Seizure, CAT Scan, Urine Sampling, Thyroid Testing, MRI, EEG, Hyperventilation. Reason?

Posted on Sat, 29 Sep 2012

Question: Looking for an opinion on a 31 year old healthy female who experienced a first time seizure almost two weeks ago. Went to hospital, did a CAT Scan, blood work, urine sampling....all came back normal. Also had thyroid testing, MRI and more blood work, all coming back fine. Had an EEG performed and this showed"questionable seizure activity during hyperventalation and post with spikes. Prior to seizure was exercising more regularly, was at a concert the night before attack with drinking involved. Opinion please.

Answered by Dr. Pratap Sanchetee (2 hours later)

Hi,

Thanks for the query.

Single seizure with precipitants like late night and drinks, assuming no family history, CT/MRI being normal, no obvious neurological deficit- standard practice is to observe and treat with antiepileptic drug should seizure recurrence is there.

I will also go for a sleep record EEG (after almost full night awakening) to look for definite abnormality on EEG.

Please discuss regarding this with your treating doctor and start on antiepileptic medications and maintain regular follow ups.

Please avoid driving, swimming during the treatment and take medications regularly.

Hope this answers your query. In case of any doubts, I am available for the follow ups.

Regards.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Pratap Sanchetee (2 hours later)

Don't understand what they mean however by "questionable seizure activity during hyperventalation and post with spikes" can you please try to explain that part of the terminology? THANKS.

Answered by Dr. Pratap Sanchetee (24 hours later)

Hi and thanks again,

I apologies for delay in posting the reply.

Brain activity is recorded during XXXXXXX breathing. Your neurologist reported that there could be possible (questionable) seizure activity on the EEG during XXXXXXX breathing.

Unless this is confirmed, I would prefer to wait and observe before using the anticonvulsants specially when all other reports have come up normal.

You may discuss with your neurologist about the need for anticonvulsant drugs now. A repeat EEG, preferably the sleep record EEG is perhaps entailed.

Hope my answer is adequate and informative.

Wish you good health.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar