epilepsy symptoms/diagnosis and alzheimer

[Lizziedalia]

My mum who is suffering from Alzheimer supposedly has had once an epileptic fit. She was taken to the hospital (urgency) and was prescribed some medication (keppra) to take. However, she has not had any further medical examinations to confirm or not whether she is suffering from epilepsy. Does she need a diagnosis and if so what kind of medical examinations should she undergo ? Thanks for your feedback. Lizziedalia-

 

[jenniferpa]

I can't speak to what kind of medical exams she should have, but I can say that seizures can be the result of healing brain lesions (the sort of thing you might get after a stroke). So I have to ask: is there any possibility that the AD diagnosis is not correct? Or if she might also have vascular dementia which is the result of mini-strokes? If this is a possibility you might push for a MRI but I have to say, it probably won't make much difference in terms of treatment. In fact, I would be surrpised if she hasn't already had one when she was taken to hospital.

You say she's been prescribed keppra: this is about all that can be done in terms of treatment, apart from ensuring that her blood pressure is under control and any risk factors for clotting are addressed. Are you concerned about her taking this medication or is it just that you want to be certain of the diagnosis?

 

[Lizziedalia]

Hi Jenniferpa, thanks for your answer. I would say that I am concerned about getting the right diagnosis and hence the right treatment for my mum. Lizziedalia.

I can't speak to what kind of medical exams she should have, but I can say that seizures can be the result of healing brain lesions (the sort of thing you might get after a stroke). So I have to ask: is there any possibility that the AD diagnosis is not correct? Or if she might also have vascular dementia which is the result of mini-strokes? If this is a possibility you might push for a MRI but I have to say, it probably won't make much difference in terms of treatment. In fact, I would be surrpised if she hasn't already had one when she was taken to hospital.

You say she's been prescribed keppra: this is about all that can be done in terms of treatment, apart from ensuring that her blood pressure is under control and any risk factors for clotting are addressed. Are you concerned about her taking this medication or is it just that you want to be certain of the diagnosis?

 

[Shedrech]

Hi Lizziedalia
lots of info given by jenniferpa
if you have any concerns, I always think it's worth having a chat with the GP to settle your mind, s/hr should have access to the notes from the hospital visit, so just check it all out with them
best wishes

 

[Lizziedalia]

Thanks Shedrech: yes this is what I need to do next time when I visit mum. Her GP should have access to the medical notes on what happened on that time. lizziedalia-

Hi Lizziedalia
lots of info given by jenniferpa
if you have any concerns, I always think it's worth having a chat with the GP to settle your mind, s/hr should have access to the notes from the hospital visit, so just check it all out with them
best wishes

 

[stanleypj]

Hi Lizziedalia, my wife who has pretty advanced dementia and also some Parkinsonisms has had four fits of some kind in the past year. The first one effectively took away her already very compromised mobility. They may not be epileptic fits - she doesn't have all the usual symptoms - but most professionals have simply said that when the brain is so messed up anything can happen, including fits.

Our GP was reluctant to prescribe any medication for the fits because of potential side-effects and because the fits aren't happening very often. He said that as Sue is either in a hospital bed or strapped into a wheelchair she isn't in much danger of injuring herself in the event of a fit. This made sense to me. He did give us buccolam which is sprayed on the inner surface of the cheeks. If the fit is going on too long this can act as a fit-breaker and is a sedative that allows the person to recover gradually.

It may be that none of this applies to your mum but I thought it could be of interest.

 

[Saffie]

My husband had 2 severe seizures one evening towards the end of his life. He suffered from vascular dementia with possible some Alzheimer's too. He was prescribed a low dose of an anti-epileptic drug and had no further seizures. I understood that it is not uncommon to suffer seizures with dementia.

 

[Padraig]

Fits- Seizures

My late wife had a number of fits or seizures in her final three years. As I alone was caring for her at home I initially found them frightening. The first time she had a seizure was when I awoke her to prepare her for the daily stroll. Her body went into a spasm, her eyes stared in fright as she bled from having bitten her tongue. I had her rushed to hospital for treatment where I was refused entry to the treatment room. After treatment I insisted on her being returned home. Her clothing was returned to me in a plastic bag, they had cut them from her.

Some months later she had another seizure and again she was rushed to hospital, only that time I refused to be separated from her. Fortunately the young lady doctor welcomed my presence when I explained I was her only carer. Four hours later she was safely back home. More seizures followed and I administered the prescribed medication: Diazepam Rectitude once she calmed down.

Though an appointment was merely a suggestion I deemed it important to uncover the underlying causes. An EEG test was arranged and I gave written consent to a video recording of the brain's malfunction to be made. In my presence Electrodes were connected to her head and hands. During the hour long test she drifted off to sleep.

A week later I received the results of the Consultant's analysis: "Her EEG initially contains predominantly theta activity, but as she becomes drowsy large amounts of delta activity appear. When she is alert, the data inhibits and is replaced by faster frequencies. There are some left-sided sharp waves seen predominantly from the posterior central, but sometimes from the temporal regions. The slow dominant frequency is reflecting abnormal cortical function, compatible with her known Alzheimer's disease, but there appears to e some probable epileptiform transients coming from the left hemisphere, so this area is potentially epileptogenic, conclusion: probably Epilepsy."

As a result of the conclusions the referral to a stroke clinic was arranged. That's another story. The good news the fits-seizures stopped and there were no recurrence in her final year to 18 months.
Sorry for such a long post. Thought it may be of help.

The Consultant's analysis

 

[JohnBG]

Epilepsy, my son had two such events he too had an EEG, the nurse suggested that even when people has episodes or events while testing these did not show a long term condition or on the results. These two separate events never happened again so no diagnosis or subsequent medication was required. It was mention that these could be single events or never happen again, abstention this is challenging to witness.

I assisted a lady recently with my own experience who was having a seizure, we waited ages for an ambulance to attend who seemed rather nonchalant about t huh e whole event although her lips were blue from a continuous event.

Good luck in your quest for some answers.

John.

 

[Dayperson]

Epilepsy is usually diagnosed with a brain scan and an EEG, and the only two treatments are surgery and drugs. I'm guessing that surgery is not an option for someone with dementia or the elderly and you have to go through a lot of tests to get it to make sure it will be beneficial.

I know from experience Keppra makes you drowsy and it can have the side effect of 'Keppra rage' where you are more irritable.

 

[Lizziedalia]

Epilepsy is usually diagnosed with a brain scan and an EEG, and the only two treatments are surgery and drugs. I'm guessing that surgery is not an option for someone with dementia or the elderly and you have to go through a lot of tests to get it to make sure it will be beneficial.

I know from experience Keppra makes you drowsy and it can have the side effect of 'Keppra rage' where you are more irritable.

Yes, this is exactly my mum's situation. I have visited her lately and have noticed drowsiness and lots of irritability/fatigue leading her to being all of a sudden verbally aggressive for a few minutes with no apparent reason, then she calms down. My mum is a very "quiet" person even with her advanced Alzheimer. I made a note for the GP. Hopefully they sort out this discomfort. She also had 2 recent falls backwards (not dangerous) when walking though her usual is to walk bending forward on her two feet (she is extremely cautious as she seems to be aware somehow of the potential danger when walking) and she used to fall going forward not backwards.