Q. In 1996, my husband suffered a head injury at work, when a heavy box fell from above onto his head, near the area of the temporal lobe. he didn't say anything about it to me, and thought he was fine! That night, however, he began having auditory and visual hallucinations and was completely disoriented X3. I thought he was having a psychotic episode or had taken a hallucinogen!! He was taken to a hospital and continued the same throughout the night. A CT scan showed a concussion, and only the next day did he remember being hit on the head. He continued to experience what were called "confusional episodes" by various Drs., and then, his first (among many) grand mal seizure, six months later, (hospitalized then, too).

Every neurologist he's been to has done nothing but a cursory exam and ordered EEG's (normal) and MRI, which showed slightly enlarged ventricles (though there was disagreement on this Dx). He was put on Depakote, which seemed to do very little, and then changed to Dilantin and Klonopin, which only worked when the Dilantin levels were at therapeutic levels...though they fluctuated due to his use of Zoloft (?) (due his depression). His grand mal seizures have decreased markedly, but he still has them every two or three months. (he does not tolerate Tegretol at all...experiences severe ataxia, vertigo and nausea and dc'd it), but the "confusion" continues, along with blurred vision, short-term memory loss, lack of balance and behavioral changes such as irritability, shortness of temper, increased anger at small things, and anxiety for no reason...all these things particularly in the evening. The latest neurologist diagnosed these as temporal lobe seizures. We are at a loss, what would you recommend?

A. Really could not say what to try at this point. Seizure control is of primary importance, and needs to be handled. I will leave this up to the neurologists. I would suggest using Serzone to treat the depression as it is not epileptigenic. Dose of 450-600 mg at bedtime would help. Obviously, work up to this dosage. Neurontin may be a drug to consider for the seizures if it has not been tried.