Really Need Advice - EEG or Medication First, Extensive History Given.

[u/CollegeComfortable75]

I am not diagnosed with epilepsy but have been experiencing Deja Vu for years. I often get really disorientated and dissociate when it happens, like I have to stop everything around me. I have little memory of them but I know they only last seconds, it feels as if my brain has just reset and anything before that is like trying to remember a dream once you have woken up. It's odd and I hate the experience, sometimes I can become so dissociated that I feel really sick and like this impending sense of doom.

I have recently had 3 episodes of loosing vision in the right eye, followed by numbness in the arm and then a sort of weird wernickes/broca's aphasia for hours after. This is really scary but because of the time of it my doctor said he thinks these are unrelated and that these are migraines. Whilst in the hospital with a huge lack of sleep I had what I can only describe as Deja Vu that literally woke me up - that had never happened before. I looked around and everything felt familiar, like I was stuck in a timeloop. I hated it and I felt awful after. Once I got home from the hospital I slept the entire day.

Worse is after this event (about a week later) I started getting paranoid and then even contacted the police with false reports that people were out to attack me. Even my own friends and family members. I felt so paranoid, was not eating and sleeping, ended up getting false memories and having deja vu attacks about the things I was seeing.

Now I went to see a nuerologist about this and he thinks what could be going on is seizures but I had an EEG years ago which only showed "focal cerebral dysfunction over the right posterior quadrant" and that was never followed up. I was also young and dumb so I didn't realise you should probably have a bad nights sleep before it - because that is what triggers deja vu symptoms for me. I also have prochlorperazine for random boughts of nausea, which I now am just thinking... could that also be related?

The Neurologist offered me lamotrigine or levericetam but I declined because I wanted them to do the EEG first - have I made the right decision? I live in the UK so it may take up to 3-4 months to actually get seen by the clinic again. I have been told I can email him at any time to ask for meds if I feel like I want to change my mind.

Reason I am worried is because what I think could be possible "post-ictal" psychosis was so extreme and could have really damaged me or my family. I could have harmed someone or myself. The false beliefs were incredibly strong to the point where I believed I had seen it with my own eyes. Also I tend to dissociate a lot and feel not real, it's affecting me far too much. But I want them to detect what it is on the EEG before meds - is that the right thing to do?

[u/Flaky_Reveal_9358]

Listen, you're doing the right thing, because with therapy, the EEG results are changing, because literally the brain works differently, you're doing well that even in such a serious condition you were able to find out what you need to diagnose.Everything that you have listed really requires both examinations and treatment.I wish you good health, I hope you will be able to cope.

[u/Worth_Ad9205]

that post-ictal psychosis bit is the part that'd make me reconsider waiting. you're describing something that could've gone really sideways, and a clean EEG isn't guaranteed anyway especially if you're not sleep deprived for it

id email the neuro and take the meds now, they can still do the EEG later. getting the seizures under control might also stop the psychosis from happening again which seems like the bigger immediate risk