Re: Syncope or Epilepsy-Medical Report

[Guest guest]

Hi Zoe,

Makes sense. Does it say what kind of tests we should

take? (The link didn't work when I tried it.)

Thanks,

Pepper

--- zoe88025 <Zll51@...> wrote:

> Hey group,

> This issue will come up again and again. Studies

> indicate that the

> diagnosis of epilepsy is often wrong, may be by as

> much as 40%.

> Syncope can look identical to seizure disorders too,

> so it makes

> sense to consider this if someone is not responding

> to AED therapy.

> Zoe

> --------

>

> An anorexic woman with convulsive loss of

> consciousness. Syncope or

> epileptic fits?

>

> Int J Cardiol. 2007; 116(2):e34-8 (ISSN: 1874-1754)

> Attanasio A; Argiriadou V; Sandri G; Diomedi M

>

>

> We report the case of a young anorexic woman who

> suffered a sudden

> loss of consciousness with convulsions, diagnosed as

> epilepsy

> associated with a migrational disorder, as

> documented at MRI.

> Standard 12-lead ECG showed a prolonged QT interval.

> Biochemical

> tests revealed a severe hypokalemia. Continuous 24-h

> ECG recording

> detected a ventricular tachycardia in torsades de

> pointes inducing a

> syncopal convulsive attack that seemed to be related

> to oral

> Cisapride assumption for dyspepsia. Discontinuation

> of cisapride and

> normalization of kalemia caused disappearance of

> both ECG

> abnormalities and loss of consciousness episodes.

> Syncope is a

> condition often misdiagnosed as epileptic seizures.

> http://www.medscape.com/medline/abstract/17070606

>

>

Alternative Epilepsy Treatments

http://epilepsyalternatives.freeservers.com

________________________________________________________________________________\

____

TV dinner still cooling?

Check out " Tonight's Picks " on TV.

http://tv./

[Guest guest]

Thanks Zoe I will pass this info on.

http:health./group/epilepsyapproach1/

http://www.sleep-safe.co.uk/id90.htm

>

> Hey group,

> This issue will come up again and again. Studies indicate that the

> diagnosis of epilepsy is often wrong, may be by as much as 40%.

> Syncope can look identical to seizure disorders too, so it makes

> sense to consider this if someone is not responding to AED therapy.

> Zoe

> --------

>

> An anorexic woman with convulsive loss of consciousness. Syncope or

> epileptic fits?

>

> Int J Cardiol. 2007; 116(2):e34-8 (ISSN: 1874-1754)

> Attanasio A; Argiriadou V; Sandri G; Diomedi M

>

>

> We report the case of a young anorexic woman who suffered a sudden

> loss of consciousness with convulsions, diagnosed as epilepsy

> associated with a migrational disorder, as documented at MRI.

> Standard 12-lead ECG showed a prolonged QT interval. Biochemical

> tests revealed a severe hypokalemia. Continuous 24-h ECG recording

> detected a ventricular tachycardia in torsades de pointes inducing a

> syncopal convulsive attack that seemed to be related to oral

> Cisapride assumption for dyspepsia. Discontinuation of cisapride and

> normalization of kalemia caused disappearance of both ECG

> abnormalities and loss of consciousness episodes. Syncope is a

> condition often misdiagnosed as epileptic seizures.

> http://www.medscape.com/medline/abstract/17070606

>

[Guest guest]

Hi Pepper,

Try cutting and pasting the link. I just tried it and it worked. I'm

looking up some information for you and will post more on this ASAP.

Meanwhile, is there any reason that would make you wonder if this

might be behind your seizures-like do you have a heart murmur or

something?

Later,

Zoe

>

> > Hey group,

> > This issue will come up again and again. Studies

> > indicate that the

> > diagnosis of epilepsy is often wrong, may be by as

> > much as 40%.

> > Syncope can look identical to seizure disorders too,

> > so it makes

> > sense to consider this if someone is not responding

> > to AED therapy.

> > Zoe

> > --------

> >

> > An anorexic woman with convulsive loss of

> > consciousness. Syncope or

> > epileptic fits?

> >

> > Int J Cardiol. 2007; 116(2):e34-8 (ISSN: 1874-1754)

> > Attanasio A; Argiriadou V; Sandri G; Diomedi M

> >

> >

> > We report the case of a young anorexic woman who

> > suffered a sudden

> > loss of consciousness with convulsions, diagnosed as

> > epilepsy

> > associated with a migrational disorder, as

> > documented at MRI.

> > Standard 12-lead ECG showed a prolonged QT interval.

> > Biochemical

> > tests revealed a severe hypokalemia. Continuous 24-h

> > ECG recording

> > detected a ventricular tachycardia in torsades de

> > pointes inducing a

> > syncopal convulsive attack that seemed to be related

> > to oral

> > Cisapride assumption for dyspepsia. Discontinuation

> > of cisapride and

> > normalization of kalemia caused disappearance of

> > both ECG

> > abnormalities and loss of consciousness episodes.

> > Syncope is a

> > condition often misdiagnosed as epileptic seizures.

> > http://www.medscape.com/medline/abstract/17070606

> >

> >

>

>

> Alternative Epilepsy Treatments

> http://epilepsyalternatives.freeservers.com

>

>

>

>

______________________________________________________________________

______________

> TV dinner still cooling?

> Check out " Tonight's Picks " on TV.

> http://tv./

>

[Guest guest]

Hey again Pepper and group,

Here's a good editorial on this subject.

BMJ 1997;314:158 (18 January)

Editorials

Epilepsy: getting the diagnosis right

All that convulses is not epilepsy

Epilepsy may present with a variety of symptoms, and other conditions

may mimic its manifestations. The diagnosis is almost always based

solely on the clinical history. It is therefore not surprising that

diagnostic accuracy remains a major problem.1 About a fifth of

patients referred to specialist units with " intractable epilepsy " are

found, on further assessment, not to have epilepsy.2 It is also

common for patients to have symptoms for months or even years before

epilepsy is diagnosed. Thus, it is important to be aware of both the

heterogeneous and sometimes subtle forms of epilepsy and of the

alternative diagnoses.3

The differential diagnosis of epilepsy includes all causes of

transient loss of awareness, falls, paroxysmal sensory-motor

phenomena, and generalised convulsive movements which are the most

common presenting symptom of epilepsy.3 Tonic-clonic seizures ( " a

convulsion " ) start with sudden loss of awareness, a guttural cry,

generalised stiffening of the body and limbs, followed by rhythmic

jerking of the limbs, often associated with tongue biting and urinary

incontinence. The convulsive movements usually last for at most one

to two minutes, and, as the attack proceeds, the jerking slows in

frequency and increases in amplitude. There is often cyanosis and

irregular breathing followed by confusion, headache, and drowsiness.

Tonic-clonic seizures may sometimes be preceded by myoclonic jerks in

idiopathic generalized epilepsy or by a simple partial seizure

( " aura " ) in partial epilepsy. When all or most of these features are

reported there is little room for diagnostic confusion.3

However, other conditions may present with similar phenomena. If

misinterpreted, these can lead to unnecessary treatment and social

and occupational handicap. The most common sources of confusion are

vasovagal syncope and non-epileptic attacks of a psychological

origin. Syncope is often misdiagnosed, as it may be accompanied by

brief stiffening or jerking of the extremities, and consequently is

liable to be reported as a convulsion by witnesses. A video study of

syncope induced in healthy volunteers has shown that multifocal and

generalised myoclonic jerks are common in syncope.4 However, syncope

can usually be correctly identified by the presence of precipitating

factors and prodromal symptoms. Syncope often occurs on prolonged

standing or when rising quickly, particularly if associated with

peripheral vasodilatation. Syncope is unusual when recumbent, unless

it is of cardiac origin. Fright, painful stimuli, cough, and

micturition (particularly in older people) may also be triggers.

