Lots of symptoms and questions but no answers

About a year ago my wife had a spell of some sort.  It was like a fainting spell but she was laying down when it happened.  She jerked quickly and was out about 30-40 seconds, when she came out she was extremely tired and slept about 3 hours.  Over the next 2 months she had about 5 more of these spells.  Always laying down at the time.  She also had 2-3 classic fainting spells during this period where after running up stairs or getting up quickly she blacked out for 30-40 seconds, when she woke she was able to resume activities and was not extremely tired.  She has always been very easily tired.  Some times she feels so wiped out she wont get out of bed for 1-2 days.  She has many aches and pains and gets sick more often than most w/ what ever virus is going around.  About a year prior to this spell it was found that she had a visual field defect in her left eye (about a 15% loss).  Numerous tests were run and one neurologist said she may have MS since there were 2 small spots on her front lobe. After seeing numerous more specialists, MS was ruled out and the visual loss was blamed on a severe migraine.  From time to time she did and still does get visual migraines w/ aurora.  Recently these have gotten significantly worse.  Now back to the spells, some of the specialists we have seen said these were seizures while others said they were fainting spells while others said they think they were caused by mini strokes.   In order to drive again they have required her to be on an anti-seizure meds.  She has had almost every test to check her brain w/ no evidence of stroke, epileptic seizure, MS (w/ exception of 2 spots that have not changed), blood pressure issues, etc.  Except one test (bubble test) revealed she has a significant PFO w/ paradoxal flow, w/ arterial aneurism (aneurysm). Finally something!  However, although every symptom described above when googled could be related to this condition her 2 cardiologist said that it is not related and she does not qualify to have the PFO hole closed.  They offer no help, no suggestions or referrals they just say I don’t know, come back in 6 months.  She feels that there are no competent dr’s willing to help her.  I am beginning to feel the same way.  A little about her, she is an aerobics & dance instructor, has little to no body fat, 33 years old mother of 2, has a very outgoing and happy personality.  She does not tolerate most medications (even birth control) but has been able to stay on the anti-seizure meds for almost 6 months.  Is there any dr. out there that cares enough to spend more than the 10 min office visit to determine what is going on with her?

[Dr. Kokil Mathur]

Hi
Welcome to the MedHelp forum!
Yes, it is possible that PFO is causing her to have a black out or fainting spell especially since it happened after running around. However since she is into aerobics and dancing, it will be good to get a complete cardiac assessment done (probably has been done). So if no cardiac abnormality is found other than PFO, usually nothing is done and person is monitored and kept on low dose aspirin to prevent clots. It is possible that your wife has postural hypotension and this should be ruled out. Since she has fainted and jerked back on lying down, it can be seizures too. Prolonged sitting in one position (reclining in bed) can cause fainting due to ear’s balance organ not being able to adjust, anemia causing low supply of blood to brain or due to cervical spondylitis. Of these only severe anemia can cause lower blood supply to brain at rest, causing a person to lose sense and then the body adjusts and the supply to brain restored and person jerks back. A similar picture is possible in case of valve insufficiency of heart, especially mitral valve, where at rest enough blood does not reach brain and then body adjusts and blood supply is restored.
If you notice this in bed after supper or dinner or any major meal, then this is due to post prandial lowering of blood pressure. Avoiding going to bed immediately after food may help. Polycystic disease of the ovary causing hypoglycemia too could be a cause. Please discuss these possibilities with your doctor. Also if possible please consult a cardio-thoracic surgeon.
Hope this helps. It is difficult to comment beyond this at this stage. Please let me know if there is any thing else and do keep me posted. Take care!