Q. For the last four months, my brother's spouse has been having mood swings, uncontrolled rages and suicidal thoughts/activities. Although he has been previously diagnosed as bipolar, his current episodes appear to have a BPD component. About the same time as the rages became uncontrollable, he started suffering from increased episodes of absence seizures. although the neurologist was unable to confirm the seizure activity (no seizures occurred during the EEG), it is believed that the mood swings and suicidal behavior are seizure related and Tegretol was prescribed.

My questions are
1. Can seizures account for personality changes/rapid mood swings?
2. I have read that on an EEG a BPD rage registers in a similar manner as a seizure. Is this accurate? Could the rages be a trigger to the seizures?
3. If epilepsy is not the primary problem, will Tegretol be effective?

  A. Good questions.
1. Seizures can cause mood changes. Statistically, there is a much higher chance that the seizures are pseudoseizures--not epileptic--but they must be worked up to rule out seizure activity.
2. No, rage does not look like a seizure. Rage may appear to trigger a seizure if the rage is a portent of pseudoseizures.
3. Tegretol was studied in BPD by Cowdry and Gardner in the mid-80's for treatment of BPD, and it worked better than anything else available at the time. So, even if they are not seizures, it can help.