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Tonic Clonic Seizure
My son who is 39 years old had a hole in his heart which we didn't know anything about. He has led a very active life and is a State police officer. He has a 169 total cholestorel and 120 avg. blood pressure, but a slight blood clot got to the brain from the hole in the heart and caused a stroke 8 months ago. Last week he had a Tonic Clonic seizure this happened after a very active day of therapy for his left hand which is still not responding, hours at a the YMCa working out and working with his Saebolt which opens and closes the hand. He did have 3 beers the previous day with a buddy and his wife thinks that is what caused it, but the neuorologiest said no. They put him on 500 Mg of Keppar and she wants him to go to a different doctor. They have given him a EEG and other tests. Was he diagonoised properly??
MEDICAL PROFESSIONAL
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.
Without the ability to examine your son and obtain a history, I can not tell you what the exact cause of his symptoms is or how to treat it. However I will try to provide you with some useful information.
Close to 20% of the population (normal people) have something called PFO or patent foramen ovale, which is a small “hole” in the heart between the right and left side. It has been implicated in the etiology of strokes, however there is still not 100% consensus about how to treat this, as many normal people have this without problems. After a stroke, most neurologist begin with an antiplatelet agent, like aspirin or so. Surgery has been suggested, however there is still not a final answer if this is required or not and each individual case should be analyzed.
A seizure happens when there is an abnormal electrical activity in the cortex of the brain, and suddenly there is synchronization of discharges leading to the occurrence of the seizure. There are multiple causes for seizures, and certainly a alcohol intake or withdrawal can trigger a seizure but usually in a patient who is susceptible to seizures, does not happen in every patient. A patient who has suffered a stroke, specially in the cortex (outer part of the brain), may be susceptible to have seizures coming from the area that suffered the damage from the stroke. And patients who have had a stroke in the past, and have seizures coming from the damaged area will have a higher chance of having subsequent seizures, therefore some patients may require antiepileptic agents.
The EEG will be helpful to determine the area where the seizures are coming from, however if it is not abnormal, does not rule out that what he had was a seizure.
Some important issues to be aware are: avoid sleep deprivation and other triggers, such as alcohol. He should discuss with his neurologist all the potential risks associated with seizures, and situations he should avoid, such as driving, operation of machinery or weapons, heights, bathing and swimming, and other situations in which he or others may be at risk from a seizure.
Without being able to obtain a detailed history and examine him, I cannot tell you exactly what he had, however I think that a seizure is highly possible, and could be associated with his recent stroke. I think your son should have a close follow up with a neurologist, discuss all the issues he is concerned, including treatment for these events, and situations to avoid.
I hope this information is useful.
Without the ability to examine your son and obtain a history, I can not tell you what the exact cause of his symptoms is or how to treat it. However I will try to provide you with some useful information.
Close to 20% of the population (normal people) have something called PFO or patent foramen ovale, which is a small “hole” in the heart between the right and left side. It has been implicated in the etiology of strokes, however there is still not 100% consensus about how to treat this, as many normal people have this without problems. After a stroke, most neurologist begin with an antiplatelet agent, like aspirin or so. Surgery has been suggested, however there is still not a final answer if this is required or not and each individual case should be analyzed.
A seizure happens when there is an abnormal electrical activity in the cortex of the brain, and suddenly there is synchronization of discharges leading to the occurrence of the seizure. There are multiple causes for seizures, and certainly a alcohol intake or withdrawal can trigger a seizure but usually in a patient who is susceptible to seizures, does not happen in every patient. A patient who has suffered a stroke, specially in the cortex (outer part of the brain), may be susceptible to have seizures coming from the area that suffered the damage from the stroke. And patients who have had a stroke in the past, and have seizures coming from the damaged area will have a higher chance of having subsequent seizures, therefore some patients may require antiepileptic agents.
The EEG will be helpful to determine the area where the seizures are coming from, however if it is not abnormal, does not rule out that what he had was a seizure.
Some important issues to be aware are: avoid sleep deprivation and other triggers, such as alcohol. He should discuss with his neurologist all the potential risks associated with seizures, and situations he should avoid, such as driving, operation of machinery or weapons, heights, bathing and swimming, and other situations in which he or others may be at risk from a seizure.
Without being able to obtain a detailed history and examine him, I cannot tell you exactly what he had, however I think that a seizure is highly possible, and could be associated with his recent stroke. I think your son should have a close follow up with a neurologist, discuss all the issues he is concerned, including treatment for these events, and situations to avoid.
I hope this information is useful.
Thank you very much for your response. My son did receive surgery to repair the hole in his heart in June and after several exams it appears to have repaired the opening with no problems.
In reading about the seizure it stated that pneumonia is a possibility and he is coughing a lot now so that is another concern, because he also takes Humira for angeloinaspondelitis. He has only been on Humira seen last November but I am not finding anything on that drug that may have caused a stroke or seizure?? The Docotor that have examined him have not indicated that and is his internal medicine doctor and his Neurologist didn't make a distincition about it either??
Thank you again
In reading about the seizure it stated that pneumonia is a possibility and he is coughing a lot now so that is another concern, because he also takes Humira for angeloinaspondelitis. He has only been on Humira seen last November but I am not finding anything on that drug that may have caused a stroke or seizure?? The Docotor that have examined him have not indicated that and is his internal medicine doctor and his Neurologist didn't make a distincition about it either??
Thank you again
A related discussion, pfo closed and still having seizures was started.
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