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Suggest Treatment For Seizures While Having Stroke
Question: I have been having XXXXXXX seizures for over a month...they last only 10 to 20 seconds each....they occur 3 to 10 times a day....mostly when I am exposed to stress...I suffered a stroke on 1988 and have had a full recovery ...Iam 77 yrs old white male 5'7'' 160lbs and I like jogging ...bp 126over76....but these continuing XXXXXXX seizures are very disturbing....have you ever run across this in your practice? Would you please offer an opinion on these symtoms......Thank you XXXXXXX XXXXXXX @ XXXX
Brief Answer:
Read below.
Detailed Answer:
I read your question carefully and I understand your concern.
Regarding whether I have come across seizures in an individual who has suffered a stroke, yes, stroke is a possible cause for seizures even after a long time.
However it is unclear what do you mean by XXXXXXX seizures, you provide no detail whatsoever on what happens during these episodes that you call seizures, sometimes it is difficult to divide seizures from cardiac issues or anxiety.
Also there can be metabolic issues at the root of the episodes, issues such as low blood sugar which may happen in diabetic patients with metformin. It is unclear whether you have monitored your blood sugar, in particular when these episodes happen. It is not clear whether you have had any type of test for that matter.
So to evaluate a patient with seizures what is needed is very detailed information on the manifestation of symptoms as well as some tests such as complete blood count, glucose, electrolyte panel, liver and kidney function, thyroid function, EKG. Head imaging may also be considered as well as prolonged EKG monitoring when a cardiac arrhythmia is also suspected.
I remain at your disposal for other questions.
Read below.
Detailed Answer:
I read your question carefully and I understand your concern.
Regarding whether I have come across seizures in an individual who has suffered a stroke, yes, stroke is a possible cause for seizures even after a long time.
However it is unclear what do you mean by XXXXXXX seizures, you provide no detail whatsoever on what happens during these episodes that you call seizures, sometimes it is difficult to divide seizures from cardiac issues or anxiety.
Also there can be metabolic issues at the root of the episodes, issues such as low blood sugar which may happen in diabetic patients with metformin. It is unclear whether you have monitored your blood sugar, in particular when these episodes happen. It is not clear whether you have had any type of test for that matter.
So to evaluate a patient with seizures what is needed is very detailed information on the manifestation of symptoms as well as some tests such as complete blood count, glucose, electrolyte panel, liver and kidney function, thyroid function, EKG. Head imaging may also be considered as well as prolonged EKG monitoring when a cardiac arrhythmia is also suspected.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Dr Taka....I will try to fill in the blanks...most recent blood sugar reading 2hrs ago was 111..just had my 4th episode today...results= ability to communicate is dramatically diminished....chills...goose bumps flow down my body from top of head to ankles....lose stablity and need help in holding on to any stable object....I am experiencing emotional outbreaks including crying....these seem a bit less in the past few days...any sudden surprising events or not ordinary occurences have a shock to me.....i have always been a very stable business person and I am trying to place a name on this condition... XXXXXXX XXXXXXX
Dr Taka...I had a through cardiac workup including EKG.with Dr XXXXXXX Engel at XXXXXXX Presbyterian....cardiac issues have been ruled out...
Dr Taka...I had a through cardiac workup including EKG.with Dr XXXXXXX Engel at XXXXXXX Presbyterian....cardiac issues have been ruled out...
Brief Answer:
Read below.
Detailed Answer:
Thank you for the additional information.
I would say a cardiac cause to be unlikely, not only because of the EKG (as I said prolonged monitoring is needed at times), but also because the episodes do not seem likely to be due to arrhythmia.
I would still not exclude low blood sugar spells, not unless there have been measurements during those episodes, it can manifest all those symptoms.
Most of the other recommendations remain. Unless low blood sugar is found (in that case medication with metformin is reseen) any seizure or suspicion of it should be evaluated with a routine blood work, an EEG and brain imaging to look for the possibility of new lesions apart from the old stroke you mention.
At times there is also the issue of simple anxiety to be considered, but since you describe your self never to have had any issues with it I would leave that as the last possibility.
Let me know if I can further assist you.
Read below.
Detailed Answer:
Thank you for the additional information.
I would say a cardiac cause to be unlikely, not only because of the EKG (as I said prolonged monitoring is needed at times), but also because the episodes do not seem likely to be due to arrhythmia.
I would still not exclude low blood sugar spells, not unless there have been measurements during those episodes, it can manifest all those symptoms.
Most of the other recommendations remain. Unless low blood sugar is found (in that case medication with metformin is reseen) any seizure or suspicion of it should be evaluated with a routine blood work, an EEG and brain imaging to look for the possibility of new lesions apart from the old stroke you mention.
At times there is also the issue of simple anxiety to be considered, but since you describe your self never to have had any issues with it I would leave that as the last possibility.
Let me know if I can further assist you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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