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Had A Brain Haemorrhage. Started Feeling Drowsy After Taking Telma 80. What Is Causing This?

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Posted on Mon, 5 Nov 2012
Question: Hello Doctor,

My dad had a brain haemorrage around 8 years ago and he had a convulsion episode 2 months ago. But after his discharge from the hospital, the doctor has increased his BP tablets from 40 mg to 80 mg. Post discharge, we noticed that he is feeling drowsy most of the time. The doctor has prescribed Telma 80 AM tablets. We are a bit concerned since he has been quiet inactive after discharge. Do you feel that because the doctor prescribed a high dosage for the BP, it is causing heavy drowsiness in case of my Dad. His age is 64 and he is completeley paralysed from the right side. Please advice if BP tablets are causing the drowsiness and inactiveness because pre hospitalization,he was very much active.
doctor
Answered by Dr. Sudhir Kumar (35 minutes later)
Hi,
Thank you for contacting Healthcare magic.
The drowsiness in your father's case is more likely to be related to Eptoin, the medicines to prevent further convulsions.
We have an option of changing it to non-sedating medicines such as levetiracetam (keppra or levipil) at a dose of 500 mg twice daily.
Regarding the BP medications, please check his BP a few times. If BP is normal, please continue the same dose. If BP is found to be low or high, the medicine dose may need to reduced or increased (your physician can suggest the dose).
In addition, sometimes the drowsiness can also be unrelated, such as low serum sodium. Please check the sodium level in his blood. If sodium level is low, it can be corrected.
I hope it helps. Please get back if you have any more queries.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir Kumar (33 hours later)
Dear Doctor,

Thank you for your quick response.
Also the doctor has mentioned that the drowsiness is due to pressure formation in his Brain and he mentioned about a surgery where shunting will be done and the fluid will be drained to his kidney. But the tricky part is that he had mentioned that the symptons are severe headache and further complications which is missing in my dad's case. He has never mentioned about any type of headache. Please suggest whether drowsiness can be caused due to the pressure formation in his brain??.

Awaiting your quick response for the same.

Regards, XXXXXXX
doctor
Answered by Dr. Sudhir Kumar (17 minutes later)
Hi,
Thank you for getting back with more details.
The symptoms of high pressure in the brain (raised intracranial pressure-ICP) are headache, vomiting, double vision and decreased alertness. As you have mentioned, he does not have headache or vomiting.
If one is not sure of raised ICP, we can check his fundus- a part of eye retina- which gets swollen if brain pressure is high. This can be checked by the neurologist and if a doubt is there, it can be confirmed by eye specialist.
The best method of checking brain pressure is by ICP monitor. We have this facility at Apollo Hyderabad, but most hospitals may not have that facility. In this method, a small device is placed in the brain ventricle (which contains the brain water-cerebrospinal fluid-CSF) and we can get the actual measurement of the brain pressure.
If the brain pressure is high, then shunt surgery will be useful, otherwise, it may not be.
I hope it clarifies.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Sudhir Kumar

Neurologist

Practicing since :1994

Answered : 6232 Questions

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Had A Brain Haemorrhage. Started Feeling Drowsy After Taking Telma 80. What Is Causing This?

Hi,
Thank you for contacting Healthcare magic.
The drowsiness in your father's case is more likely to be related to Eptoin, the medicines to prevent further convulsions.
We have an option of changing it to non-sedating medicines such as levetiracetam (keppra or levipil) at a dose of 500 mg twice daily.
Regarding the BP medications, please check his BP a few times. If BP is normal, please continue the same dose. If BP is found to be low or high, the medicine dose may need to reduced or increased (your physician can suggest the dose).
In addition, sometimes the drowsiness can also be unrelated, such as low serum sodium. Please check the sodium level in his blood. If sodium level is low, it can be corrected.
I hope it helps. Please get back if you have any more queries.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad