Healthy Living: Seizures, similar events can have many explanations Orlando FL

Among the most challenging and serious conditions physicians must deal with are patients with a sudden, unexplained loss of consciousness. This presentation is frightening for patients, families and co-workers. It also carries with it many limitations, such as inability to drive a car, work at heights or work with heavy machinery.

The words seizure, spell, fit and attack are often used to describe these events. Although there are many reasons, they all involve a loss of awareness associated with abnormal neurologic function.

The term “seizure” is often used to describe events related to epilepsy. Approximately 9 percent of the U.S. population will at some point suffer a seizure, but only a third of those events are related to epilepsy. The rest are triggered by events outside the brain, usually involving the heart, lungs, toxic exposure or behavioral issues.

Neurocardiogenic syncope is a broad term used to describe loss of consciousness because of a malfunction between the heart and brain. The heart pumps blood to the brain. If the pump does not work efficiently, it cannot keep up with the demands of the brain. The heart may beat too slowly or out of rhythm, causing an arrhythmia. When the heart does not keep up, the brain goes into a rest period by losing consciousness (fainting). This can be related to extreme pain, fever, coughing or fright, such as when seeing blood. Lowering of blood pressure and subsequent loss of consciousness can also be a side effect of some medications.

Seizures related to the pulmonary system are typically the result of low oxygen levels. Any pulmonary condition, such as emphysema, asthma or pneumonia, can result in confusion or loss of consciousness. Recently, we have begun to notice patients suffering from sleep apnea (inability to breathe while sleeping) will likely fall asleep suddenly during the day. This can occur while driving, often causing collisions.

Ingestion of toxic substances also may result in loss of consciousness. The most common scenario is excessive alcohol intake. This also can be seen with medication overdosage or as a side effect to some medication.

Stress, anxiety and depression sometimes can become overwhelming and result in a psychogenic seizure.

A thorough medical evaluation including bloodwork, an imaging study of the brain (CT or MRI), electroencephalogram and electrocardiogram should determine the cause of these events.

The principal rule for patients who suffer from a seizure of any type is never to participate in an activity that will be dangerous to yourself or others if an event should occur.

Norwich Bulletin

Anthony G. Alessi, M.D., is a neurologist on The William W. Backus Hospital medical staff in private practice at NeuroDiagnostics LLC in Norwich. This column should not replace advice or instruction from your personal physician. E-mail Alessi at aalessi@wwbh.org.