# Temporal lobe seizure and Irritable bowel syndrome



## raghavan (Jan 23, 2002)

Hi,I am back at the forum after a gap of nearly 8- 9 months. I have a peculiar symptom which involves losing depth of vision and other visual hallucinations when motion reaches my rectum without my even realizing it and the symptoms clear immediately after I pass motion. Kathleen and others said it could be vaso vagal syncope and asked me to consult a neurologist or cardiologist. Well I luckily consulted a neurologist and told him about this symptom which no other doctor could understand. The neurologist straight away said he wanted me to have an EEG. I underwent an EEG and presto! There it was. The neurologist studied the EEG and told me I have temporal lobe seizures also generally called temporal lobe dysrhythmia. He said the above symptoms that I described is called epigastric aura and it occurs in 60 to 70% of patients with Temporal lobe seizures. He also said my IBS -D was due to this seizure. I have been taking oxcarbazepine 300 mg twice a day and clonazepan MD (Mouth dissolving) 0.5 mg twice a day. All my fatigue has vanished and I am now feeling very energetic. He says my IBS will also go away over a period of time. I wanted to share my experience with others here. If you have funny and vague symptoms before passing motion it is not necessary that it could be vaso vagal syncope. It could be also TLE (Temporal lobe epilepsy). I am a bit worried that my IBS has still not gone away. I want to know from the experts in the forum whether what my neurologist says is correct. Somebody please help. Is there any medical expert in the forum who can throw some light on this. ThanksRegardsRaghavan


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## Erika41 (Oct 22, 2007)

I'm no expert... but I do have questions.... I have been diagnosed with IBS about a year ago. I found my symptoms don't seem to fit the "norm". I've questioned my dr about food allergy's and intollerance and everything and all my tests come back normal. However... I was told I have a Vasil Vagal reaction when I have attacks. Basically I get horrible pain in my lower left abdomin pass out or come near to passing out (VV reation) and if I come to or can do before I pass out, eliminate (D) my attack ends and I'm left exhausted and I have to sleep for a short time after. I just keep getting told its the VV and that an IBS attack takes a lot out of you... but I've never felt that my diagnois has been acurate more that I'm just being told it to passify me. Do or did you have previous seizure history?


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## raghavan (Jan 23, 2002)

Hi Erika,Your symptoms seem very similar to mine. I too feel like I am going to faint if I don't pass the stools as soon as it reaches my rectum. As soon as I pass the stools everything becomes normal. I too had a lot of fatigue and tiredness. Please consult a neurologist and tell him about your symptoms in detail. Ask him if an EEG is necessary? Then also consult a Psychiatrist. I have depression as a side effect of my epilepsy. But my epilepsy was the last to be diagnosed. My neurologist says after some time I will be able to stop my anti-depressant medications. So please consult a neurologist and also a Psychiatrist. I am not saying you have some mental problem. Please don't take it in that sense. My epilepsy and depression are linked through the common factor called neuro transmitter imbalance. So please do consult a neurologist and a Psychiatrist. IBS should not be diagnosed just by bowel symptoms and blood tests. Unfortunately some Gastro enterologists don't realize this.


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## raghavan (Jan 23, 2002)

Oops. I forgot to add. I did have seizures during my childhood. But it was completely cured. That is not connected to the partial seizures that I have nowj. By the way simple partial seizures of the temporal lobe are the most difficult to diagnose. Symptoms can be drastically different from person to person. Sometimes even EEGs don't pick up the symptoms. If your neuro suggests that you take an EEG examination ask him whether it includes light strobes. They will ask you to close your eyes and flicker light on and off at various rates and measure your brain's response. Some EEG technicians don't do that. It is a mistake. It is a must for an EEG.


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## Kathleen M. (Nov 16, 1999)

I'm glad you found out what it was. Sometimes the most common explanation for a symptom (like vasovagal syncope) is not the right explanation which is why it is good to have things evaluated to make sure what it is.It is important, I think, to not assume that all symptoms one has is just IBS and have symptoms that do not fit with IBS to be investigated separately by someone who is a specialist in the area you need.You can have IBS in addition to other things, so fixing the other problem might not totally resolve the IBS for everyone. Treating the other issues should help the IBS as physical stress makes IBS worse.Usually with vasovagal syncope the recovery from feeling faint/lightheaded/dizzy, etc. is fairly short.K.


