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Q: Does This Sound Like Bipolar
I need to know if this sounds like a bipolar child. My son who is 14 headed a
soccer ball in Jan. Since then the day after he got the flu. THree days
later he woke up and could not talk. THen he got volgar. After that he reverted
to like a child. He was in 2 hospitals had MRI, EEG, CTscan, Spinaltap,
bloodtest, urinetest, strepttest, thyroidtest, chestexrays. No one knows what
this is. He was diagnosed with Severe Extreme Sinusitis. And that was all they
could find. He has these episodes every 2 weeks. And lasts 4-5days. This last
time he actaully went almost 5 weeks being ok. When this happens all he wants to
do is sleep and he will sleep all day for those 4-5 days if I let him.When he
comes out of this he does not remember hardly anything. My Question is does this
sound like a bipolar person? He is
seeing a Phyciatrist now. And is on Seroquel, and Welburtrin. I just need a
direction to go or someone to help me find the right help for him.
Dear Robin --
There are two things that stick out here which are not very consistent with
bipolar disorder. First and most important, is your statement "When he
comes out of this he does not remember hardly anything". That is
much, much more typical of a seizure-type problem. Now as you've probably
learned, seizures aren't supposed to go on for 4-5 days. And it's pretty
typical of bipolar disorder to have phases where somebody wants to sleep all
day, alternating with phases of severe symptoms that could include
"vulgar" (where that was not characteristic of the person
otherwise).
If there was a clear history in your family of bipolar
disorder, I'd be more suspicious of that (or having at least on person in each
generation above him with some severe mood problems; or profound alcohol
problems, with multiple affected people in each generation). I'd also be
more suspicious if during those times when he wants to sleep so much he's
depressed: low energy, low motivation, can't enjoy things.
The other thing that sticks out it the "he could not
talk" part. That's more typical of some serious neurological problem,
and is seen only in the most severe forms of bipolar disorder.
Some seizure problems can't be seen with routine
EEG. I'd look for a second neurologic opinion, and maybe a third, and see
if you can get an EEG when he's clearly having profound symptoms (and maybe a
comparison when he's not).
And eventually we treat bipolar and seizures almost the
same anyway, and there's some reason to think that bipolar disorder is pretty
close to a "seizure disorder" in some ways anyway, so you could just
start treating this as though it were bipolar disorder: even if it were a
seizure disorder, you could get a good result. I'm surprised he's not on
an anticonvulsant, of the type that we routinely use for bipolar disorder (Depakote,
Trileptal, or lamotrigine); maybe those were already tried? That would be
one way to go, you see: just treat it and see if it gets better, even if you're
not sure what it is (i.e. and skip, or postpone, the further diagnostic
evaluations, until you see where you can get with this approach).
In any case, I'm sure this must be terrible to have to
watch, such a transformation, and I hope something good comes of all your
efforts soon.
Dr. Phelps
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