Epilepsy and the Heart

[Valencia]

In 94 I was diaagnoes as haveing left temporal lobe seizure the EEG showed abnormal. I had been on dilantin now for about 5 years. Just recently I went into the hospital. I was to change med. and begin to take Limictol ( spelling?) While I was there I was coming off of the Dilantin I had a lot of Chest pains my heart felt sooooo tired and I would palpitate. this was the most uncomfortable thing to me and scary. My Dr. decided they wanted to see what my seizures look like so they decided to keep me until I had one I did have ONE event where I felt light headed and couldn't really respond. It felt a little like the Twilight zone. Later my Dr. told me that I DON'T HAVE SEIZURES AFTER ALL IT IS ALL MY HEART. They only saw one of these and while it may be true my heart is a problem I feel a bit lery that that is all to the story. Around my time of the month is when I have my seizures. I feel worried now they have discontinued all of my medication. How is it that after so many years and one event under your belt so to speak can some one make a call like that.

I am wearing a heart monitor now. But my heart doctor doesn't by this story totally either. Any advice?

[CCF Neuro[P] MD, RPS]

Dear Valencia:

Let me ask one question, during the five years on dilantin, did you have a seizure event that corresponded to the one you had in the hospital?  Have you ever had a seizure like the one in the hospital before?  One may have a short PVC event and become light-headed with some mental changes (due to hypoxia), however your EEG should be normal.  There is something called syncope-related seizures.  This is where you have a syncopial episode (fast heart rate or positional syncope) and the person will then have a seizure.  If you never had an event such as the one in the hospital before, I would doubt that your seizures are only rlated to your heart.  In fact, your seizures might cause your heart problem.  However, since I am not sure what they saw on the EKG that was associated wtih the seizure event, I can't tell you if the two are related.

Dilantin can cause heart rhythm problems, especially if it is started too fast or taken away too fast.  If I remember it is a class III heart medication.  Anyway, I am alittle worried that your event in the hospital was a typical seizure event for you.  It might have been just related to the rhythm changes because you were going off your dilantin.  I am betting that you need your seizure medications because you have epilepsy.  I also bet that the heart problem is related to your weaning off dilantin too fast or maybe it was a finding that is distinct from your heart.

You should be further evaluated for the heart problem and whether it is related to your seizures needs also to be evaluated.  But, I think I am in the same thought process as your heart doctor who doesn't buy the heart-seizure concept.

Sincerely,

CCF Neuro MD

[Valencia]

No, to answer your question not while on dilantin did I ever have a seizure like that. Yet, this event I had in the hospital sort of reminded me of what I would feel like before I was on any medes. at all. The events that I had ON dilantin were much more intense than that. I would have a aoura,smells and then instant replay. My head would feel like their were shocks going off. My doctor told me that my MRI came up with Scars on the left temporal lobe. Now I have aura's everyday I didn't use to when I was on meds. The doctors did say during this event ( the one in the hospital)my EEG was normal that is what led them to believe that I don't have seizures anymore or maybe never had them and the person who said I did must have made a mistake. Also fast heart rate was an issue here. I am trying to find the person who caught my seizure years ago now.

What is meant by class 3 heart Med?

I really agree with you. I don't believe that the Dilantin and it's effect on my heart was taken into consideration enough. I do have a serious Heart problem TGA. No surgery to correct this though. again my concern is my time of the month I know I have more problems around that time.

[Valencia]

While in the hospital my doctor spoke to me about Epilepsy sudden death. There was a concern that I could be in danger of this. Is it true every Epileptic is in danger of this? Exactly what is this. I believe that Jackie Joyner (Flo JO) died of this. Is that true? Please Explain this.

[THOMAS HENCKE]

POST CONCUSSION SYNDROME INEED HELP!!!!!!!

[CCF Neuro[P] MD, RPS]

Dear Valencia:

The earlier abnormal EEG indicates that you have epilepsy, especially since you have had seizures fully compatible with the location of the abnormal EEG.  Just because you have had one EEG that was thought to be normal during what was an altered mental state doesn't mean that you did not have epilepsy.  Since you are older and have a TGA you must have a baffle, and there are times where your heart will beat fast and you will have decreased oxygenation of your blood and therefore less oxygen to your brain.  This might account for your altered feeling during the heart rhythm episode.  Since you also have MRI changes in the temporal lobe, I am hard pressed to think that you do not have epilepsy.

The doctor to told you that you may die from epilepsy sudden death should explain what he meant.  If you do not have epilepsy as he/she suggested then this is a non-entity.  There are people who have epilepsy who die suddenly.  We do not know why, but the percentage is very small.  Some think that it has to due with the heart and rhythm changes but NO ONE KNOWS WHY!!!  

Sincerely,

CCF Neuro MD

[Valencia]

Today I had a seizure. Do you Believe it???? I have a hard time with all this. My Heart doctor said next one he would like me to go to Emergency He says he'll put me in the hospital for monitoring. It is impossible to reach my Neurologist at this time. I left a message today but no respond

[Valencia]

Thomas, I have had that before. What is your specific problem for me I forgot where I put things I basically suffered short term memory loss. My husband would ask for his laundry that I had left at the laundry to name one incident. How didi you come by a concussion?

[TO :THOMAS]

Thomas, I have had that before. What is your specific problem for me I forgot where I put things I basically suffered short term memory loss. My husband would ask for his laundry that I had left at the laundry to name one incident. How didi you come by a concussion? valencia

[CCF Neuro[P] MD,RPS]

thanks for the comment.

