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What's The Link Between BPD And Temporal Lobe Seizures?

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Dear Dr. Heller,

Good job with your site. I have a question regarding the symptoms of Temporal Lobe Epilepsy (TLE) showing up in those who have Borderline Personality Disorder. I had severe depression/anxiety/depersonalization several years ago that responded well to Prozac and Klonopin (in addition I had many BPD symptoms). After several years of medication, I discontinued for awhile only to start up again, this time with only the Prozac. After another year, I stopped taking it, and that's when I began occasionally experiencing TLE symptoms. The symptoms were: A strong feeling of deja vu, panic, nausea, and half formed memories rising up. Sometimes it would be jamais vu. The feeling would never last longer than a minute.

These "spells" come every couple of months or so. My question(s): Would this be part of the BPD I am experiencing? Or is it most likely TLE? And will it progress to a more severe form of epilepsy? I was on a high dose of Prozac (80mg with 2mg Klonopin a day) and I never had these "seizures" then. Even on the second round of medication (20mg Prozac alone) they never happened, only when I stopped taking it. I am currently awaiting the results of an EEG and an MRI, but even my neurologist doesn't think anything will show up there.




I believe the BPD is a form of epilepsy (nerve cells firing inappropriately and out of control) in the deep brain structures located within the limbic system. Because these structures are deep in the brain, the seizures are rarely seen on surface brain wave tests (EEG), so the neurologist is correct in saying that the EEG will likely be normal. When the epileptic dysphoria (anxiety, rage, depression and despair) develops, the seizure can spread to the temporal lobes causing the deja vu, unreality, etc.

If you fit BPD criteria, it's a part of the BPD. If not, temporal lobe seizures may indeed be to blame. I view temporal lobe symptoms as another part of dysphoria (anxiety, rage, depression and despair) that needs to be treated. My patients learn how to treat dysphoria when it occurs with Haldol 2mg / Tegretol 200mg / Risperdal 3mg as needed. Dr. Heller's Dysphoria Instruction Sheet goes into more detail.

It's unlikely to progress to a more severe epileptic phenomenon.

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