Derek S. TMS and Epilepsy

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Question

TMS and epilepsy
I have TMS and am finally making great progress. I also have epilepsy and simple partial seizures with generally no loss of consciousness but sometimes under certain circumstances I will lose consciousness . It's not clear whether my seizure meds actually do anything [even puzzles my neurologist who is fantastic and honest and acutely aware of mind body issues more than your average doc] . Sometimes I wonder if its a placebo effect [when the meds seem to be working since sometimes they don't]. As I finally started to make progress and my "back and leg problem" is getting better, of course it migrates - hair started to fall out, night sweats other odds and ends. Recently, I have had 2 seizures where I did blackout for much longer than usual [2 minutes vs 15 seconds] and I thought hmm, is this just TMS moving about...One of the factors that can cause seizures in people who have epilepsy is lack of oxygen [when you get an EEG they have you hyperventilate to change your breathing to see what happens] and it occurred to me if the body pain is from lack of 02, is my brain just directing lack of o2 elsewhere causing more intense seizures?
It's kind of like the way drs, including the neuro, say "stress" and "anxiety" can cause or worsen body pain etc, make you more susceptible to seizures if you have epilepsy etc etc. I'm wondering if the "spot" in my back, where there is a classic herniated disk and where TMS showed up is just like the spot [there actually is one] in my brain that causes the seizures is similarly now not getting enough oxygen...
I think there is a difference of course between epilepsy and back pain, but perhaps more similarities than one realizes?
Obviously, I will be checking in with my neurologist about recent events, but was curious what people thought. Thanks!

 

[Derek Sapico MFT]

Answer

Hi there.

As a psychotherapist, I am going to have to neglect a significant portion of the medical discussion because it's out of my scope. That said, I would like to address the oxygen deprivation aspect of your question.

More recently, many TMS/MBS/PPD clinicians have moved on from the O2 deprivation explanation for the cause of TMS pain. Based on the recent discourse and body of research available, we believe that TMS symptoms are a result of learned neural pathways in the brain, heightened central nervous system sensitization, and central nervous system muscle tension.

This basically means that the brain can learn (and thus unlearn) pain, and that when your reptilian brain is in a near-constant state of fight-or-flight, this can have an effect on many different systems in your body, particularly musculoskeletal.

While I have heard of cases of stress induced seizures, I could not say if your seizure intensity is related to stress and anxiety. What I do know is that stress and anxiety seem to have an impact on almost every aspect of physical and emotional health and therefore must be tended to.

I would try to worry less about what's what and focus on actively managing your stress/anxiety/fear levels and continuing to work with your wonderful neurologist. You can collaboratively sift through your symptoms and work on ways for you to manage your epilepsy and TMS as effectively as possible.

Best of luck to you!

-Derek

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[Walt Oleksy (RIP 2021)]

Wonderful advice, Derek.
I keep telling my mind to leave me alone instead of giving me anxiety or pain.
Most of the time, it listens to me. If it doesn't I give it the finger.
James Thurber, my favorite humorous author, wrote a book about that.