannot communicate very well at all during the seizure even though I can hear most of what is going on around me. The problem is that some people are not believing that the pill is affecting my seizure that quickly and that it is acting like a placebo. And that upsets me greatly because I am terrified through my seizures and I can feel if the medication is going to help with just one pill or not. I would do anything I could to stop them if I could. I desperately want to stop these.

3.) Do you know of any place in the United States it is studying the correlation between Traumatic Brain Injury and seizures and working with patients? I know there have to be many many other people with similar issues, especially with so many PTSD veterans. My injury is a form of PTSD as well. There are so many seizures that are not epileptic. I was extremely blessed to be able to live through two of my falls but now I feel maybe not so blessed because nobody really seems to understand what I am going through nor do they believe that it is not just psychological.

Unfortunately, I keep falling and repeatedly hitting my head. This is most probably causing the worsening of my cognitive abilities as well as of my seizures. I feel like an 83-year-old woman in the 52-year-old body with both Parkinson and Alzheimers as my mom and dad have now. The symptoms are so similar. I know I have brain damage and many have admitted that. Any help or device in this area that you could provide or that your colleagues may know about my conditions or where I could get help would be extremely appreciated. Thank you so much for you time.
doctor
Answered by Dr. Erion Spaho (23 hours later)
Brief Answer:
Follow up.

Detailed Answer:
Welcome back.

About your questions,
1.yes there are form doses of ODT available,

2. oral tablet dissolves gradually if it is used sublingual, but it takes longer than ODT.

3. as far as I know XXXXXXX Clinic Epilepsy Center is one of the best centers in USA that evaluates and treats successfully nonepileptic seizures.

Hope I helped you.

Wishing you good health and a Happy New Year!

Above answer was peer-reviewed by : Dr. Raju A.T
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Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4272 Questions

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Suggest treatment for seizure activity after TBI

Brief Answer: Diazepam oral dispersion tablet takes 10 minutes to act. Detailed Answer: Hello and thanks for using HCM. I have read your question and understand your concerns. If the 10 mg tablet of Diazepam that you use to control nonepileptic seizures is a formulation known as oral dispersion tablet, it takes approximately 10 minutes from putting it under the tongue till start of therapeutic effect. Common formulation tablet of Diazepam takes up to 40 minutes to start the therapeutic effects. It is true that nonepileptic seizures are often misdiagnosed and taken for psychiatric disorders. If the diagnosis is right, the most effective treatment modality about nonepileptic seizures today with positive results in stopping nonepileptic seizures in around 60% is cognitive behavioral therapy informed psychotherapy together with the use of sertraline. Hope you found the answer helpful. I remain at your disposal for further questions and clarifications. Greetings.