Syncopal attacks are preceded by a feeling of lightheadedness,

dizziness, nausea, ringing in the ears, and the vision " going grey " –

features that are rare in epilepsy. Incontinence is rare, and

recovery of consciousness usually occurs within a minute.3

Non-epileptic attack disorder may be characterised by semi-purposeful

thrashing of all four limbs that waxes and wanes in intensity over

many minutes, and some patients exhibit prominent pelvic movements

and back arching, often with evidence of retained awareness.2

Recovery is variable and may be much quicker than expected from the

duration of the attack.3

In this week's BMJ, McCrory and colleagues describe what they

call " concussive convulsion, " (p 171) another potential pitfall in

the diagnosis of epilepsy.5 Convulsions that occur within seconds of

an impact to the head have been widely assumed to represent a form of

post-traumatic epileptic seizure, but McCrory and colleagues suggest

that these are a non-epileptic phenomenon. Studying a series of 22

well documented attacks, some captured on video, that occurred after

minor head trauma during Australian football, the authors were able

to ascertain the benign nature of these attacks. The convulsions

occurred within two seconds of the impact and resembled tonic-clonic

seizures. The convulsions were usually brief, but some lasted for

over two minutes. Recovery was quick; indeed, in two cases the

players were alert and oriented within seconds of the convulsive

event. Of particular importance is that, after a mean follow up of

3.5 years, no subjects developed epilepsy. This corroborates

Jennett's observation over 20 years ago that seizures confined to the

time of the head injury are not associated with subsequent epilepsy.6

The clinical characteristics of concussive convulsions seem to differ

somewhat from those after syncope. There is a more prominent tonic

phase, and the attack lasts longer. Electroencephalography shows that

syncopal convulsions are non-epileptic, but it remains to be

established whether these events arise as a result of an epileptic

discharge. McCrory et al argue that they do not. Alternatively, we

suggest that they represent an acute symptomatic but benign seizure.

Pathophysiology notwithstanding, the observations provide helpful

prognostic information. Concussive convulsions should be

distinguished from seizures that occur within the first week of head

injury rather than instantly after impact. These carry a 25% risk of

later epilepsy.6

Every effort should be made to reach a firm diagnosis in cases of

possible epilepsy. If doubt remains after the first event it is

usually wise to await further events and reach a secure diagnosis,

rather than initiate anti-epileptic treatment prematurely.

J W A S Sander, Senior lecturer,a M F O'Donoghue, Research fellow a

a Institute of Neurology, National Hospital for Neurology and

Neurosurgery, Queen Square, London WC1N 3BG

----------------------------------------------------------------------

----------

Sander JWAS, Shorvon SD. The epidemiology of the epilepsies. J Neurol

Neurosurg Psychiatr 1996;61:433-4.

Lesser R. Psychogenic seizures. Neurology 1996;46:1499-507. [Medline]

Duncan JS. Diagnosis–Is it epilepsy? In: Duncan JS, Shorvon SD, Fish

DR. Clinical epilepsy. Edinburgh: Churchill Livingstone, 1995:1-23.

Lempert T, Bauer M, Schmidt D. Syncope: a videometric analysis of 56

episodes of transient cerebral hypoxia. Neurology 1994;36:233-7.

McCrory PR, Bladin PF, Berkovic SF. Concussive convulsions:

phenomenology, aetiology and outcome. BMJ 1997;314:171-4.

[Abstract/Free Full Text]

Jennett B. Epilepsy after non-missile head injury. London: Heinemann,

1975.

http://www.bmj.com/cgi/content/full/314/7075/158

>

> > Hey group,

> > This issue will come up again and again. Studies

> > indicate that the

> > diagnosis of epilepsy is often wrong, may be by as

> > much as 40%.

> > Syncope can look identical to seizure disorders too,

> > so it makes

> > sense to consider this if someone is not responding

> > to AED therapy.

> > Zoe

> > --------

> >

> > An anorexic woman with convulsive loss of

> > consciousness. Syncope or

> > epileptic fits?

> >

> > Int J Cardiol. 2007; 116(2):e34-8 (ISSN: 1874-1754)

> > Attanasio A; Argiriadou V; Sandri G; Diomedi M

> >

> >

> > We report the case of a young anorexic woman who

> > suffered a sudden

> > loss of consciousness with convulsions, diagnosed as

> > epilepsy

> > associated with a migrational disorder, as

> > documented at MRI.

