Q. For as long as I can remember, I've had what I later learned to be temporal lobe seizures. When I'm having one of these seizures, it is as if I'm remembering something, but it is accompanied by an overwhelming sense of fear. The memory itself is not a fearful memory (although I never can remember it when it's over). I simply don't feel like I'm a part of my current surroundings anymore and I'm somewhere else. However, I know that I'm having this seizure and I can see the room that I'm in, etc. It's a very sickening feeling and so incredibly difficult to explain to someone who has never experienced it.

For the longest time, I thought everyone had these episodes. I had heard the term "deja vu" when I was young and heard it described as a sense of remembering something or the strong feeling that you had been some place before and that is what I thought these seizures were. It was not until I was in college that I realized that what was happening to me was not normal. Still, I was only having these episodes a few times a year and they weren't ruining my life or anything, so I just never did anything about it. I never talked about it with anyone because it seemed too weird and I was embarrassed by it.

I'm now 35 years old and over the last few years, the seizures have increased. I finally went to a neurologist about 3 years ago when I found that, not only was I having these horrible seizures 3-4 times a week, but I was feeling strange almost constantly. My EEG showed that I was having some sort of seizure activity every few minutes. My CT Scan was normal. I was put on Dilantin and have been doing much better since starting the medication. I still have seizures occasionally, but nothing like they were before.

My biggest concern now is that these seizures have somehow zapped my memory to the point that I'm seriously afraid of having Alzheimer's before I'm 50. I'm a reasonably intelligent person and I have somehow managed to hide this severe memory loss from pretty much everyone. My husband is aware because I've told him about it, but I'm certain he doesn't know exactly how bad it has gotten. I've pretty much mastered the memory bluff. At work, I've learned to document absolutely everything I do, so that when someone asks me something that I should know, I simply tell them I'll get back with them on that and I find the documentation of it and call them back. It has become second nature for me. It's really beginning to worry me, though. My job is very thought-intensive and I'm afraid the day will come that this memory loss will cause me to really mess something up. (I track legislation for a large insurance company).

My question to you: Is there anything I can do to help with the memory loss I have as a result of my temporal lobe epilepsy and can I expect it to get progressively worse?

A. If indeed you have temporal lobe epilepsy, it is advisable to stay on an anticonvulsant. Dilantin is an okay drug, but it will, unfortunately, enhance your memory deficits. Most of the antiepileptic drugs have a negative impact on memory. Some feel Neurontin is less severe, but this is an anecdote. Truthfully, I have no patients with temporal lobe epilepsy, so can only expound on the little bit I have read.

Another possibility is that you have limited symptom panic attacks, and are getting depersonalization and derealization from this. An antidepressant like Effexor or Serzone or Zoloft might help if this is the case. While it is unlikely you have two illnesses--Temporal lobe epilepsy and panic, it is possible. The Dilantin is helping, but you sound as if you still have some symptoms. Perhaps another antiepileptic will completely work, or perhaps the Dilantin is reducing panic episodes which are the true cause of your problems. I doubt the latter, but it must be considered.

I would probably try you on one of the three antidepressants mentioned in conjunction with the Dilantin. None are likely to cause seizures to worsen. Serzone may even be antiepileptogenic (has the least chance of the three of causing seizures). An alternative seizure medication may help, too. Consult your neurologist about any changes.

If all else fails, it is not likely you have Alzheimer's. You have an illness (panic or seizures or both) that can perturb memory. Likewise, you are on a medication (Dilantin) which is known to worsen memory. The structure you set up is a great way of dealing with the problem. The fact that you are able to function at such a high power job, collect and record the data so well, and remember you did it all argue against permanent brain damage. You are doing well, and probably a lot better than you give yourself credit for doing.