CCF Neuro MD

[Rick]

My son has long chain fatty oxidation disorder.  A recent chest x-ray showed a "prominent aortic arch".  In research that my wife has done, it is suggested that metabolic disorders can cause an enlargement of the heart which would lead to the aortic arch.  Does this sound reasonable?  What are the long term ramifications of this condition and are there any treatments?

[CCF Neuro[P] MD, RPS]

Dear Rick:

I am sorry to hear about your son.  As you know, the heart uses alot of fatty acids for energy.  Is your son on a proper diet?  To facilitate fatty acid use, are you on carnitine?  If not, check with your metabolic doctor as I think it will help.  The prominent aortic arch... I not sure what to make out of it.  Cardiomyopathy can cause heart enlargement and abnormally low ejection fraction.  I am not sure how this would translate into an enlarged aortic arch.  Since the output of cardiomyopathy is usually decreased output, stress on the arch should actually decrease.  

As you are probably aware, the level of long chain fatty acids can be bad for mitochondria function.  The carnitine will help change the bad form of long chain fatty acid to a more non-toxic from.  Our body uses fatty acids for energy and there are specific essential fatty acids.  Make sure your son gets enough.  As we are stressed, either in disease or fasting, our bodies natural response is to release fatty acids for energy.  These are usually long chain fatty acids that the mitochondria break down and then use for energy production.  During these time periods your son will need extra carbohydrates for energy production.

Sincerely,

CCF Neuro MD

[Guy]

I would like to first start out by saying that I am in no way shape or form an expert on the topic of epilepsy.  I can only share w/ you my experiences over the last twenty yrs.  If I were to pinpoint the  reason for my epilepsy I have to say it was do one level of concussion or another ( i.e.,high school football or car accident).  
     I know that my heart is racing after my siezures(grandmal)
but I don't recall experiencing any abnormal heart rythms before a siezure. The only triggers I'm aware of are what's known as horas (sort of a mental pause lasting only secounds). After an uncountable number of fits over almost twenty yrs. my MD put me on new medication called Depakote and/or Depakeen. I can't remember feeling better.  I have much more energy; I think I have a better outlook on life in general. I hope I was able to provide you with some type of help and if I can be of anymore help feel free to ask:?)

[CCF Neuro[P] MD, RPS]

thank you for the comments.

CCF Neuro MD

[Lalitha jayant]

My husband has an epilepsy problem since he was 15 yrs old.He has been on Dilantin since then.For the past seven yrs he was incident free. His neurologist's prescribeda  reduced dosage of 250mg/day instead of 300mg. After this change he was okay for 2 yrs.But now suddenly within the span of 6 months he has had 2 attacks ( one on the 20th of this January) and both of them very vigorous ones. His dilantin level was 8.5mcg/dl on the day of his seizure ,even though he had taken his dosage that morning. Both hia attacks were early in the morning when he was taking a bath.
My questions are as follows
1.Should he go back on his 300 mg dosage (His blood dilantin level was 7.1mcg/dl when he was 200 mg dialntin dosage and when he was on 300 mg dosage the blood dilantin level was 24.1mcg/dl).

2 why is he suddenly getting these attacks now
3.Has taking a bath got to do anything with getting a seizure attack

4. So far I thought That epileptic attacks are not fatal.Is it possible that they can cause death.Why and how? Any precautions?

5.What effects could seizure attacks have on his heart. Also can dilantin cause any side effects that could lead to heart diseases?

6.Both times he complained of sleeplessness. Could that cause an attack

[CCF Neuro[P] MD, RPS]

Dear Liltha Jaynat:

The most logical reason for the breakthrough seizures is the low dilantin level.  The level should be 10-20 total dilantin in the serum (although each person can be different as far as optimal level). In addition, sleep deprivation can lower the seizure threshold.  Both could have played a part in your husbands break through seizures.  There is an increased incidence of sudden death in epilepsy patients.  This seems to be related to control vs non-control but patients in complete control are also at risk for sudden death.  However, no one really knows what causes sudden death in epilepsy.  The percentage is low, at least that is good news.  Dilantin can cause changes in the heart rhythm but is not really associated with heart disease.

I hope I have helped you.

Sincerely,

CCF Neuro MD

[Valencia, Thank You]

The chances of you reading this DR. is pretty slim it's been a while since I originally posted. But I just wanted to thank you so very much for your help. I told my DR. about you and she had a negative reaction only to come back and have to acknowlegde that you were RIGHT. See original post. I do have seizures she was saying I don't when I put on a EEg at home it caught it! She was really apologetic concerning you as I was so sure you were right. Now I am on Lamictal I must say though I am a little worried about it. The label says don't take if you have a heart condition which I do. I am trying to find out more about that now. Well I will try to post just in case you don't read this. I noticed that a lot of people have visited. It would be nice just to have a Epilepsy/Heart Forum but I know that would be to much.
Thanks Again!

[CCF Neuro[P] MD, RPS]

Dear Valencia:

I am sorry that I was correct, as one always hopes that epilepsy might not be the diagnosis.  But I am glad that your on medication.  Lamictal is a good medication with few side effects.  Although one can get a tachycardia or syncope with it, we have not seen this side effect.  Many people are on it who have a cardiac condition.  You will just have to see if your heart has a reaction to it.

Sincerely,

CCF Neuro MD