> > Standard 12-lead ECG showed a prolonged QT interval.

> > Biochemical

> > tests revealed a severe hypokalemia. Continuous 24-h

> > ECG recording

> > detected a ventricular tachycardia in torsades de

> > pointes inducing a

> > syncopal convulsive attack that seemed to be related

> > to oral

> > Cisapride assumption for dyspepsia. Discontinuation

> > of cisapride and

> > normalization of kalemia caused disappearance of

> > both ECG

> > abnormalities and loss of consciousness episodes.

> > Syncope is a

> > condition often misdiagnosed as epileptic seizures.

> > http://www.medscape.com/medline/abstract/17070606

> >

> >

>

>

> Alternative Epilepsy Treatments

> http://epilepsyalternatives.freeservers.com

>

>

>

>

______________________________________________________________________

______________

> TV dinner still cooling?

> Check out " Tonight's Picks " on TV.

> http://tv./

>

[Guest guest]

Hello Pepper and group,

Anyone concerned about seizures and syncope misdiagnosed as epilepsy

may want to also look at potassium deficiency. That's what caused the

woman's " heart problem " in the medical report. It would be worth

checking out causes of potassium deficiencies [AEDs?] and exploring

if this may be triggering the seizures\syncope spells.

Zoe

----

Printed from www.healthatoz.com

Hypokalemia

Definition

Hypokalemia is a condition of below normal levels of potassium in the

blood serum. Potassium, a necessary electrolyte, facilitates nerve

impulse conduction and the contraction of skeletal and smooth

muscles, including the heart. It also facilitates cell membrane

function and proper enzyme activity. Levels must be kept in a proper

(homeostatic) balance for the maintenance of health. The normal

concentration of potassium in the serum is in the range of 3.5-5.0

mM. Hypokalemia means serum or plasma levels of potassium ions that

fall below 3.5 mM. (Potassium concentrations are often expressed in

units of milliequivalents per liter [mEq/L], rather than in units of

millimolarity [mM], however, both units are identical and mean the

same thing when applied to concentrations of potassium ions.)

Hypokalemia can result from two general causes: either from an

overall depletion in the body's potassium or from excessive uptake of

potassium by muscle from surrounding fluids.

Description

A normal adult weighing about 154 lbs (70 kg) has about 3.6 moles of

potassium ions in his body. Most of this potassium (about 98%) occurs

inside various cells and organs, where normal concentration are about

150 mM. Blood serum concentrations are much lower-only about 0.4% of

the body's potassium is found in blood serum. As noted above,

hypokalemia can be caused by the sudden uptake of potassium ions from

the bloodstream by muscle or other organs or by an overall depletion

of the body's potassium. Hypokalemia due to overall depletion tends

to be a chronic phenomenon, while hypokalemia due to a shift in

location tends to be a temporary disorder.

Causes and symptoms

Hypokalemia is most commonly caused by the use of diuretics.

Diuretics are drugs that increase the excretion of water and salts in

the urine. Diuretics are used to treat a number of medical

conditions, including hypertension (high blood pressure), congestive

heart failure, liver disease, and kidney disease. However, diuretic

treatment can have the side effect of producing hypokalemia. In fact,

the most common cause of hypokalemia in the elderly is the use of

diuretics. The use of furosemide and thiazide, two commonly used

diuretic drugs, can lead to hypokalemia. In contrast, spironolactone

and triamterene are diuretics that do not provoke hypokalemia.

Other commons causes of hypokalemia are excessive diarrhea or

vomiting. Diarrhea and vomiting can be produced by infections of the

gastrointestinal tract. Due to a variety of organisms, including

bacteria, protozoa, and viruses, diarrhea is a major world health

problem. It is responsible for about a quarter of the 10 million

infant deaths that occur each year. Although nearly all of these

deaths occur in the poorer parts of Asia and Africa, diarrheal

diseases are a leading cause of infant death in the United States.

Diarrhea results in various abnormalities, such as dehydration (loss

in body water), hyponatremia (low sodium level in the blood), and

hypokalemia.

Because of the need for potassium to control muscle action,

hypokalemia can cause the heart to stop beating. Young infants are

especially at risk for death from this cause, especially where severe

diarrhea continues for two weeks or longer. Diarrhea due to laxative

abuse is an occasional cause of hypokalemia in the adolescent or

adult. Enema abuse is a related cause of hypokalemia. Laxative abuse

is especially difficult to diagnose and treat, because patients

usually deny the practice. Up to 20% of persons complaining of

chronic diarrhea practice laxative abuse. Laxative abuse is often

part of eating disorders, such as anorexia nervosa or bulimia

nervosa. Hypokalemia that occurs with these eating disorders may be

life-threatening.

Surprisingly, the potassium loss that accompanies vomiting is only

partly due to loss of potassium from the vomit. Vomiting also has the

effect of provoking an increase in potassium loss in the urine.

Vomiting expels acid from the mouth, and this loss of acid results in

alkalization of the blood. (Alkalization of the blood means that the

pH of the blood increases slightly.) An increased blood pH has a

direct effect on the kidneys. Alkaline blood provokes the kidneys to

release excessive amounts of potassium in the urine. So, severe and

continual vomiting can cause excessive losses of potassium from the

body and hypokalemia.

A third general cause of hypokalemia is prolonged fasting and

starvation. In most people, after three weeks of fasting, blood serum

potassium levels will decline to below 3.0 mM and result in severe

hypokalemia. However, in some persons, serum potassium may be

naturally maintained at about 3.0 mM, even after 100 days of fasting.

During fasting, muscle is naturally broken down, and the muscle

protein is converted to sugar (glucose) to supply to the brain the

glucose which is essential for its functioning. Other organs are able

to survive with a mixed supply of fat and glucose. The potassium

within the muscle cell is released during the gradual process of

muscle breakdown that occurs with starvation, and this can help

counteract the trend to hypokalemia during starvation. Eating an

unbalanced diet does not cause hypokalemia because most foods, such

as fruits (especially bananas, oranges, and melons), vegetables,

meat, milk, and cheese, are good sources of potassium. Only foods

such as butter, margarine, vegetable oil, soda water, jelly beans,

and hard candies are extremely poor in potassium.

Alcoholism occasionally results in hypokalemia. About one half of

alcoholics hospitalized for withdrawal symptoms experience

hypokalemia. The hypokalemia of alcoholics occurs for a variety of

reasons, usually poor nutrition, vomiting, and diarrhea. Hypokalemia

can also be caused by hyperaldosteronism; Cushing's syndrome;

hereditary kidney defects such as Liddle's syndrome, Bartter's

syndrom, and Franconi's syndrome; and eating too much licorice.

Symptoms

Mild hypokalemia usually results in no symptoms, while moderate

hypokalemia results in confusion, disorientation, weakness, and

discomfort of muscles. On occasion, moderate hypokalemia causes

cramps during exercise. Another symptom of moderate hypokalemia is a

discomfort in the legs that is experienced while sitting still. The

patient may experience an annoying feeling that can be relieved by

shifting the positions of the legs or by stomping the feet on the

floor. Severe hypokalemia results in extreme weakness of the body

and, on occasion, in paralysis. The paralysis that occurs is " flaccid

paralysis, " or limpness. Paralysis of the muscles of the lungs

results in death. Another dangerous result of severe hypokalemia is

abnormal heart beat (arrhythmia) that can lead to death from cardiac

arrest (cessation of heart beat). Moderate hypokalemia may be defined

as serum potassium between 2.5 and 3.0 mM, while severe hypokalemia

is defined as serum potassium under 2.5 mM.

Diagnosis

Hypokalemia can be measured by acquiring a sample of blood, preparing

blood serum, and using a potassium sensitive electrode for measuring

the concentration of potassium ions. Atomic absorption spectroscopy

can also be used to measure the potassium ions. Since hypokalemia

results in abnormalities in heart behavior, the electrocardiogram is

usually used in the diagnosis of hypokalemia. The diagnosis of the

cause of hypokalemia can be helped by measuring the potassium content

of the urine. Where urinary potassium is under 25 mmoles per day, it

means that the patient has experienced excessive losses of potassium

due to diarrhea. The urinary potassium test is useful in cases where

the patient is denying the practice of laxative or enema abuse. In

contrast, where hypokalemia is due to the use of diuretic drugs, the

content of potassium in the urine will be high-over 40 mmoles per day.

