Gifted Issues Discussion homepage Forums Twice Exceptional His doc is shocked.

Hi everyone. I'm hoping someone would have an idea that would lead me towards the right direction. I thought of listing the various things I've been hearing from teachers to his doctor because, it seems everyone is confused.

• My DS18 has been ID gifted since kindergarten.
  
  
• His psych doc dx him ADHD combo type in 9th grade. Medication seem to improve poor grades for lengthy assignments.
  
  
• Participated in university study on Twice Exceptional behavioral research where they had said he has an extremely fast processing speed.
  
  
• Last two years of high school he has not had consistent grades (extremely low then extremely high grading pattern)
  
  
• Teacher has continually said, he is highly capable when he can focus.
  
  
• He took himself off of meds in January.
  
  
• He started having attendance and grade issue due to sleep problems
  
  
• He went to truancy court for 16 non-consecutive days of absences. I thought this was a choice he made with poor sleeping habits and giving himself a day off for waking up late.
  
  
• His gen practitioner thought poor sleep habits and gave suggestion to help incorporate better sleeping habits.
  
  
• Psych doc supports 'no med' decision son made.
  
  
• Thoughts of Asperger like tendencies and behavior. Psych doc and psychologist suggested further testing.
  
  
• He went back on med through my urgent concern. He was more successful and had fewer sleep issues when he was on them.
  
  
• In the past 6 weeks, his grades significantly improved and he did not have problems getting to school on time.
  
  
• The judge urged the school and myself seek further testing to explain why a student who obviously enjoys school is having issues with grades and attendance.
• He does not use recreational drugs and has been tested for it when he was summoned to truancy court.
  
  
• Son starts having sleep issues again. It seems like he is caught up in the excitement of graduation and interacting with his peers online before everyone goes off to college.
  
  
• He has a grand mal seizure waking up in the morning this week. He never had one before
  
  
• Paramedics had difficulty transporting because he went into an explosive angry fit. Sedation was difficult.
  
  
• ER Neurologist wants to wait before assigning a dx.
  
  
• Psych doc seems troubled. He has not had a patient who has had a seizure under his care and took him off of meds. (he now takes Keppra as neurologist prescribed)
  

From an exhausting week I am now very confused on what to think anymore.

Well, I agree with the ER neurologist that further evaluation is in order. I'm assuming that they have done brain MRI, EEG, etc. to rule out tumors, infarcts, infections, and closed head injuries as possible sources of his issues. Do you have all the results back from these tests? If not, it is really too soon to start trying to diagnose what is causing the behavior or the seizures.

Yes, he has done a CT, MRI, EEG as well as various blood and urine tests. They all report normal The neurologist released him the next day though I was concerned about his slightly unusual behavior. He was very euphoric, unable to sit still, and chattered random impulsive thoughts. The neurologist said this may be expected for a week and its so difficult for me to wonder if his medication, seizure or both is causing it. The next day, he was sluggish, a bit down, and extremely forgetful about what he was suppose to do next.

I guess I'm worried his afternoon sleeping spells could have been seizures as well as his poor ability to stay awake in the morning. I'm also wondering if he was having absence seizures instead of ADHD type issues.

Would the next course of action be .... finding a neurologist? Would most of them be aware of twice exceptional kids?

This could be totally off base, but I am wondering if bi-polar has been considered or if there is any family history of that? Sleep issues, wildly fluctuating performance, and moods fluctuating from explosive anger to euphoric behavior could be possible symptoms.

I'm no expert (PLEASE let me stress this!), but I think finding a really good neurologist would be the next step. This sounds like a medical issue, and I personally wouldn't be thinking too much about 2E issues. Neurologists should be able to give you feedback on ADHD and Asperger's, as well. I knew a boy growing up who would sometimes zone out, and had some other behavioral issues. He was eventually diagnosed with epilepsy/absence seizures. Seizures can cause drowsiness afterwards. If he's having lots of sleep issues/ daytime sleepiness, you may also want to discuss a sleep study. Best wishes and hope you get some answers soon

Like Cricket2, I was thinking bipolar disorder when reading your post. Has this been mentioned as a possibility?

Cricket2, while some of this does sound like bipolar, these manifestations can also be symptoms of complex focal seizures.

This is a great link that does a good job of briefly discussing seizure disorders. Pages two and three are particularly relevant here, I think.

http://www.medicinenet.com/seizure/article.htm

Your baby's health is most important first of all, but have you spoken with his school guidence counselor about the doctors visits, tests, and homework and working out a plan about school attendance in the meantime.

We had thought about bipolar a few years ago. After some time, it seemed his moods would change due to predictable OE reasons.

I am very happy with his school's,efforts in keeping him adequately challenged and accomodating. There is a small population of 2e students in his class. We had him on two separate intervention plans. One for the past two years. The gist of it is that he has to start advocating for his needs as well as attend an end of sclass day study period to check on his assignment progress, grades. Timelines, and ask for clarification or tutorials. He is allowed to retake failing exams if he requests so in a timely manner.

As far as behavior, I am really leaning towards his sensory issues. Light, sound and touch does irritate him.

Lights can set off seizures, just saying, so everything could lead back to seizures.

A little girl across the street has been diagnosed with just about everything under the sun: speech/language delay, autism, add, behavior disorder, intellectual disability, and when she was finally treated for seizure disorder one by one the other dx proved to be not so accurate although she is still understandably behind. When her seizure meds need to be adjusted, she once again has problems in school. She also has problems with heat (which isn't great in FL)