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What Causes Epilepsy?
Question: 45 year old woman, presenting with confusion and auditory hallucinations. left internal carotid artery aneurysm clip 8 years ago (developed epilepsy after surgery). acute: Potassium 3.3 (L), gamma GT 119 (H), total protein 63 (L), Globulin 21 (L), Phosphate 1.68 (H), White cell count 12.3 (H), Lymphocytes 4.9 (H), Monocytes 1.4 (H), platelets 148 (L). Also: several falls, minor head tremor. no psych Hx
What is the possible diagnosis? how can the blood levels be explained? is there a correlation? organic cause?
I am still a little puzzled with the presentation as the patient denies any alcohol consumption, only admits cannabis use occasionally.
She is taking the following medications:
Valproate 1200 per day
Oxycodone
Rosuvastatin
Metoprolol
Topiramate
aspirin
Oestradiol
Risperidone 10 mg per day (just started yesterday)
Benzos prn
CRP was normal
Would there be any organic caus explaining the picture of psychosis, epilepsy, blood level changes and reoccuring falls? I am thinking of Sklerodermia or progressive supranuclear palsy or similar?
Or is it just a accumulation of epilepsia, cerebelar vascular deficiency and epilepsy that causes psychosis and falls?
Thanks again for your answer.
cheers
Dr. Ube
What is the possible diagnosis? how can the blood levels be explained? is there a correlation? organic cause?
I am still a little puzzled with the presentation as the patient denies any alcohol consumption, only admits cannabis use occasionally.
She is taking the following medications:
Valproate 1200 per day
Oxycodone
Rosuvastatin
Metoprolol
Topiramate
aspirin
Oestradiol
Risperidone 10 mg per day (just started yesterday)
Benzos prn
CRP was normal
Would there be any organic caus explaining the picture of psychosis, epilepsy, blood level changes and reoccuring falls? I am thinking of Sklerodermia or progressive supranuclear palsy or similar?
Or is it just a accumulation of epilepsia, cerebelar vascular deficiency and epilepsy that causes psychosis and falls?
Thanks again for your answer.
cheers
Dr. Ube
Brief Answer:
She may have organic psychotic disorder
Detailed Answer:
HI
Thanks for using healthcare magic. I, Dr Abhishek Kapoor, would help you in this query.
In my opinion, epilepsy or falls could be due to brain damage due to cerebrovascular damage. That could be possible due to aneurysm or aneurysmal clip. Epilepsy or falls are common post surgerical complication.
In that case, psychosis may be due to underline organicity. If patient has psychosis few days after surgery, then there is temporal correlation between two. In that case, diagnosis would be organic psychotic disorder.
Deranged liver function test and another test could be due to valproate or other drugs like carbamazepine. All these drugs effect on liver function.
I do not think, she has any immunological disorder or supranuclear palsy. She does not have any other symptoms related to that.
If you have more query, you can ask.
Regards
Dr. Abhishek Kapoor
Psychiatrist
She may have organic psychotic disorder
Detailed Answer:
HI
Thanks for using healthcare magic. I, Dr Abhishek Kapoor, would help you in this query.
In my opinion, epilepsy or falls could be due to brain damage due to cerebrovascular damage. That could be possible due to aneurysm or aneurysmal clip. Epilepsy or falls are common post surgerical complication.
In that case, psychosis may be due to underline organicity. If patient has psychosis few days after surgery, then there is temporal correlation between two. In that case, diagnosis would be organic psychotic disorder.
Deranged liver function test and another test could be due to valproate or other drugs like carbamazepine. All these drugs effect on liver function.
I do not think, she has any immunological disorder or supranuclear palsy. She does not have any other symptoms related to that.
If you have more query, you can ask.
Regards
Dr. Abhishek Kapoor
Psychiatrist
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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