Hello Strider...
Sorry I missed your post. Hopefully, you'll be back again to keep us informed on how things go for you.
I know someone with a minor form of Epilepsy
(not saying I think this may be the case by any means but just putting it out there as it having some sort of temporal issue could be worthwhile to look into) so I'll try and help you out if I can.
Yowza: It depends on what angle you want to approach this at. You mention marijuana as helping with these sensory issues maybe by having somewhat of a balancing effect? Has the doctor ever recommended an anticonvulsant for you?
You mention performing poorly on working memory tests yet with very good processing speed and IQ. Maybe your temporal lobes could be firing erratically at times (there are subclinical forms of epilepsy without visible seizures or loss of consciousness) or maybe not.
Strider: Yes, I guess a sort of normalizing effect. No, the doctor has not recommended an anticonvulsant...but what good would that do?
An anticonvulsant may be of some benefit If you have a minor form of "atypical epilepsy" with absence seizures that occur at different points during the day or night
(this can be as little as a second or two and and may manifest as a breif staring spell among other things).
To test for this, most "clinical neurologists" would look at an EEG and examine factors such as:
-the basic organization of brain wave patterns
-a general change in state that contrasts from the usual wave patterns
(drowsiness or excitability for instance) -check for any notable events such as spikes or sudden changes over a certain area (
there are many different electrodes used on an EEG; each electrode placement correlates to a different brain region); these may be marked as an epileptic like event
Usually an erratic discharge emanating over a certain region is an indicator for possible epileptiform-like activity. Most "clinical nuerologists" will only diagnose a person with "epilepsy" on basic clinical criteria they use to analyze the EEG for obvious signs. However, this may not always be detected; there are erratic discharges that can occur in split seconds or fly under the radar for some other reason resulting in these slight abnormalities seen (or not seen) in the EEG as being regarded as nothing clinically significant. This is why, it is very important to find a clinician whose not only experienced but also is ahead of the game.
The most obvious route to finding a clinician would be just to look up the nuerologists in your area and start making telephone calls. However, this will more than likely get you no where. Most clinicians who go under the title "nuerologist" usually don't interact much with psychologists or psychiatrists; these type of "nuerologists" usually work with the elderly, people with degenerative brain disorders, or very clear signs of brain dysfunction as opposed to people dealing with "psychiatric" and/or "psychological" issues
(or in other words more non-physical forms of brain function not usually classified by a "clinical neurologist" no matter their experience or specialization especially if in a non-research oriented setting). In the future, this may change, but at the moment, "biotypes" and "phenotypes" aren't being used in the
mainstream psychiatric or psychological settings. In order to find a doctor practicing more specific diagnostic methods, it would have to be someone who bridges the gap between "neurology" and "psychiatry/psychology".
This can be quite difficult so I'll provide you with a few links:
http://www.amenclini...A&Search=Search (search under "clinician", "psychiatrist", or "psychologist"; not all of these are great referances though so before calling you may want to first ask if they use SPECT or QEEG testing on the premisis; QEEG is not only less costly but also offers some advantages to SPECT despite what Dr. Amen may imply in his books)The above link is referral listings (by state) as posted on Dr. Daniel Amen's site. If you've read any of his books (that are sold everywhere including the local Borders bookstore or Amazon), you'll know that he's been using "Spect Scans" (
functional imaging studies looking at brain bloodflow and how it relates to localized metabolism) to provide a general picture that links disruption of metabolism to a specific psychiatric issue. If looking at "epilepsy", most often there will be an "interictal effect"
(meaning timeframe between epileptic activity); this may show up as lowered metabolism that stays in a certain region, such as a temporal lobe
( if 1 temporal area low then this would most likely effect the other one too causing them to be out of sync with one another), as an aftereffect of an "absence seizure" that may have occurred breifly at some point during the day or night. Often on the verge of sleep or while waking up is when these will most likely occur.
As a result, throughout the day, someone with "epilepsy" could be experiencing fluctuations in cognition or lowered attention while sort of living within an interictal zone
(how the brain activity is between seizures). If absence seizures are happenning quite frequent, the brain will try to cope around this issue; therefore, some regions of the brain may become too overly charged to compensate for the regions that aren't. For instance, if one were to look at the suppressed interictal regions on a SPECT scan
(such as the lowered temporal regions being suppressed during an interictal time frame), they'd also notice some spotty activity of high and low areas throughout the cortex. Besides these patchy areas
(maybe as the brain's way of trying to cope around a suprressed region to my understanding) there may also be seen hot spot regions indicating possible focal areas susceptible to epileptic activity.
There are many other links to finding practitioners who practice a different/cheaper alternative to SPECT scans too:Many QEEG practioners are out there
(keep in mind, purely for professional reasons, that if the doctor doing the QEEG is a psychologist or therapist who doesn't closely work with a psychiatrist; they may be hesitant about using diagnostic labels but will most likely suggest something MAY be the case; finding someone who practices this and has a psychiatrist or nuerologist on staff would probably be the best bet):Here's a directory of providers:
http://www.ecnsweb.c...-directory.htmlAlso, here's somewhere I found people discussing the basics of what a QEEG is (
http://neurotalk.psy...ad.php?t=111211).
In regards to QEEG (quantitative EEG), the testing procedure is quite different to a basic EEG; QEEG tests are often done in shorter stints with some being task oriented (5 min. eyes closed, 5 min. eyes open, drawing, reading, ect.). The analyzing and interpretation differ as well since the QEEG uses a computer program to analyze the EEG recordings and also uses a quantitative database (to compare one's recording to a "normal population" to see where/how it contrasts). After the QEEG analysis is done, a report spits out showing the "brainmaps" and other interpretive data for the clinician to look at (often times in a QEEG report there is a very breif clinic report of the raw EEG then the quantitaive/digitilized interprretation follows). Samples of these kinds of reports can be found online by simply googling.
