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What Causes Sudden Loss Of Consciousness?
Question: My 18 year old daughter had a seizure for first time today. Think it was a seizure, wasn't there. She make a sound, tensed up and fainted. Dr at er not sure it was seizure. Blood work fine, bit low on potassium, cat scan ok, ekg fine. Real scared for her, keep watching her. What could cause a seizure? Will make a dr appt XXXXXXX
Brief Answer:
EEG needed
Detailed Answer:
Hello. I have been carefully through your query and understand your concern.
Loss of consciousness has many causes and clearly only a few of them are real seizures. The signs one should search that lead to a probable seizure is contraction for 20 secs, shaking for approx 20 sec followed by involuntary urination, bite of tongue edges and confusion once the consciousness is regained. Now, not all this features may be present during a seizure. Since you were not there it is difficult to rule out a seizure, but if there was no bleeding from the tongue (caused by biting) it is not a seizure quite for sure, at least not a classic seizure.
CT scan, blood count and ECG rule out most of the causes that lead to a probable seizure or loss of consciousness.
Still, the next step to definitely rule out a seizure is an electroencephalogram.
Remember, the probability that a loss of consciousness be a seizure is very low.
Hope this helps. Please feel free for further questions.
EEG needed
Detailed Answer:
Hello. I have been carefully through your query and understand your concern.
Loss of consciousness has many causes and clearly only a few of them are real seizures. The signs one should search that lead to a probable seizure is contraction for 20 secs, shaking for approx 20 sec followed by involuntary urination, bite of tongue edges and confusion once the consciousness is regained. Now, not all this features may be present during a seizure. Since you were not there it is difficult to rule out a seizure, but if there was no bleeding from the tongue (caused by biting) it is not a seizure quite for sure, at least not a classic seizure.
CT scan, blood count and ECG rule out most of the causes that lead to a probable seizure or loss of consciousness.
Still, the next step to definitely rule out a seizure is an electroencephalogram.
Remember, the probability that a loss of consciousness be a seizure is very low.
Hope this helps. Please feel free for further questions.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
I think she did urinate a bit and her tongue does appear red on the side( I don't want to ask to see it, she's already very upset) what are chances this is nothing serious? So scared!
Brief Answer:
there are real chances that this is not serious
Detailed Answer:
Hello. The chances generally speaking are low. But it is difficult to have a percentage given that the history is not clear and not all the required tests are completed.
You should have your daughter have an EEG which will help on understanding better the electric activity of the brain, since seizures are electrical abnormalities. Then you can also schedule an MRI because it has better sensitivity than CT but this is not an emergency.
Urination is not a feature exclusive for seizures, while tongue bite is for sure related to seizures.
You should be concerned but not worried because there is no finding till now that lead to seizures. Please keep me informed on the following procedures.
Best regards
there are real chances that this is not serious
Detailed Answer:
Hello. The chances generally speaking are low. But it is difficult to have a percentage given that the history is not clear and not all the required tests are completed.
You should have your daughter have an EEG which will help on understanding better the electric activity of the brain, since seizures are electrical abnormalities. Then you can also schedule an MRI because it has better sensitivity than CT but this is not an emergency.
Urination is not a feature exclusive for seizures, while tongue bite is for sure related to seizures.
You should be concerned but not worried because there is no finding till now that lead to seizures. Please keep me informed on the following procedures.
Best regards
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hi dr. Fejzo,
Just got back from family dr. She said she didn't think it was a seizure based on cat scan. Potassium, sodium a bit low and slightly dehydrated but everything else ok. My daughters legs are still a bit achy and she was a little off balance when dr checked her standing on one foot. Don't know if it's because her legs are still achy. She has a bit of scoliosis, don't know if that has anything to do w/balance though. She has an appt w/neurologist in March. Do you think we need a sooner appt?
Just got back from family dr. She said she didn't think it was a seizure based on cat scan. Potassium, sodium a bit low and slightly dehydrated but everything else ok. My daughters legs are still a bit achy and she was a little off balance when dr checked her standing on one foot. Don't know if it's because her legs are still achy. She has a bit of scoliosis, don't know if that has anything to do w/balance though. She has an appt w/neurologist in March. Do you think we need a sooner appt?
Brief Answer:
you need a neurological objective exam
Detailed Answer:
Hello again. Scoliosis is not associated with seizures and probably not related to difficulties in walking since it appeared after this episode.
Anyway scoliosis should be monitored closely because if it is high grade it can cause problems, but in a progressive fashion rather than acute onset.
The pain in the feet is unusual but can be related to a possible contraction during the eventual seizure. These are all assumptions. So, march is too far for the neurological consult.
You should provide one earlier because objective exam is very important to rule out any motor or sensory involvement in the feet.
Hope this helps.
you need a neurological objective exam
Detailed Answer:
Hello again. Scoliosis is not associated with seizures and probably not related to difficulties in walking since it appeared after this episode.
Anyway scoliosis should be monitored closely because if it is high grade it can cause problems, but in a progressive fashion rather than acute onset.
The pain in the feet is unusual but can be related to a possible contraction during the eventual seizure. These are all assumptions. So, march is too far for the neurological consult.
You should provide one earlier because objective exam is very important to rule out any motor or sensory involvement in the feet.
Hope this helps.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Hi dr fezjo,
I'm sorry I'm still extremely anxious. What is the likelihood of this happening again? Also it was her legs not her feet that were achy. She said they feel better. The dr mentioned vasovagal syncope or something like that. Possible? If it was a heart issue would it have been addressed? I know she needs an eeg but could it have been a spell that had seizure like behavior? Also she has anxiety issues. Thank you!
I'm sorry I'm still extremely anxious. What is the likelihood of this happening again? Also it was her legs not her feet that were achy. She said they feel better. The dr mentioned vasovagal syncope or something like that. Possible? If it was a heart issue would it have been addressed? I know she needs an eeg but could it have been a spell that had seizure like behavior? Also she has anxiety issues. Thank you!
Brief Answer:
the chances for this to happen again are low
Detailed Answer:
Hello dear.
Vasovagal syncope is the most common cause of loss of consciousness. It is not a real cardiac problem rather than a eposodic venous insufficiency. It happens when there is not a efficent contraction of the veins in the orthostatic position (standing up) causing little blood going in the brain which causes fainting. In order to prevent this you need just to hydrate regularly and physical activity. Less common is cardiac problems for which you need a 24 hours holter ecg.
Still dear, I am explaining extensively to understand all the possible eventualities so rule out all of them, but remember the chances that this repeats again are extremely low.
Hope this helps.
Sincerely
Geldon Fejzo MD
the chances for this to happen again are low
Detailed Answer:
Hello dear.
Vasovagal syncope is the most common cause of loss of consciousness. It is not a real cardiac problem rather than a eposodic venous insufficiency. It happens when there is not a efficent contraction of the veins in the orthostatic position (standing up) causing little blood going in the brain which causes fainting. In order to prevent this you need just to hydrate regularly and physical activity. Less common is cardiac problems for which you need a 24 hours holter ecg.
Still dear, I am explaining extensively to understand all the possible eventualities so rule out all of them, but remember the chances that this repeats again are extremely low.
Hope this helps.
Sincerely
Geldon Fejzo MD
Above answer was peer-reviewed by :
Dr. Raju A.T
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