Small town girl you have been really helpful and considerate and helping trying to put my mind at ease. Just I read all the forums saying its temporal lobe seizures? And I have had this on and off for years but it has never got any better if anything it's worse than years ago. It can happen when I'm relaxed too.
I am scared small town girl I really am worried that I will be told it's epilepsy and now the neurologist has said he is going to give me some clobazam just to see if it helps. Now clobazam is given to patients to with seizures.
This was my neurologists last email. Please see below and let me know your thoughts.
I am referring to your latest emails and I am sorry if the response took a little longer. Let me please confirm that I saw you last on 14 August 2017. You had at that time recurrence of déjà vu symptoms. There is an anxiety and panic attack disorder known with you. You have seen other colleagues and I mentioned that MR brain and EEG which I requested were normal. in my conclusion at that time I said that your deja vus were related to anxiety and not consistent with a neurological disorder such as temporal lobe epilepsy. For further details please see my letter.
I then wrote to you again at the end of August 2017 in which I explained again simple partial seizures and their character and came again to the conclusion that your anxiety is the probable caused of your symptoms. You then sent my secretary, Jill, an email on the 24 April 2018 and you said that in the last couple of days you experienced intense deja vus, in which you are feeling spaced out and that you are panicking a little. You also mentioned that you are not under any stress.
Obviously, it is always difficult commenting on these episodes which you described in more detail in your email from my desk and not seeing you personally. However, they do really sound like anxiety attacks and not like seizures from my point of view. I appreciate that you informed me also that you have no amnesia (memory loss, shaking or unusual mouth or body movements.
Then in your email to my secretary today after you read things up on an epilepsy forum. I very much acknowledge also your sinister concern especially as you very rightly mentioned that after these panic attacks were initially treated with antidepressants some years ago you had a generalised seizure and your MR and EEG was thought to be consistent with temporal lobe epilepsy. As I mentioned to you, my colleagues, Dr Gosal, Dr Ealing and Dr Gow, who saw you prior, also thought that your anxiety was probably the main trigger for these episodes.
I of course entirely realise your situation and your concern that you might now develop a generalised seizure.
I would suggest for the moment this management:
1. I would discuss with your GP a drug for anxiety which might be helpful such as Mirtazapine in a low dosage of 15 mg.
2. for the moment I would also take Clobazam 10 mg once daily. This is a drug which is originally a benzodiazepine and we give it as an additional drug with patients who suffer from seizures. The reason for me recommending this is that I would be reluctant starting you on any anti-epileptic medication which needs to be carefully titrated and patients need to take this for at least 12 months to see if there is any efficacy.
Clobazam also has an effect versus anxiety which though is not very significant. However, it reduces the increased brain activity for people who have seizures. It would be interesting if you take this for 4 weeks and see if this changes your symptoms. You then need to be gradually weaned off that drug and the situation needs to be checked again.
I would also suggest that you see me then again in one of my clinics and I would discuss further management with you then personally.