Here's 1 directory that goes by state:
http://www.ecnsweb.c...-directory.htmlKeep in mind that the shorter stints
(5 min. of 1 thing then going to 5 min. of the next) may not be ideal for epilepsy testing (
although it is ideal for assessing cognitive function/dysfunction); a regular EEG with longer recording times
(usually always done with eyes closed to eliminate potential outside factors causing excitability), sleep deprivation, with maybe some hyperventilation+light stimulation at the beginning of the recording are all factors that can increase the likelihood of catching any potential epileptic activity with the EEG. Unlike a QEEG (where you want to stay awake during the recording), relaxing and maybe trying to be in a sleepy mode is actually encouraged while doing a regular EEG recording such as this.
If I were you, I'd do 1 QEEG and 1 regular sleep-deprived EEG with a longer recording with maybe some hyperventilation and light stim. at the beginning thrown in.
I am not having seizures. However, I should note that my father has had seizures in the past, but is on medicine for it so it does not effect him. But I do not think he is epileptic as in gets seizures from flashing lights. But yeah perhaps I do have one of the subforms of epilepsy? How would I test if I do though? How likely could I have that?
This very well could be the case, although if your dad has them then this would increase the likelihood alot. If yours is harder to detect, it could be very hard to find out for sure. That's why I took the time to right everything above so you (and anyone else curious) could try and find a practitioner who attempts to bridge the gap between neurology and psychology/psychiatry. Not everyone who uses an EEG as part of their testing regimen will use this form of testing to examine psychiatric issues just as not every psychologist is willing to go the extra distance in terms of using objective testing to refine a diagnosis.
Yowza: Otherwise, you could just be hypercoherent in which case certain parts of the brain could become worn down at times; too fast of a processing speed isn't all good since the brain can either burn out or lock up in certain areas to cope with situations where the gas pedal's pushed down all the way while stuck in park. Do you have sudden dropoffs in functioning at the end of a busy work day where there's lots of noise+flourescent light?
This auditory issue you mention is most likely due to the marijuana (a common effect I've noticed in most people who've taken this frequently); however, in addition to this, it could also be due to this "working memory" issue you mention too. Trying to access thoughts or past memories to apply to a given situation requires fluid transmission from working memory to executive function.
Strider: True. I wouldn't really say I have a sudden dropoff at the end of a day. I mean I might but I think it might be just normal to be tired at the end of the day. Actually, I would say that I have more energy at night than during the day. So perhaps its just that my sleep cycle is messed up? I also went to an endocrinologist and will have testing done on my thyroid and adrenal glands so hopefully that will clear stuff up.
Although I will say that with my audio functioning that it tends to be better in the morning than later during the day. Sometimes, I have a hard time listening to what people have to say. It is not the volume that I have trouble with(most of the time). In addition, some people have noted, and also I have noted as well, that sometimes I speak really loud in comparison to other people without knowledge that I am doing so. It is only until after that I realize it.
Sleep Cycle could be an issue. There are various labs that outsource to chiropractors (who practice nutritional therapy) and some holistic medicine providers such as naturopaths. Ones such as diagnostechs (
http://www.diagnoste...asi_doctor.html) prominently advertise on their site all the various biochemical issues that can underlie disturbances of the mind. However, this is taking a different angle at addressing your concerns. Based on what you've said so far, this definitely could have a hormonal underpinning but there may be something else at play as well...
The slowed sensory processing could be an indication of slight psychomotor impairment; sometimes the mind may not be interacting with the environment in a connected manner (especially when overwhelmed) so it begins to internalize and sequence thoughts in a manner that will make sense of everything. Impaired sensory input but ability to use logic, reason, empathy, intuition, and other faculties may be an indicator of a disruption of some sort that's makes the mind retreat inwardly as a coping mechanism when overwhelmed.
Your energy being more at night as opposed to during the day could be an indication of light sensitivity. Check out the first page of this thread
http://www.imminst.o...ceptor-agonist/ . This links to a totally different topic but there's a pretty interesting piece of info. on how the light interacts with the eyes (
in the diagram, there are various brain areas related to cognition that can effect or be effected by visual sensory input). Please keep in mind that I'm
not suggesting any of the drugs that are discussed on this thread
(if something like Galantamine, even at a very low dosage, were taken alone without an anticonvulsant for someone with hypercoherence or epileptic activity, this would worsen things if not taken with another prescribed substance that would keep things controlled and balanced).
Well, I am going to a sensory processing disorder/dysfunction therapist...perhaps they have this test? Although they primarily work with children, I think they said can work with adults that have SPD as well. Thanks a bunch for the input...hopefully I'll be able to pinpoint what exactly is causing this--whether its a bodily gland dysfunction, bad sleep, a sensory processing problem, genetics or perhaps even a combination of these factors.
I'm glad you appreciate it.
The therapist sounds like an option although I'm not so sure what sort of diagnostic test they'd run. Most professions in healthcare don't overlap so I don't know if it can be expected to get specific answers from them in regards to certain kinds of testing procedures like the QEEG that would probably fall outside their field.
Genetics is starting to become interesting as there are a few companies out there who do gene based neurotransmitter tests (although a bit limited). There are many avenues to look into but that takes a lot of money. It all depends on which avenue you'd feel would provide the most objective answers and individualized treatment plan. Please let us know what you think.
Edited by yowza, 16 September 2010 - 03:21 AM.