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## SpAsMaN* (May 11, 2002)

Should i consult a neurologist if the ligths close for a second?It happen once a month.Never collapse from it but i don't like having black out.


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## raghavan (Jan 23, 2002)

Spasman,I would definitely recommend that you consult a good neurologist. Explain all the symptoms in detail to him. First note down even little things like whether the symptom happens before or after you take a meal, or does it happen before or after you pass stools, or does it happen when you are standing for a long time, or when you wake up from sleep and things like that. Prepare a detailed list. By the way do you see sparks of light? That is another symptom that neurologists always ask their patients. Trust me I have an association with neurologists from 1980 when I first got my partial seizures which were images of everything shaking violently for two to three minutes. But outwardly I will look normal, talk normal and everything will seem normal. But the EEG picked it up. So Spasman please do consult a neurologist. If everything turns out to be normal then please consult an experienced Psychiatrist and everytime explain all the symptoms that you get. Don't think that since the other specialist said a particular symptom is nothing to worry about it should not be mentioned to yet another specialist. I made that mistake. So start from A to Z when you consult the neuro and the psychiatrist. If needed stress that you would like an EEG done. Nothing wrong to err on the safer side. By the way do you get any unusual symptom just as you are swallowing the first few mouthfuls of food? Like your eyes feel like popping out or as if the eyes are under some internal pressure. I had that and never thought it was important to tell to the doctor. That was the biggest mistake I made. It is a classical symptom of epigastric aura. This symptom is known as the rising stomach and it pushes the stomach against the diaphragm separating the chest cavity from the gut. But if you explain this symptom to a gastroenterologist they simply stare at you in amazement. They are baffled by this symptom. But a neuro will immediately pick it up as epigastric aura. ( Aura means the premonition that you are going to have a seizure). People with partial seizures get auras before the actual seizure. There are a diverse set of auras depending on which lobe or which foci of the lobe the seizure is going to start from. Well I can go on and on and on about this. But let me not bore you down with this. Please do consult a neuro and then follow it up with a Psychiatrist. Hope you find a solution to your problem. All the best.


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## SpAsMaN* (May 11, 2002)

I don't know.I tougth my one second black out was du to vagus nerve being confused by IBS.


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## Kathleen M. (Nov 16, 1999)

Vagas nerve issues are a very common cause for fainting/lightheadeness, etc.It is not the one and only explanation as we see here. Just because it could be something common and not serious doesn't mean you shouldn't go to the doctor and tell them about it.Most of the time it will be the most common reason for a symptom (that is why it is common). Sometimes like in this case it is not and it is something else that needs a specific treatment for that thing.If the doctor already proved it was just a vasovagal syncope you probably do not need to do more (there are ways to tell if it is that). If you just decided on your own what it was, then it is doctor time.K.


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## raghavan (Jan 23, 2002)