Treatment

In emergency situations, when severe hypokalemia is suspected, the

patient should be put on a cardiac monitor, and respiratory status

should be assessed. If laboratory test results show potassium levels

below 2.5 mM, intravenous potassium should be given. In less urgent

cases, potassium can be given orally in the pill form. Potassium

supplements take the form of pills containing potassium chloride

(KCl), potassium bicarbonate (KHCO3), and potassium acetate. Oral

potassium chloride is the safest and most effective treatment for

hypokalemia. Generally, the consumption of 40-80 mmoles of KCl per

day is sufficient to correct the hypokalemia that results from

diuretic therapy. For many people taking diuretics, potassium

supplements are not necessary as long as they eat a balanced diet

containing foods rich in potassium.

Prognosis

The prognosis for correcting hypokalemia is excellent. However, in

emergency situations, where potassium is administered intravenously,

the physician must be careful not to give too much potassium. The

administration of potassium at high levels, or at a high rate, can

lead to abnormally high levels of serum potassium.

Prevention

Hypokalemia is not a concern for healthy persons, since potassium is

present in a great variety of foods. For patients taking diuretics,

however, the American Dietetic Association recommends use of a high

potassium diet. The American Dietetic Association states that if

hypokalemia has already occurred, use of the high potassium diet

alone may not reverse hypokalemia. Useful components of a high

potassium diet include bananas, tomatoes, cantaloupes, figs, raisins,

kidney beans, potatoes, and milk.

For Your Information

Resources

Books

Brody, Tom. Nutritional Biochemistry. San Diego:Academic Press, 1998.

Source: Gale Encyclopedia of Medicine, Published December, 2002 by

the Gale Group

The Essay Author is Tom Brody, PhD.

This article was updated on 08-14-2006

---

>

> > Hey group,

> > This issue will come up again and again. Studies

> > indicate that the

> > diagnosis of epilepsy is often wrong, may be by as

> > much as 40%.

> > Syncope can look identical to seizure disorders too,

> > so it makes

> > sense to consider this if someone is not responding

> > to AED therapy.

> > Zoe

> > --------

> >

> > An anorexic woman with convulsive loss of

> > consciousness. Syncope or

> > epileptic fits?

> >

> > Int J Cardiol. 2007; 116(2):e34-8 (ISSN: 1874-1754)

> > Attanasio A; Argiriadou V; Sandri G; Diomedi M

> >

> >

> > We report the case of a young anorexic woman who

> > suffered a sudden

> > loss of consciousness with convulsions, diagnosed as

> > epilepsy

> > associated with a migrational disorder, as

> > documented at MRI.

> > Standard 12-lead ECG showed a prolonged QT interval.

> > Biochemical

> > tests revealed a severe hypokalemia. Continuous 24-h

> > ECG recording

> > detected a ventricular tachycardia in torsades de

> > pointes inducing a

> > syncopal convulsive attack that seemed to be related

> > to oral

> > Cisapride assumption for dyspepsia. Discontinuation

> > of cisapride and

> > normalization of kalemia caused disappearance of

> > both ECG

> > abnormalities and loss of consciousness episodes.

> > Syncope is a

> > condition often misdiagnosed as epileptic seizures.

> > http://www.medscape.com/medline/abstract/17070606

> >

[Guest guest]

Hi Zoe,

Thanks, I got the link to work. I wonder because my

potassium was really low when I had my first seizure,

AED's haven't been all that effective, and 40% is a

rather large number.

Best wishes,

Pepper

--- zoe88025 <Zll51@...> wrote:

> Hi Pepper,

> Try cutting and pasting the link. I just tried it

> and it worked. I'm

> looking up some information for you and will post

> more on this ASAP.

> Meanwhile, is there any reason that would make you

> wonder if this

> might be behind your seizures-like do you have a

> heart murmur or

> something?

> Later,

> Zoe

>

>

>

> >

> > > Hey group,

> > > This issue will come up again and again.

> Studies

> > > indicate that the

> > > diagnosis of epilepsy is often wrong, may be by

> as

> > > much as 40%.

> > > Syncope can look identical to seizure disorders

> too,

> > > so it makes

> > > sense to consider this if someone is not

> responding

> > > to AED therapy.

> > > Zoe

> > > --------

> > >

> > > An anorexic woman with convulsive loss of

> > > consciousness. Syncope or

> > > epileptic fits?

> > >

> > > Int J Cardiol. 2007; 116(2):e34-8 (ISSN:

> 1874-1754)

> > > Attanasio A; Argiriadou V; Sandri G; Diomedi M

> > >

> > >

> > > We report the case of a young anorexic woman who

> > > suffered a sudden

> > > loss of consciousness with convulsions,

> diagnosed as

> > > epilepsy

> > > associated with a migrational disorder, as

> > > documented at MRI.

> > > Standard 12-lead ECG showed a prolonged QT

> interval.

> > > Biochemical

> > > tests revealed a severe hypokalemia. Continuous

> 24-h

> > > ECG recording

> > > detected a ventricular tachycardia in torsades

> de

> > > pointes inducing a

> > > syncopal convulsive attack that seemed to be

> related

> > > to oral

> > > Cisapride assumption for dyspepsia.

> Discontinuation

> > > of cisapride and

> > > normalization of kalemia caused disappearance of

> > > both ECG

> > > abnormalities and loss of consciousness

> episodes.

> > > Syncope is a

> > > condition often misdiagnosed as epileptic

> seizures.

> > >

> http://www.medscape.com/medline/abstract/17070606

> > >

> > >

> >

> >

> > Alternative Epilepsy Treatments

> > http://epilepsyalternatives.freeservers.com

> >

> >

> >

> >

>

______________________________________________________________________

> ______________

> > TV dinner still cooling?

> > Check out " Tonight's Picks " on TV.

> > http://tv./

> >

>

>

>

Alternative Epilepsy Treatments

http://epilepsyalternatives.freeservers.com

________________________________________________________________________________\

____

8:00? 8:25? 8:40? Find a flick in no time

with the Search movie showtime shortcut.

http://tools.search./shortcuts/#news

[Guest guest]

Hi Pepper,

Let's hope you are on to something here. Imagine, for some reason,

your postassium levels got low. Due to this your heart function was

affected which triggered a seizures. The seizures were diagnosed as

epilepsy and you were treated for a brain disorder you didn't have,

no wonder the drugs didn't work. Next concern is... what if you go to

a cardiologist and are identified as having arrythmia, but the

relationship to low potasssium levels isn't recognized. You might

then be prescribed medication for your " heart condition " which you

don't need, or even be advised to get a pacemaker. Another reason to

check things out again and again as you learn new information. I hope

you are figuring out what is triggering your seizures and how to

manage them. I'll post more on syncope later. We don't know how many

of that 40% may have low potassium or other deficiencies affecting

heart rate and seizure thresholds.

Zoe

> > >

> > > > Hey group,

> > > > This issue will come up again and again.

> > Studies

> > > > indicate that the

> > > > diagnosis of epilepsy is often wrong, may be by

> > as

> > > > much as 40%.

> > > > Syncope can look identical to seizure disorders

> > too,

> > > > so it makes

> > > > sense to consider this if someone is not

> > responding

> > > > to AED therapy.

> > > > Zoe

> > > > --------

> > > >

> > > > An anorexic woman with convulsive loss of

> > > > consciousness. Syncope or

> > > > epileptic fits?

> > > >

> > > > Int J Cardiol. 2007; 116(2):e34-8 (ISSN:

> > 1874-1754)

> > > > Attanasio A; Argiriadou V; Sandri G; Diomedi M

> > > >

> > > >

> > > > We report the case of a young anorexic woman who

> > > > suffered a sudden

> > > > loss of consciousness with convulsions,

> > diagnosed as

> > > > epilepsy

> > > > associated with a migrational disorder, as

> > > > documented at MRI.

> > > > Standard 12-lead ECG showed a prolonged QT

> > interval.

> > > > Biochemical

> > > > tests revealed a severe hypokalemia. Continuous

> > 24-h

> > > > ECG recording

> > > > detected a ventricular tachycardia in torsades

> > de

> > > > pointes inducing a

> > > > syncopal convulsive attack that seemed to be

> > related

> > > > to oral

> > > > Cisapride assumption for dyspepsia.

> > Discontinuation

> > > > of cisapride and

> > > > normalization of kalemia caused disappearance of

> > > > both ECG

> > > > abnormalities and loss of consciousness

> > episodes.

> > > > Syncope is a

> > > > condition often misdiagnosed as epileptic

> > seizures.

> > > >

> > http://www.medscape.com/medline/abstract/17070606

> > > >

> > > >

> > >

> > >

> > > Alternative Epilepsy Treatments

> > > http://epilepsyalternatives.freeservers.com

> > >

> > >

> > >

> > >

> >

>

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> >

>

>

> Alternative Epilepsy Treatments

> http://epilepsyalternatives.freeservers.com

>

>

>

>

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[Guest guest]

Hey Pepper,

I hope you are doing better with seizure control. Let's get this

discussion on syncope\seizures rolling. If there is any suspicion

your seizures are triggered by your heart function then it is

important to check it out, as some anticonvulsants can make a heart

disorder worse, and this could be life threatening.

As you already know, about forty percent of the time people

labeled with epilepsy may be misdiagnosed. They may have a cardiac

disorder that is triggering the seizures and seizure-like episodes.

In several studies patients misdiagnosed with epilepsy had vasovagal

syncope, also called reflex anoxic seizures, seizures triggered by

an over-reactive vagus nerve.

In vasovagal syncope, the vagus nerve over-reacts to something,

maybe being startled, digestive distress, or anything causing a fear

reaction. The nerve over-responds leading to a change in blood flow

and a drop in blood pressure. Momentarily not enough blood is pumped

through the heart and brain, triggering the seizure-like symptoms and

brief loss of consciousness.

There are other types of syncope that may trigger seizures as

well. In bradycardia, the heart beats too slowly, blood supply to the

brain is diminished and this may trigger a seizure. In tachycardia

the heart is beating too quickly and the change in blood flow to the

brain alters the metabolism, which can set off a seizure.

Tilt table testing is one of the ways to evaluate for syncope, and

rule out epilepsy. The table test re-creates what happens during a

syncope spell and can help distinguish between seizures and syncope.

ECGs and EEGs may be perfectly normal in people with syncope, so the

additional testing can be important for obtaining a diagnosis.

Nutrition is also important for heart function. Low levels of

several nutrients can trigger cardiac arrythmias and trigger

seizures. You mentioned having low levels of potassium and this is

clearly linked to seizures.

Deficiency can be caused by diuretics, like caffeine and medications

that cause you to urinate more often, which depletes the levels of

salts and minerals including potassium.

Minerals can be depleted from diarrhea, vomiting, and too

frequent use of laxatives or enemas. Fasting can also cause the

potassium levels to fall. Pain and cramping in the legs are symptoms

of low potassium too.

If you know you have or had low levels of potassium, are you

getting it monitored? Do you know why they were low? According to an

article I found at Healthatoz.com, " . Hypokalemia can also be caused

by hyperaldosteronism; Cushing's syndrome; hereditary kidney defects

such as Liddle's syndrome, Bartter's syndrome, and Franconi's

syndrome; and eating too much licorice. " Too much potassium can also

cause problems.

What are your thoughts about your seizures now? It will be nice to

know if they were triggered by low potassium and if getting your

levels normalized stops them. Please let us know what you find out on

this.

Zoe

p.s. You may also want to drop a note to this cardiologist and ask

for his feedback on his forum. His focus was on vasovagal syncope,

but I expect he will be familiar with potassium levels and syncope

too.

http://heartdisease.about.com/cs/generallinks/a/syncopeseizure.htm

-

>

> Hi Zoe,

>

> Thanks, I got the link to work. I wonder because my

> potassium was really low when I had my first seizure,

> AED's haven't been all that effective, and 40% is a

> rather large number.

>

> Best wishes,

> Pepper