Blackouts

I am very worried about my 21 year old son who has started having 'blackouts'.  There is no warning at all, he just collapses. Recently he fell and badly gashed his nose and has two black eyes.  He is under a great deal of personal stress.  Can stress cause these 'blackouts' or could it be epilepsy.  He had a brain scan a couple of years ago but this did not show anything untoward. Any information would be much appreciated.

[CCF Neuro[P] MD, RPS]

Dear Sue B:

Sorry to hear about your son.  I think that there are acouple of possibilities to think about.  One would be as you mentioned, seizure activity.  A good history, physical exam, and EEG might help to lead you in this direction.  Another thought is syncope.  A visit to the cardiologist might help with this, and maybe some cross talk with a neurologist concerning tilt table testing and EEG together.  Medications and drugs are another avenue to pursue.  An inner ear infection could also be a problem.  A periodic disorder might be considered but this is a long shot (electrolyte analysis during an event would sort this out).  Orthostatic hypotension might be a confounding finding in a syncope work-up, this can be caused by the syncopial episode (the etiology of central or peripheral causes) or part of an dysautonomia.  This would also be pretty rare.  So, there are plenty of reasons why this might happen.  I would begin in the neurological arena intially.

I hope the problem can be found and corrected.

Sincerely,

CCF Neuro MD

[mstoby]

A related discussion, blackouts was started.