vasovagal reactions/seizure like

[what2do2010]

First, some history - about 8 years ago my husband had a tension-pneumo thorax and had a chest tube placed. Several hours later he woke from sleep complaining of extreme nausea and being "hot" then suffered a syncopal episode along with what appeared to be a "seizure."  Upon further evaluation the neuro determined it was a vasovagal reaction to the chest tube.  About a year ago he experienced another "seizure" like episode - this one also was preceeded by a hot flash and some nausea.  He was supine, it appeared out of the blue and lasted about 20 seconds.  After a ER visit, several evals by neuros it was determined that it was again a vasovagal reaction.....to what?  Last week it happened again!  Only a year or so since the last one - before that it was 8 years.  I have witnessed all 3 episodes and they certainly appear to look like a seizure.  He stiffens up, his eyes roll back, he has a slight arch to his back, there is no "shaking", no incontinence, no tongue biting, they usually last about 20-30 seconds and his body is completely still (as if he is not breathing) right before he comes out of it.  He has that "deer in the headlights" look when he comes to, he seems coherent but describes it has being somewhat alert but unable to act upon what he is thinking.  Example: he wants to speak but it is seconds before he is able to.  We know what to expect now - but are very concerned about the time frame of only a year or so between episodes. For days after he is exhausted, has a loss of appetite, and does not feel well at all. Anyone have anything similar or advice???  Thank You

[caregiver222]

This does not appear to me to be vagal syncope. I don't buy it.

It appears to be a classical seizure of unknown etiology. And the recovery seems to be a typical post-ictal reaction.

That being said, he needs evaluation as a hospital that specializes in seizure disorders.

A common trigger is a flashing red light, or even a television set. In such a case wearing polarized sunglasses sometimes helps.

Usually there is a premonition, or aura. It is important not to be leaning on a train platform or driving when such an event takes place.

I am hesitant to suggest he give up driving, but at this point, my opinion leans in that direction.

Anti-seizure medications will resolve the issue and permit him to live a relatively normal life. After a period without seizures his driving priviliges will be restored.

[Dr. A. Srivastava]

Hi, Thank you for your question. Your symptoms might be due to postural hypotension or vasovagal syncope. This is triggered by stress, sudden onset of extreme emotions, sudden standing-up, prolonged physical activity with hyperthermia, and even seeing non-pleasurable event etc. This pre-syncope (like lightheadedness and dizziness) is very early stage of syncope which may last for few seconds to minutes and can be prevented by early interventions measures like lying down, elevation of legs, deep breathing, immediate glucose drink and inhalation of any stimulant like spirit of ammonia etc. Please arrange an appointment with a neurologist who will evaluate the further prognosis here and can provide you an appropriate treatment. Hope this helps.