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Child Having Frequent Unconsciousness. Nil Observation Shown In EEG And CT Scan. Taking Propranol And Lamotrigine. Suggest The Cure?

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Posted on Wed, 13 Nov 2013
Question: Hi My 13 year old son is having frequent unconsciousness since last 3 weeks. His EEG & CT SCAN also carried out with nil observation. He is taking PROPRANOL & LAMOTRIGINE. In spite of medications he continude to become unconscious all most 3 times a day. PLEASE HELP
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Answered by Dr. Dr. Shruti Rijhwani (40 minutes later)
Brief Answer:
Follows.

Detailed Answer:
Dear Madam,

Thank you for posting your query on XXXXXXX .

Well looking into your problem I can see that your son gets recurrent attacks of unconsciousness 3 times a day despite on lamotrigine intake which is very strange .

See this is very tricky situation it will be difficult to point one thing out but still we can discuss the possibilities . It is not always possible to get abnormalities in EEG or CT scan in epilepsy patients . I think his treating doctor should consider getting 24 hour EEG monitoring done .

Plus cardiac evaluation is also required . He is on propranolol for migraine I guess but sometimes it leads to bradycardia that is low heart rate which can lead to unconsciousness so that needs to be excluded .

Table tilt test should also be done to rule out syncope as it can be a mimic of epilepsy .

Take care.

Dr. Shruti
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Shruti Rijhwani

Rheumatologist

Practicing since :2008

Answered : 2366 Questions

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Child Having Frequent Unconsciousness. Nil Observation Shown In EEG And CT Scan. Taking Propranol And Lamotrigine. Suggest The Cure?

Brief Answer:
Follows.

Detailed Answer:
Dear Madam,

Thank you for posting your query on XXXXXXX .

Well looking into your problem I can see that your son gets recurrent attacks of unconsciousness 3 times a day despite on lamotrigine intake which is very strange .

See this is very tricky situation it will be difficult to point one thing out but still we can discuss the possibilities . It is not always possible to get abnormalities in EEG or CT scan in epilepsy patients . I think his treating doctor should consider getting 24 hour EEG monitoring done .

Plus cardiac evaluation is also required . He is on propranolol for migraine I guess but sometimes it leads to bradycardia that is low heart rate which can lead to unconsciousness so that needs to be excluded .

Table tilt test should also be done to rule out syncope as it can be a mimic of epilepsy .

Take care.

Dr. Shruti