Misdiagnosis?

My mother (77y.o.) has been dx with petit mal epilepsy since the early part of the 1980's.  Her present meds are Dilantin (300 mg) and Primidone (375 mg).  

Mid-November of 2007, she was hopitalized for a fall and had arthoplasty.  Her recovery period has been extremely slow.  She was back in the hospital this past Friday (1/25/08) for pneumonia.  While in the hospital (my sister observed this) she had a 'seizure'--blank stare, no talking, fidgeting with something in her hand, urinated.  It lasted a couple minutes and took her about 10 minutes to come out of it; difficulty speaking, not making sense.

She had another episode in front of the Dr.  He informed me that from what he observed, he is more apt to believe that these are not seizures, but TIA's that she is experiencing and is keeping her in the hospital to check her medication levels.

My questions:

~what other tests can be performed in order to differentiate between a petit mal seizure and a TIA?
~these episodes have happened a handful of times during the past year alone and are clearly brought on by emotional triggers (being sad, melanchony, depressed, thinking of the past); can these episodes truly be triggered?
~Mom states that before a seizure, she usually feels an aura, but with these--she moreso felt tired and said she must have 'dozed off.'  Would a person with a TIA remember anything about the episode?
~Besides aspirin therapy which she's been on for at least several years, along with Lopressor for the past 3 years for blood pressure, after a lobectomy surgery, are there any other medications suggested for TIAs?

Thank you for any insight you can offer.

[Abhijeet Deshmukh, MD]

Hello.

Hope your mother is better.

The first investigation you should be looking at is the EEG (Electroencephalogram). This will show any seizure activity. Though it may come normal if done in between the attacks, a normal EEG "during" an episode almost rules out a seizure. The patient usually does not remember what happened during the seizure.

You won't need to ad any more medicines to prevent a TIA.

Try to ask her neurologist about an EEG.

Regards