Or both?
From what I understand, bipolar disorder and seizures often go hand in hand. I wonder if this is the case with Rye. It was suggested to me a while back that he may have Frontal Lobe Epilepsy. And the more his ‘incidents’ occur the more I think it’s possible.
Sometimes it’s so weird to me how they can come and go so suddenly and he seems to have very little recognition of them afterward. This sudden onset and sudden disappearance are unlike normal mania, from what I can tell from other people’s experiences. For example, in this last incident that I interpreted as mania, looking back on it it really looked more like a seizure. I mean he was fine one minute and then the next got very agitated and began verbally blasting out expletives as if he had absolutely no control of his brain or verbalization – basically like they depict people as having Tourette’s Syndrome in movies. Just one expletive after the next, after the next. Completely nonsensical. Then he got extremely out of control hyper, angry and violent and then got that weird, distant look and was having delusional thinking about going to California. Then finally when I said I needed to give him the Abilify, shortly thereafter the whole thing was completely over. And he was fine the rest of the weekend.
Weird.
And when these events happen he never really has much of a memory of the whole event or has any ideas of the indicator of what triggered it. Especially the verbal part. He will have no memory of blurting out expletives at a rate of about one per second for 30 seconds. It’s just completely involuntary.
Anyway, from what I have read seizures can look like many things including severe hyperactivity, night terrors, anger outbursts, acts of violence, loss of verbal inhibition, and even hallucinations and delusions. Many times people with bipolar disorder also have seizures. And many times people with seizures are misdiagnosed as having psychiatric disorders when, in fact, they have seizure activity.
Here are some links on the subject:
http://www.epires-journal.com/article/S0920-1211(09)00081-3/abstract
http://en.wikipedia.org/wiki/Frontal_lobe_epilepsy
http://en.wikipedia.org/wiki/Temporal_lobe_epilepsy
Interestingly many famous people, some of whom were thought to have bipolar disorder, have also been suspected as having Temporal Lobe Epilepsy including Sylvia Plath, Edgar Allan Poe and Lewis Carroll (Charles Dodgson).
6 Comments
Interesting. Definitely something to talk to his doctor about. I agree that it doesn’t sound like a typical manic episode. There is rapid cycling bipolar disorder, but what you described doesn’t exactly fit. His not remembering it right after it happened does sound more like a symptom of a seizure.
The similarity of symptoms could be why the anti-seizure drugs like Depakote and Topamax are so often used to treat Bipolar disorder. Perhaps it is not Bipolar disorder that the patients really have?
HB
I wrote this post a while back which contains several links about this topic:
http://bipolarsoupkitchen-stephany.blogspot.com/2007/04/epilepsy-seizures-or-bipolar-disorder.html
Because, there are seizures, and many organic reasons for certain psychotic behaviors, I’ve been down the MRI,CT,EEG road besides genetic syndrome testing with my daughter.
Find a neurologist is my advice, or a neuropsychologist.
From what you are describing – the lack of memory, the involuntary expletives – that doesn’t sound like mania, even for people affected by ultra rapid or ultradian cycling. Do you give Ryan Abilify on an as-needed basis? I thought that type of medication needed to be taken continuously for several weeks to be effective, like the SSRI’s.
Yes, we go see the psychiatrist tomorrow and I am going to ask him about what you all said. Stephany said the same thing about the Abilify not being a PRN medicine and that maybe it was a placebo effect that made him snap out of it. Don thought they may have been the case as well. I’m going to ask about all of this tomorrow. Thanks everyone for the input.
If you do suspect that Rye may have Frontal or Temporal Lobe Epilepsy an EEG may help in identifying it or by taking him to a specialist (Epileptologist).
very interesting. our psychologist mentioned getting an EEG but our pediatrician said he didn’t think he was having seizures. but i didn’t know seizures could look like that. maybe we should get tested. brains are so complicated aren’t they?