Cardiac Problems after Subdural Hematoma Burr Hole Evacuation

[amye_mt]

I hope this is the right place for this question. My 59 year old mother recently had a spontaneous subdural hematoma that required burr hole evacuation. After surgery, she had a short episode of slurred speech so her neurosurgeon prescribed Keppra. It has been one month and now she is showing signs of bradycardia and sick sinus syndrome. Her cardiologist is considering a pace maker. The only other medications that she takes are estrogen (post hysterectomy) and synthroid (treating hypothryroidism).  Could the Keppra be causing the new cardiac problems? Would a trial period of stopping the Keppra help? Should all her doctors get together and know what each other is doing? My mom is normally very healthy and active. This event is causing a slight depression that she is fighting. She doesn't like being like this and definitely does not want a pace maker. She just wants to return to her job and normal activity. Do you have some advice for us? Thank you for helping.

[amye_mt]

I want to thank you for taking the time to post a response. We are experiencing a lot of frustration. We approached the neurosurgeon with a list of questions and he responded with he has other patients to see and we should see a neurologist. We are now in the process of trying to find a neurologist that will take her case since they all seem to specialize in certain conditions (ie. MS, parkinsons etc.) It has now been over 40 days since her discharge from the hospital, and the keppra is not allowing mother to lead a normal life. The pace maker is out. She does not want one at all. I firmly believe that stopping the keppra will help her to recover to where she was. Moderate work outs and being able to lift weights are a part of her life and she won't give that up without a fight. Lying in bed so much due to this medication is taking it's toll on her and she is not able to return to work at this time. The neurosurgeon just said that he knew that this extreme weakness and tiredness was a side effect, and he refuses to take her off of it and he is pretty much done with her as a patient. It is hard to remain compliant when the prescribed treatment is worse than the condition. She is trying to comply though. I reminded her that ultimately she is in charge of her health care and she should be able to get answers to her questions and not blown off by her physicians. I work in the medical field myself and know how patients can be treated. This is frustrating to me as well to be on the patient side of the bed and not get the care we feel we need. Thanks again for the advice. This is far from over.

[Dr. Kokil Mathur]

Hi!
There have been cases where bradycardia has been reported due to Kreppa, However noting can be said to sure. Any brain surgery and hypothyroidism too can cause bradycardia. Sick sinus syndrome is often associated with a heart problem like a valve disease or prolapsed or coronary artery disease. I suggest you discuss this with your mother’s doctor and if the option is available (ie is good for your mother) switch her to some other drug and see. Otherwise a pacemaker will make her active by taking care of her abnormal rhythm. She’ll be able to do all her work and things she enjoys except strenuous workouts, lifting weights and things. Do discuss this with her doctor. Take care!