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What do my lab test reports indicate?

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Practicing since : 2004
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My 94 yr. old mother has started having "events" in her head....sensations across her forehead and down one side of her face. Sometimes during the "event (less than 2 min.) she reports she hears voices. Following the event she has severe anxiety. She has been diagnosed with tic doulereaux. I think it may be simple partial on-set seizures. She is on Xanax and Depakote, recently changed to Triceptal. They are only moderately successful in controlling her moods, but not the "events" or the anxiety. Any suggestions for causes of the events or a change in meds?
Posted Thu, 30 Nov 2017 in Headache and Migraines
Answered by Dr. Olsi Taka 10 hours later
Brief Answer:
EEG should be done.

Detailed Answer:
I read your question carefully and I understand your concern.

The description you provide doesn't seem to be related to tic doulereaux, not part of its manifestations. It is a little unclear what has she been taking Depakote and Trileptal for, whether for seizures or another diagnosis. I imagine she is taking Xanax for anxiety (though it is not that advisable to continue long term treatment with Xanax because it develops tolerance and side effects on cognition).

Partial seizures which you mention are a valid hypothesis. However it should be investigated with an EEG. While EEG is not always conclusive and doesn't exclude the diagnosis, if it shows any changes it would confirm the diagnosis.
As for treatment Trileptal would be an appropriate treatment for partial seizures.

Regarding other possibilities, if EEG shows no changes then possibility of those episodes being hallucinations should be considered. At her age cognitive changes are more common in general, actually medication like Xanax and antiepileptics do not help either. An evaluation for dementia is necessary, however before considering treatment for that EEG should be done first.

I remain at your disposal for other questions.
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