Seeking Guidance on Seizure Episodes
I am reaching out for some assistance regarding my child, who is 16 years old and identifies as FTM. I have obtained their consent to share videos documenting their experiences. They are currently being monitored by a neurologist, and we have scheduled a five-day inpatient EEG in the near future. These episodes have been occurring for just over two years, but the recent one is the first instance we managed to record. There is a history of significant psychological issues, including anxiety, depression, PTSD, and potential bipolar disorder. Presently, my child is on a regimen that includes 60 mg of Prozac, 900 mg of lithium, Zyrtec, over-the-counter vitamins, and hydroxyzine as needed. A previous 24-hour EEG yielded negative results. During the latest episode, their heart rate, recorded by an Apple Watch, fluctuated between approximately 135 to 150 beats per minute. Throughout the episode, they were entirely non-responsive but mentioned afterward that they could occasionally hear distant voices, although their recall of the event is minimal. The initial episode lasted around 30 minutes, followed by a brief intermission of about five minutes before resuming for an additional 40 minutes. Interestingly, they have no memories of that five-minute gap. While we have called EMS previously, this time, my child chose not to go to the emergency room afterward. They reported feeling extremely fatigued but managed to regain their usual demeanor within around ten minutes. I am keen to gather further insights into what might be happening and what specific questions would be prudent to discuss with the neurologist. We have long suspected psychogenic non-epileptic seizures, yet this episode appears markedly different from other examples I have observed. An MRI conducted approximately a year ago returned normal results. I am aware that this forum isn't intended for diagnosis, but with the EEG still a couple of weeks away, my concerns are mounting. Any advice or recommendations would be greatly appreciated.
Answers (1)
6/19/2025, 3:01:23 PM
OpenHealth AI
It's understandable to be concerned about your child's seizure episodes, especially given the combination of their medical history and recent experiences. You are taking proactive steps by monitoring and documenting these episodes, as well as seeking professional guidance. The scheduled EEG will hopefully provide more clarity on the situation.
Here’s a brief overview: The episodes you describe may fall into the category of seizures, which can be either epileptic or non-epileptic (such as psychogenic non-epileptic seizures). The fluctuation in heart rate, changes in consciousness, and recovery time can be indicative of various conditions.
Explanation
Given your child's complex medical history involving significant psychological issues, it's crucial to differentiate between potential epileptic seizures and non-epileptic seizures. While the previous EEG was normal, it is not uncommon for seizure activity to not be captured during a brief EEG. The upcoming 5-day EEG is a vital step to provide a better understanding of what might be triggering these episodes.
Psychogenic non-epileptic seizures can manifest similarly to epileptic seizures but are often linked to psychological factors, and they may not show electrical abnormalities on an EEG. Your child's ability to hear distant voices and their fatigue afterward might hint at a different underlying issue or a response to stressors, rather than classic seizures.
Next Steps
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Preparation for the Neurologist:
- Compile all relevant information: Document the frequency, duration, and nature of the episodes, including any heart rate changes and post-episode symptoms.
- Consider keeping a detailed diary of these episodes leading up to the EEG, noting factors like stress, fatigue, or significant life events that may correlate with these incidents.
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Questions to Discuss with the Neurologist:
- What is the likelihood of psychogenic versus epileptic seizures based on the upcoming EEG?
- What other diagnostic options may be necessary if the EEG remains inconclusive?
- How might your child's psychological conditions influence these episodes?
- Are there specific behavioral or safety measures you should consider after these episodes occur?
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Monitoring and Support:
- Continue to provide a calming and supportive environment for your child after episodes, emphasizing your availability to talk if they want to discuss their feelings or experiences.
- Encourage your child to engage in self-care strategies for managing stress and anxiety, including regular physical activity, mindfulness practices, or hobbies that they enjoy.
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Immediate Actions:
- Ensure your child has a safety plan for when episodes occur, including who to contact or what to do in case their condition worsens or they feel unwell.
It’s great that you are actively involved and seeking answers. The upcoming EEG may offer necessary insights, and the ongoing communication with your child's healthcare team will be crucial in navigating their care.
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