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Need Advice

Thu, 07/08/2004 - 19:01
My daughter is 21 years old. Almost a year ago she began fainting. The more she did it we noticed prior to fainting she would "zone out", after coming to she would have head pain and not remember things leading up to the loss of coniousness. We have had an a cardiac workup done (tilt table test, EKG, echo) and neurology has done some things, EEG, catscan, MRI and after a little over a year still no diagnoses. They are now talking about inpatient video monitering. Is this that hard to diagnose? They have become less frequent but we still do not know the cause and we are getting frustrated.

Comments

RE: Need Advice

Submitted by michael46 on Thu, 2004-07-08 - 13:08
Hi, and welcome to the forum. I presume you are referring to epilepsy when you ask: "Is this that hard to diagnose?" If my presumption is correct then the answer to your question is: Yes, it can be. Epilepsy is a diagnosis of exclusion. This is to say that doctors need to be able to rule out the possibility of other neurological disorders before assigning the diagnosis of epilepsy; this can be a time consuming process and, as you are discovering for yourself, a frustrating one. You might however take comfort in the knowledge that the doctors are being thorough and are unwilling to rush to judgement. With all this said however, I am, admittedly, surprised that no dianosis has yet been assigned, especially given that your daughter's tests haven't shown anything (a common result in the case of epilepsy). You may therefore want to consult with her neurologist and simply ask: "What else could it be?"Michael Haileymhailey@telus.net

RE: Need Advice

Submitted by cledder on Thu, 2004-07-08 - 13:36
I was about 21 too when I was diagnosed. I went to many doctors trying to figure out what these strange episodes were and nobody seemed to know. In my case I ended up with a grand mal seizure which gave them an ah hah moment. Simple partials can occur and easily be misdiagnosed and unrecognized. I'm glad to hear they are being thourough and not rushing to judgement.Chris

RE: Need Advice

Submitted by seeker2 on Thu, 2004-07-08 - 19:01
There are some good replies in this thread.A year does seem a long time to be sure,and you are right in wanting answers to this.It's not as simple-has been pointed out to get a clear cut answer on this.Simple partials are easily missed,as the articles/posts on here tell you.As the partial extracts below points out,you have to rule everything out to get a diagnosis not easily reached.Video-EEGVideo-EEG is often necessary to record typical clinical events and to correlate them with any electrographic changes.Many SPS are characterized by EEG patterns that are difficult to record, and the diagnosis may depend entirely on video analysis of reproducible ictal semiology of multiple events, or on observation by trained personnel.http://www.emedicine.com/neuro/topic342.htmdisorders such as, stomach disorders or a pinched nerve can cause some similar symptoms. Hallucinations can accompany psychiatric illness or the use of certain drugs. And some symptoms (such as déja vu) are experienced by almost everyone at some time. Whether the symptoms represent simple partial seizures depends on how often they occur and whether they are associated with other episodic changes or other seizure types.http://www.epilepsy.com/epilepsy/seizure_simplepartial.htmlLast but not least,you cannot rule out this as well,due to you mentioning fainting.Neurally mediated syncope (NMS) is called also neurocardiogenic, vasovagal, vasodepressor or reflex mediated syncope. It's a benign (and the most frequent) cause of fainting. However, life-threatening conditions may also manifest as syncope. NMS is more common in children and young adults, although it can occur at any age. NMS happens because blood pressure drops, reducing circulation to the brain and causing loss of consciousness. Typical NMS occurs while standing and is often preceded by a sensation of warmth, nausea, lightheadedness and visual "grayout." If the syncope is prolonged, it can trigger a seizure. Placing the person in a reclining position will restore blood flow and consciousness and end the seizure.http://www.americanheart.org/presenter.jhtml?identifier=4749

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