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Had A Grand Mal And Fell To The Ground. Stiff As A Board. Unable To Move Left Side Of Body. Suggest The Treatment?
Question: My 59 year old husband had a grand mal, fell to the ground cut open the head (stopped the twitching), was as stiff as a board...unable to move left side of body. 911 called. The VA wants evidence as to which occurred first...grand mal or stroke. All for benefit reasons.
Brief Answer:
Possibly seizure occurred first
Detailed Answer:
Hi,
Thank you for posting your query.
It is difficult to tell 100% which occurred first- seizure or stroke.
However, it is well known that many strokes cause seizures, called as post stroke seizures. However, seizure is the first event noted, and is the beginning of stroke, called as ischemic seizures. Then, the weakness is noted. In other words, the cause of seizure as well as weakness is same- lack of blood flow to the brain. It is just that the seizure is noted before the weakness.
I hope it helps. Please get back if you have any follow up queries.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Possibly seizure occurred first
Detailed Answer:
Hi,
Thank you for posting your query.
It is difficult to tell 100% which occurred first- seizure or stroke.
However, it is well known that many strokes cause seizures, called as post stroke seizures. However, seizure is the first event noted, and is the beginning of stroke, called as ischemic seizures. Then, the weakness is noted. In other words, the cause of seizure as well as weakness is same- lack of blood flow to the brain. It is just that the seizure is noted before the weakness.
I hope it helps. Please get back if you have any follow up queries.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
you are saying that most likely that the stroke caused the grand mall and not the other way around or Is it impossible to tell. what abut a Ct scan
Brief Answer:
Yes...most likely stroke caused the grand mal.
Detailed Answer:
Thank you for getting back.
As he has weakness of one side of body, there are good chances that he has stroke. As you mentioned, a CT or MRI scan of brain would confirm a diagnosis of stroke.
In rare cases, if CT scan is normal, then we can consider a diagnosis of Todd's paresis, where a grand mal seizure can cause weakness of one side of body but this weakness improves on own in a few hours to days.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Yes...most likely stroke caused the grand mal.
Detailed Answer:
Thank you for getting back.
As he has weakness of one side of body, there are good chances that he has stroke. As you mentioned, a CT or MRI scan of brain would confirm a diagnosis of stroke.
In rare cases, if CT scan is normal, then we can consider a diagnosis of Todd's paresis, where a grand mal seizure can cause weakness of one side of body but this weakness improves on own in a few hours to days.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
No chance that the Grand Mal hit fist ,blow to head in fall causing the stroke? He has pacemaker so no MRI. CT just showed stroke. swollen and bleeds. Witnessed whole event Grand Mal first. No real medical way to tell for sure which came first?
Brief Answer:
Clinical examination may help
Detailed Answer:
If the bleed occurred due to fall, then there would be external swelling over the scalp too and there may be a skull fracture. Also, there are certain differences on the CT appearances of spontaneous bleed in the brain as compared to bleed due to fall (a radiologist may help in that).
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Clinical examination may help
Detailed Answer:
If the bleed occurred due to fall, then there would be external swelling over the scalp too and there may be a skull fracture. Also, there are certain differences on the CT appearances of spontaneous bleed in the brain as compared to bleed due to fall (a radiologist may help in that).
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Is it most likely to say that that the Grand Mal came first then the stroke?
Brief Answer:
Yes
Detailed Answer:
Yes, it is most likely that the grand mal seizure occurred first, followed by the stroke. This is because seizures occur at the onset of many strokes, especially embolic strokes.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Yes
Detailed Answer:
Yes, it is most likely that the grand mal seizure occurred first, followed by the stroke. This is because seizures occur at the onset of many strokes, especially embolic strokes.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
The Grand Mal most likely occurred first than the stroke?
Brief Answer:
Yes.
Detailed Answer:
Grand mal occurred first and then the stroke occurred.
Dr Sudhir Kumar MD DM (Neurology)
Yes.
Detailed Answer:
Grand mal occurred first and then the stroke occurred.
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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