Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
186 Doctors are Online

Had a grand mal and fell to the ground. Stiff as a board. Unable to move left side of body. Suggest the treatment?

DOCTOR OF THE MONTH - Nov 2013
Nov 2013
User rating for this question
Very Good
Answered by

Neurologist
Practicing since : 1994
Answered : 5444 Questions
Question
My 59 year old husband had a grand mal, fell to the ground cut open the head (stopped the twitching), was as stiff as a board...unable to move left side of body. 911 called. The VA wants evidence as to which occurred first...grand mal or stroke. All for benefit reasons.
Posted Fri, 1 Nov 2013 in Brain and Spine
 
 
Answered by Dr. Sudhir Kumar 3 hours later
Brief Answer:
Possibly seizure occurred first

Detailed Answer:
Hi,

Thank you for posting your query.
It is difficult to tell 100% which occurred first- seizure or stroke.

However, it is well known that many strokes cause seizures, called as post stroke seizures. However, seizure is the first event noted, and is the beginning of stroke, called as ischemic seizures. Then, the weakness is noted. In other words, the cause of seizure as well as weakness is same- lack of blood flow to the brain. It is just that the seizure is noted before the weakness.

I hope it helps. Please get back if you have any follow up queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Above answer was peer-reviewed by
 
Follow-up: Had a grand mal and fell to the ground. Stiff as a board. Unable to move left side of body. Suggest the treatment? 7 hours later
you are saying that most likely that the stroke caused the grand mall and not the other way around or Is it impossible to tell. what abut a Ct scan
 
 
Answered by Dr. Sudhir Kumar 1 hour later
Brief Answer:
Yes...most likely stroke caused the grand mal.

Detailed Answer:
Thank you for getting back.
As he has weakness of one side of body, there are good chances that he has stroke. As you mentioned, a CT or MRI scan of brain would confirm a diagnosis of stroke.
In rare cases, if CT scan is normal, then we can consider a diagnosis of Todd's paresis, where a grand mal seizure can cause weakness of one side of body but this weakness improves on own in a few hours to days.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
Follow-up: Had a grand mal and fell to the ground. Stiff as a board. Unable to move left side of body. Suggest the treatment? 42 minutes later
No chance that the Grand Mal hit fist ,blow to head in fall causing the stroke? He has pacemaker so no MRI. CT just showed stroke. swollen and bleeds. Witnessed whole event Grand Mal first. No real medical way to tell for sure which came first?
 
 
Answered by Dr. Sudhir Kumar 9 minutes later
Brief Answer:
Clinical examination may help

Detailed Answer:
If the bleed occurred due to fall, then there would be external swelling over the scalp too and there may be a skull fracture. Also, there are certain differences on the CT appearances of spontaneous bleed in the brain as compared to bleed due to fall (a radiologist may help in that).

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
Follow-up: Had a grand mal and fell to the ground. Stiff as a board. Unable to move left side of body. Suggest the treatment? 8 days later
Is it most likely to say that that the Grand Mal came first then the stroke?
 
 
Answered by Dr. Sudhir Kumar 0 minute later
Brief Answer:
Yes

Detailed Answer:
Yes, it is most likely that the grand mal seizure occurred first, followed by the stroke. This is because seizures occur at the onset of many strokes, especially embolic strokes.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
Follow-up: Had a grand mal and fell to the ground. Stiff as a board. Unable to move left side of body. Suggest the treatment? 22 hours later
The Grand Mal most likely occurred first than the stroke?
 
 
Answered by Dr. Sudhir Kumar 30 minutes later
Brief Answer:
Yes.

Detailed Answer:
Grand mal occurred first and then the stroke occurred.
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
Diseases and Conditions
Medical Topics

The user accepted the expert's answer

Ask a Neurologist

© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor