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Tue, Feb 12 10:12pm · Transient Global Amnesia and its treatmet/medication in Brain & Nervous System

Yes, I had an EEG. That is for epilepsy testing. Is that right? I remember the doctor was slightly cautious, not saying that this was a classic read out for epilepsy. But he seems satisfied that this is what I have.
You are right. I should make him be very specific.

Tue, Feb 12 9:50pm · Transient Global Amnesia and its treatmet/medication in Brain & Nervous System

Hello Leonard, I really appreciate you taking the time to think about this and write to me. You ask good questions. I don't have answers to them all, and I wish my doctor, good though he is, were more informative.

The story is that I had a large cyst in a part of the brain adjacent to the memory part in a ventricle. (https://en.wikipedia.org/wiki/Choroid_plexus. It brought headaches and memory loss. I never lost awareness of who I am, or faces, etc. but episodes of my experience would just disappear, such as having been on an overseas business trip with a colleague, promises made and before completely vanishing. Part of the diagnosis was WAIS testing, my score for working memory was very low. MRI showed a huge inflated cyst right in the middle of my brain.

I had the surgery, and the cyst was removed, and within days the WAIS test score was above average. But then over the following year, similar (I don't know if it was the same reason) amnesia would occur. Eventually, my surgeon said it was probable that I was having brain-only epilepsy. I have never had a full-body seizure or lost consciousness. A couple of months back he started me on Valpro, but I had a physical reaction against it, and then he switched me to Vimpat (Lucosamide). I have felt cognitively sharper on it over the last month.

I am 50 now, but I have never been suspected of having epilepsy previously. My understanding is that the cyst may have somehow affected the circulation of blood, and that vascular insufficiency could have brought on this epilepsy. The acute problem with the cyst happened about two years ago, but as time goes by, it is obvious that certain memories that should be there are gone, or at least inaccessible. The furthest back I have identified such missing memories is about six years ago. So my thought is that I may have had this form of epilepsy for a long time. What I don't know is whether the subarachnoid cyst exacerbated this existing condition or actually is the cause of it, due to disrupted blood flow.

Do people go through life with mild undiagnosed epilepsy and are just thought to be a bit absent-minded?

Anyway, from my reading, I thought I had TEA, but the doctor yesterday said TGA. Do you know if TGA responds well to anti-epilepsy medication?

I would really appreciate your insight! Your profile shows that you must know an awful lot about this.

Best,
David

Tue, Feb 12 6:11pm · Transient Global Amnesia and its treatmet/medication in Brain & Nervous System

Thank you, John. I will next look at these articles.
As I said to Lisa, Mayo Clinic is such a wonderful site, and I really thank you all for your kindness and dedication.
David

Tue, Feb 12 6:09pm · Transient Global Amnesia and its treatmet/medication in Brain & Nervous System

Thank you, Lisa. And let me add what a great, great resource this website is. Incredible, actually with all the moderators and information available. And thank you for answering me so quickly.
My doc is great, but he seems very cautious in saying very clearly one way or the other about various issues. I can say that my memory feels a lot sharper since being on Lacosamide. It's just this apparently reputable journal article clearly said TGA doesn't respond to epilepsy medication, so I wonder what I am being treated for.

Tue, Feb 12 3:55am · Transient Global Amnesia and its treatmet/medication in Brain & Nervous System

Hello,
As I have written elsewhere on this site, I was treated surgically for a large, subarachnoid cyst (in the velum interpositum) in the summer of 2017. I had been experiencing severe amnesia. The operation was successful in that my memory improved. The surgeon warned of the risk of "convulsions" in the surgical plan, and over the following year or more, I had ongoing occurrences of memory loss. Last December, my surgeon started me on epilepsy medication, as a treatment for these memory failures. From my reading, I took it that I had Transient Epileptic Amnesia. Today, I went for my latest check-up and to get my next prescription of epilepsy (Vimpat aka Lacosamide), and he told me that in fact I have Transient Global Amnesia. (TGA)
So far so good, but I immediately checked the medical literature on TGA, and the first paper I read (published in QJM) says that TGA doesn't respond to anti-epilepsy drugs. https://academic.oup.com/qjmed/article/107/11/915/1512956
I thought Lacosamide is an anti-epilepsy drug. If TGA doesn't respond to it, why has the doc prescribed it? Vimpat is a non-generic drug and it's really expensive.
Does anyone have a similar situation or knowledge about TGA or its treatment?
Many thanks,
David

Tue, Jan 29 5:43pm · Rather worrying memory/processing symptoms at 23 years of age in Brain & Nervous System

Hello,
At the beginning, you wrote that these issues have presented themselves only recently. It must be quite disconcerting. Does this issue vary during the day, or is it constant? You mentioned that apart from this, you have no symptoms, so perhaps you don't get nausea or no headache? Do you ever have difficulty distinguishing colors, or recognizing people's faces that you know? Is your peripheral vision ok? Since you are beginning to notice symptoms in a separate function, your speech, I would say, get it checked out as quickly as possible. If I were you, I would keep a detailed diary of every occurrence, time, place etc. of what you notice. This will help your doctor to assess more readily the pattern of your symptoms.

Fri, Jan 25 9:18pm · Arachnoid Cyst in Brain & Nervous System

That didn't quite happen to me. I didn't forget what to say in the middle of a sentence, but I would repeat myself during a conversation which people, including my wife, reported that they found strange or alarming. I didn't have examples of what you mentioned about failing at things I'd done so many times. In my case, I have always been almost completely unaware of my seizures. The times I can remember are waking up and being confused. It happened on a plane. I woke up and had no idea where I was going or why I was there (I was going home). Maybe it was the consternation of that which is why I remember it. In many cases, it is much more mundane, and perhaps for that reason, I just don't notice while it's happening. At any rate, my wife is very positive about my improvement over the last month.

Fri, Jan 25 8:50pm · Arachnoid Cyst in Brain & Nervous System

em87, that is great news. After surgery in July 2017, I finally got referred for an EEG a couple of months ago, and it turned out that seizures were most probably causing my memory issues, even after the successful surgical resolution of my cyst about 18 months ago. In December, I got a tentative diagnosis of Transient Epileptic Amnesia ~ epilepsy limited to within the brain. I have been on drugs for this for a few weeks now, and I feel much sharper. It's not clear where this sprang from, but somehow it seems to be connected to the large cyst that I had. Doctors cannot tell me how long I had the cyst. But it is possible that it had been interfering with blood circulation ("vascular insufficiency"), which my reading tells me can be connected to (epileptic) seizures.
As time goes by, I notice more and more that my memory blanks go back several years. For example, I took my mother on a trip to Japan in 2013, but I couldn't recall it. My wife reminded me of it last week. When I cast my mind back before 2013, everything seems to be in place. I am 49, and I am confident that this is not early dementia. Moreover, the academic article I read on this said there that there is no evidence of a link between Transient Epileptic Amnesia and future onset of dementia. I guess it's kind of a mechanical issue that can be sorted out. The epilepsy medication I'm on now (Vimpat) has a very high rate of completely preventing the seizures. It's just I have to stay on it forever. Now I feel more comfortable with that.
To my surprise, it turns out that all forms of epilepsy occur in about 1% of the population. I just had no idea. Another interesting thing I read is that seizures can occur right after waking up, and that definitely happened to me. Has that happened with you too?
Good luck with this all. It has felt bewildering, but I am back in a good place now.