Brain Blips/Seizures/Unconciousness

36 year old healthy male with a heart/brain problem...

Since I have been 30 years old I have had one 'episode' a year.  Each episode invovles me passing out either from a sitting or standing position (the last one I lost all of my front teeth goig down).  While I am down, I am completely unconcious for about 7-10 minutes.  I am observed to seize for a little bit, then to turn red/blue.  I usually wake up in the back of an ambulance, fighting with paramedics due to my confused state.  Within an hour, I am sort of back to normal, but really tired and groggy.  During the last one, the emerg Dr. noted that my hear was experiencing atrial fibrillation.  They were about to intervene when it fell back into a normal rythym on its own.

These episodes usually happen with the following common factors:  Happen in the morning or shortly after getting up (within an hour), may involve sleep deprivation, has followed a night of alcohol consumption but not always, usually invovles a lack of food/water.

I also have these small 'brain blips' when I am tired and only in the morning.  I will lose awareness for a split second, and usually drop whatever is in my hands (usually a bowl of cereal or the dogs food).  If I have one during conversation, I will forget what I was talking.  My wife describes them as, my eyes blinking, and my head will shake depending on how 'big' it is.  She also says that they can be effected by my sleep pattern.  Anytime I go to bed late and get up late.....I scared my parents at the table once, but dropping my fork, then dropping my glass of milk.

I have been checked by a Neurologist and Cardioogist for almost every test you can imagine.  There is nothing there, however due to the nature of the events my neurologist has out me on Dilantin (300 Mlg at bedtime) as a precaution.  The latest investigation that they will be looking into in a problem with m carotid body.

Any thoughts.....anyone out there with similar symptoms?  PLEASE HELP!!!!

Mark

[Christopher R Newey, DO]

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 a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

It sounds like you may have syncopal events. These are related to the inability to perfuse the brain during certain activities causing you to pass out. Some people when they pass out may actually have seizure like activity secondary to the hypoperfusion. This may be due to the heart not supplying the brain with adequate blood flow, or there is increased resistance from the path the blood takes from the heart to the brain, which includes the carotids.

I would highly suggest that you have an extended EEG with EKG to capture one of these events. It would be important to see what your heart is doing when the event occurs. Additionally, other tests, such as a tilt table and QSART, may be an option to evaluate for a neuropathy (i.e., nerve problem) that can lead to difficulties with maintaining adequate perfusion.

Common causes of syncope do include underlying cardiac arrhythmias. Additionally, diabetes can lead to neuropathy that can affect the nerves supplying the heart.

You should discuss treatment options with your physician. There are medications that may be an option for you. However, these medications can cause you to have resting high blood pressure.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.