* Abdominal Epilepsy*


> Common clinical features of abdominal epilepsy include abdominal pain, nausea, bloating, and diarrhea with nervous system manifestations such as headache, confusion, and syncope (Peppercorn & Herzog, 1989). "Although its abdominal symptoms may be similar to those of the irritable bowel syndrome, it may be distinguished from the latter condition by the presence of altered consciousness during some of the attacks, a tendency toward tiredness after an attack, and by an abnormal EEG"(Zarling, 1984, p.687). Mitchell, Green- wood and Messenheimer (1983) regard cyclic vomiting as a primary symptom of abdominal epilepsy manifesting as simple partial seizures (1983). Although abdominal epilepsy is diagnosed most often in children, the research of Peppercorn and Herzog (1989) suggests that abdominal epilepsy may be much more common in adults than is generally recognized: Abdominal epilepsy is well described among pediatric patients but is recognized only infrequently in adults. Our experience over the past 15 years indicates that the disorder may not be as rare as is suggested by the paucity of literature on the subject. Moreover, the variability of the clinical presentation indicates a spectrum to both the gastrointestinal (GI) and central nervous system (CNS) manifestations of abdominal epilepsy in adults." (Peppercorn & Herzog, 1989, p. 1294) One of the primary problems in understanding abdominal epilepsy is clearly defining the relationship of the abdominal symptoms to the seizure activity in the brain. In other words, what is the pathophysiology of abdominal epilepsy. Is the essential pathology in certain areas of the brain which happen to be connected to the abdominal organs? Or, is the primary pathology in the abdomen which is conveyed through connecting nerve fibers to the brain resulting in epileptic seizures? Peppercorn and Herzog noted both possibilities in their attempt to understand the cause of abdominal epilepsy: The pathophysiology of abdominal epilepsy remains unclear. Temporal lobe seizure activity usually arises in or involves the amygdala. It is not surprising, therefore, that patients who have seizures involving the temporal lobe have GI symptoms, since discharges arising in the amygdala can be transmitted to the gut via dense direct projections to the dorsal motor nucleus of the vagus. In addition, sympathetic pathways from the amygdala to the GI tract can be activated via the hypothalamus. On the other hand, it is not clear that the initial disturbance in abdominal epilepsy arises in the brain. There are direct sensory pathways from the bowel via the vagus nerve to the solitary nucleus of the medulla which is heavily connected to the amygdala. These can be activated during intestinal contractions. (Peppercorn & Herzog, 1989, p. 1296). At this time, there is no definitive model of abdominal epilepsy which explains the association of brain seizures and abdominal symptoms. However, there is a growing body of medical information which may lead to a better understanding of this complex relationship.


http://www.meridianinstitute.com/epilepsy.htm


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## raghavan (Jan 23, 2002)

> *Abdominal epilepsy. A cause of abdominal pain in adults*M. A. Peppercorn, A. G. Herzog, M. A. Dichter and C. I. Mayman Four patients, aged 17 to 47 years, had paroxysmal abdominal pain associated with symptoms suggestive of a CNS disturbance. None had a discernible primary gastrointestinal process, but each had EEG abnormalities and a striking response to anticonvulsant medication. These findings suggest that abdominal epilepsy should be considered in the differential diagnosis of unexplained paroxysmal abdominal pain.


http://jama.ama-assn.org/cgi/content/abstract/240/22/2450


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## raghavan (Jan 23, 2002)

I have posted the above articles not to scare IBS sufferers. I was diagnosed with IBS by four gastroenterologists, two neurologists and two psychiatrists. But I did not give up. After a long period of ten years of suffering, my temporal lobe epilepsy surfaced in the EEG even though the previous EEGs turned up normal. Why I am stating this is if your bowel movements are associated with funny feelings in your head or impaired consciousness or giddiness before passing motion it should be properly evaluated by expert neurologists and psychiatrists before ruling out neurological disorders of the brain. Since the diagnosis of IBS still has no definite markers it should always be borne in mind that you should keep looking for the root cause of your GI symptoms. Please note my mentioning it as GI symptoms. Don't arrive at the conclusion that you have IBS just based on the opinions of a few Gastroenterologists. Gastroenterologists should be consulted to rule out other GI disorders. Once that is done then I would strongly recommend visits to Neurologists and psychiatrists. My case is rare. You might be one of those rare cases. So it is better to be cautious than coming to the conclusion that you have IBS and resigning to fate. (Which is what at present IBS sufferers have to undergo)PS: None of the Gastroenterologists or psychiatrists I consulted have heard anything about the symptoms of epigastric aura also called epigastric rising or rising stomach which also causes the heart rate to increase (Tachycardia) and also causes severe heart burn. Believe me it has been a nightmare for me for the past 12 to 13 years of heart burn, mental confusion, fatigue and exhaustion.


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## Flbeachbuddy (Jul 14, 2018)

Hello, Raghavan, wondering how you are feeling and if your symptoms have reduced. 
I really appreciate the information provided.


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