"Probable seizure aura with deja vu and strange smells. This is suggestive of temporal lobe dysfunction. I suspect Topamax will relieve these symptoms. At this time I do not feel we need to obtain an EEG. We're going to treat the patient for these symptoms anyway."

What does this mean??
I'm presuming that it means probably having seizure aura's and treating them even though that's all they are, right?

My szs are all simple partials and manifest with weird smells, deja vu, the whole gamut of Sp sxs, and can also be classified as "aura" - but aura are seizures in themselves, they are like a warning of the storm to come and are part of the neurochemical misfiring.

I am on Topomax and that has helped a lot, not 100% but cut back a lot on severity, number and duration. I also have complex migraines and T works for them also. Complex migraine have similar aura to SP epilepsy.

My szs have never shown up on EEG, but my neuro dxd on presentation, description and damage shown on MRI and PET. Your's must be sufficiently satisfied with what you've presented and perhaps other test results to be confident with the dx. The other thing my neuro said is if the med works, then run with it - so if the T works for you, good!

Howdy!

It means that they are so sure that you are having simple partial seizures
(aka auras) that they don't feel that an EEG is necessary. EEGs often
show as normal unless the patient has a seizure during the test!

Partial seizures (both Simple and Complex) are usually associated with
Temporal Lobe Epilepsy.

While Topomax may control the seizures, it is notorious for some nasty side
effects. There is a possibility that the cure might be as bad as the
ailment.

Thanks for the replies Lexi and Dave. That's pretty much what I thought when I asked her "so you think it's just migraines?" and she shakes her head and says "no". I'm not sure why she didn't just come out and tell me. I didn't actually use the word seizure while I was there (and in all honesty I was avoiding it for fear of it leading to driving limitations). I go back to see her in October for a follow up.
Let's just hope it stays as simple partials and doesn't progress to anything further. It's still better than the awful cp's I used to have.

stef

Howdy Stef!

One other thing to keep in mind (may not be applicable)

Not all seizures are due to epilepsy!

Dave-
In a patient with a history with epilepsy what else would seizures be caused by? I'm confused. My impression is that she is trying to tell me (but maybe doesn't want to or is unsure how) that even after surgery I'm beginning to have seizures again. Call it like it is, know what I mean? It's this side stepping that gets me confused. I'm not that fragile. I'd rather know straight out so I can deal with it than tippy toe around it and wonder what's really going on or think that everything is ok when it's not.

Once again, at least it's only simples...

Hi Stefie,
I often have a deja vu sz. that will often lead into a cp or absence sz. I smell odd odours, see colors flashing back and forth in my eyes and get a nervous feeling in my stomach which my epi told me is all part of an aura sz. I was also told the moment I start to get any of these odd senses to tighten up my muscles and make my hands into tight fists for a few seconds to stop the sz. from leading it into a cp or absence sz. and take my word it had worked great. Here's wishing you and the family well. May God Bless All of You!

Sue

I think she's actually saying that she's pretty sure these are Sp szs and we'll treat them straight up, especially considering your history. She probably feels you don't need to go through more tests to confirm things (we all know how laborious EEGs can be) so skipped straight to treatment measures. I would actually take it as a compliment to your knowledge and experience.

Howdy vodpop!

The bit about "history of epilepsy" wasn't in your post.

That was just a bit of general information based on the assumption
that this was an initial diagnosis.

Ok, I see. Thanks everyone. I tend to get confused and tend to over analyze things.. But it makes sense. I'm a pretty direct and to the point kinda person- that always works best for me, otherwise I get confused. I guess I was just expecting her to be more direct with me and to the point.
Thanks again everyone!