Fainting

My mom is a healthy 68 year old lady, active and in very good shape.She lives in South America up in the mountains (above 7 thousand feet). One day she was taking a walk with some friends and all of the sudden she fainted. She says that she did not see it coming because she was feeling just fine, She was not dizzy or cold. Her heart felt fine, she just ate lunch half an hour ago. It was so sudden that she could not even strech her arms to protect her body/face. Her face was heavily damaged. She described the event like "the switch, it was turned off" and she woke up about 1.5 hours later. She kind of remembers when they put her in the car to take her to the hospital, but everything is very blurry.
She does not know what happened. This is the first time in her life that something like this happen and she is afraid it might happen again. What can you tell me about it ? Do you have any suggestions ?. I am also afraid this could happen again when she is driving and the consequences could be fatal !. Thanks a lot !

[CCF Neuro[P] MD, RPS]

Dear Rosablanca:

Sorry to hear about your mother. It is difficult to tell you what happened to your mother.  Such a long time of loss of consciousness is not a simple vagal response.  A simple fainting spell is not a good explanation for what happened. Unless your mother fainted and her head hit a rock and she had a concussion.  This I can't tell.  The more logical explanation is stroke or epilepsy.  A small stroke could certainly do this, as well as a seizure event.  

Sorry that I am not much help.

Sincerely,

CCF Neuro MD

[Marji]

Dear Doctor,
Sorry for the second post.  Please see my question under "neck, left shoulder and arm pain". Posted 04-07-99, comment-Marji
Thank You

[Rosablanca]

Hi :
My mom really fell hard. She fell on the road and hit her face, all the impact of the fall was received by her face. She said it was all so sudden that she could not put her arms to protect herself from the fall and that the scary part.
She needed more that 40 stitches. She lost a little piece of her tongue and she needed a lot of stitches under her jaw line. She says she can remember just bit and pieces between the falling and "really" waking up at the hospital after the doctors took care of her.
I really thought this was a "neurological" matter since three weeks previous to this accident she went through a surgical procedure (face lift) and her heart checked out "fine" and she said she has feeling just fine before she lost consciousness. Is your answer still the same ? or can you be a little more specific ? Do you agree that is a "neurological" matter ?
What tests can you suggest she does to find out what happened ?
Thank you very much for your prompt response !
Rosablanca.

[nancy]

My father is seventy-four years of age, a diabetic (takes insulin injections), has a history of heart problems (bypass, stroke, angioplasty), and had a pacemaker implanted last year.  Dad has had problems keeping his blood sugar levels within normal limits.  He eats well (lives with my sister) and does get some exercise, but not enough.  He is not overweight.  He has high blood pressure.  

A couple of weeks ago, Dad had two car accidents (no longer driving now).  In both cases his blood sugar levels were recorded at under thirty.  Luckily, neither he nor anyone else was injured.  His family doctor ordered at CT Scan of his head.  The scan showed that Dad has had a stroke.  Can diabetes (low sugar in particular) trigger a stroke?  Can a stroke trigger low blood sugar?  Can you point me in the direction of further information relating to this subject?  

Thank you for any help/advice.

[CCF Neuro[P] MD, RPS]

Dear Nancy:

As I was reading your posting I was thinking this gentleman had a stroke or seizure, and sure enough your father had a stroke.  The diabetes is one cause of stroke, as the lipid level is high and athroscleroisis is usually prominant, especially in the uncontrolled diabetics.  In addition, high blood pressure is another risk factor.  Heart disease is also another risk factor. The stroke (was it ischemic? what territory of vessel was it in?) was not due to low blood sugar but likely the high blood pressure, athrosclerois, and heart problems.

Sincerely,

CCF Neuro MD

[Matthew Rubin]

Most of your fainting related questions concern older people.  I'm 34 and was diagnosed with exercise induced syncape a few years ago but I never got a satisfactory explanation of why I faint.  Usually I get light headed, and then sometimes faint/seize, towards the end of a workout or sometimes in the lockerroom afterwards.  Is this because of an ocygen deficit problem, blood sugar, heart related?  Any ideas?

[CCF Neuro[P] MD, RPS]

Dear Matthew:

What you describe is more of a thing we see in younger people.  The exact explanation is not known but most think it is related to a strong valsva-like effect where our brain doesn't get enough blood and oxygen as it is pooled in our lower extremities.  Plenty of fluid usually helps and knowing the signs of when it is going to happen so a person can sit down and drop their head.

Sincerely,

CCF Neuro MD

[Jessie]

Dear Doctor,
Is there any chance Matthew's fainting problem could be caused by Long QT Syndrome?  

[CCF Neuro[P] MD,RPS]

Dear Jessie:

Yes, but Matthew was fully worked up and I would assume a long QT time was not found.

CCF Neuro MD