Suggest Treatment For Symptoms Of Epilepsy

Posted on Mon, 28 Dec 2015

Question: What might cause epilepsy-like symptoms (epilespy has been ruled out)? My symptoms relate to balance, a feeling of "blacking out" and memory problems. A tilt table test ruled out heart induced/blood pressure induced related problems. A complete hearing test ruled out anything from that area. I call my episodes "wobbles", because all of a sudden I wobble and have to catch myself from falling over -- can occur standing, sitting, or walking. They exhaust me, with a 2 or 3 hour sleep getting me temporarily back towards normal. No sleep apnea or narcolepsy either! Male, 67, non-drinker/non-smoker.

Answered by Dr. Prof. Kunal Saha (3 hours later)

Brief Answer:
The problem could be deep in the ears

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have very carefully considered the problem. There is an organ called vestibulocochlear appraratus in our inner ear. Alongside being the organ of hearing, it is also the organ of balance. Thus some problem involving this organ could contribute to the sudden loss of balance or wobbling as you call it.

There are certain other regions of the brain including cerebellum, that could also contribute to balance problems.

You can get a neurological opinion as well as an audiometry done.

Let me know if you need to ask anything further.

Regards

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

Follow up: Dr. Prof. Kunal Saha (9 hours later)

Thanks for the reply. I've already had complete VNG testing and the results were normal. I've had 3 neurological opinions which included MRIs, sleep studies (ruled out was sleep apnea and narcolepsy), EEGs, Lumbar Puncture, and even a 5-day in-patient hospital epilepsy study which ruled that condition out. During that stay, I had several idiopathic "episodes". The only condition noted by neurologists has been myclonus, noticeable at the tongue and eyes.

I'm hoping a physician here will steer me towards the rare diagnoses possibilities so I can ask a local Dr to check on that.

Answered by Dr. Prof. Kunal Saha (24 hours later)

Brief Answer:
Your doctors have already taken the right approach

Detailed Answer:
Thanks for writing back. I did not respond faster so that I could have some suitable spare time to look up the possibilities. However, I still find it hard to provide you with a proper resolution of your problems. I understand your expectation and also the line of approach of the doctors whom you have already consulted. Since they have already approached the problem from the right direction there is not much to say in this regard. The possibilities that I myself could think of, have already been eliminated. The rest requires careful clinical observation and picking up of minor details, something that one has to observe and analyse on his own. It is like examining a crime scene, you cannot ask some other person to pick up the cues for you.

All I can say is to monitor your blood pressure periodically and to avoid intake of beta blockers (a type of medicine one takes for chronic heart disease), in case you are taking them. It is no use asking for investigations which I do not suppose to be conclusive.

One possibility that I can vaguely correlate is the possibility of electrolyte imbalance (calcium and potassium in particular) to play some role. These could also have some relevance with the myoclonus.

Regards

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj