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Suggest Treatment For Sleep Apnea And Fainting Spells
Question: for over a year I have spells where I almost pass out, they started small at first, then for the past 7 months have progressed into not being able to work, drive or walk any kind of distance without just losing consciousness, they did a halter monitor thing for a day, duplex carotid, and eeg, the neurologist said sleep apnea, when the result came back it was list as mild only, but had me do another with the mask. I never sleep on my back, trouble is I can't explain the symptoms very well, i have epilepsy and these are "focal"seizures. Does any of this make sense or have heard it before? Thank you for taking my question
Brief Answer:
Need some details to guide you better.
Detailed Answer:
Hello,
My name is Dr Muhammad Ali Rauf & I will look into your problem.
I have gone through your query and would try to help you in the best possible way. I'm sorry that you are suffering that much. There are a number of causes from syncope.
I would be in a better position to guide you anything, if you answer following questions please:
1. Are you able to recall after syncope(passing out spell)?
2. For how long syncope occurs?
3. Is there any specific thing you felt after which you pass out?
4. are you hypertensive or any other chronic illness?
5. do you or anyone in the family has history of depression or similar episodes?
6. have you undergone any CBC(complete blood count) or other investigations?
7. do you live in hot weather area?
8. when was the last time did you have epilepsy attack? are you taking any medication for it?
9. any history of abnormal heart rhythm mentioned by your doctor?
10. enlist all drugs that you are taking other than metformin.
I will be looking forward for the answers to conclude the discussion in the best interest of yours.
Thank You
Need some details to guide you better.
Detailed Answer:
Hello,
My name is Dr Muhammad Ali Rauf & I will look into your problem.
I have gone through your query and would try to help you in the best possible way. I'm sorry that you are suffering that much. There are a number of causes from syncope.
I would be in a better position to guide you anything, if you answer following questions please:
1. Are you able to recall after syncope(passing out spell)?
2. For how long syncope occurs?
3. Is there any specific thing you felt after which you pass out?
4. are you hypertensive or any other chronic illness?
5. do you or anyone in the family has history of depression or similar episodes?
6. have you undergone any CBC(complete blood count) or other investigations?
7. do you live in hot weather area?
8. when was the last time did you have epilepsy attack? are you taking any medication for it?
9. any history of abnormal heart rhythm mentioned by your doctor?
10. enlist all drugs that you are taking other than metformin.
I will be looking forward for the answers to conclude the discussion in the best interest of yours.
Thank You
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
1.Yes, as the duration is only brief
2.Seconds only, however the convulsive seizures will last 5-20 seconds, have broken two teeth recently from them.
3.Very tired and weak, even after the brief durations
4.You mean high blood pressure? No. I had prostate cancer surgery in 2011 and had complications and a cdeff infection while in hospital. Pancreatitis off and on, non alcohol user
5.My brother suffered greatly with depression, even before he was diagnosed and eventually died from aids in 1994
6.only bloodwork results I know is an A1c for diabetes and that was about 12-13
7.No, i live in Ohio
8.Yes Zonisamide, which has no effect but the bad side effects, the syncope happens several times a day from 2-8, the convulsive seizures, maybe twice a week.
9.I had a halter monitor for a day in the summer, it showed nothing remarkable, but throughout my childhood and young to middle adulthood was diagnosed with heart murmurs
10.Zonisamide and Glimiperide
2.Seconds only, however the convulsive seizures will last 5-20 seconds, have broken two teeth recently from them.
3.Very tired and weak, even after the brief durations
4.You mean high blood pressure? No. I had prostate cancer surgery in 2011 and had complications and a cdeff infection while in hospital. Pancreatitis off and on, non alcohol user
5.My brother suffered greatly with depression, even before he was diagnosed and eventually died from aids in 1994
6.only bloodwork results I know is an A1c for diabetes and that was about 12-13
7.No, i live in Ohio
8.Yes Zonisamide, which has no effect but the bad side effects, the syncope happens several times a day from 2-8, the convulsive seizures, maybe twice a week.
9.I had a halter monitor for a day in the summer, it showed nothing remarkable, but throughout my childhood and young to middle adulthood was diagnosed with heart murmurs
10.Zonisamide and Glimiperide
Brief Answer:
Head up tilt test(HUTT) to rule out neurocardiogenic syncope.
Detailed Answer:
Hello,
Thank you for getting back with the answers. I have gone through them.
First thing that your answers told me that you still have seizure attack and its frequency is also not good(twice a week). You are on anti-epileptic medication and frequency should decrease. Repeated epileptic attack causes damage to brain which in return possesses adverse effects like syncope as well. I would suggest you to discuss with your treating doctor to either increase the dose of zonisamide or change it to other strong anti epileptic drugs.
Secondly, we need to exclude neurocardiogenic syncope. This can be done by doing a head up tilt test (HUTT). HUTT test can be done under the supervision of a cardiac electrophysiologist. You need to discuss this with him.
In about 20-30% of the cases of syncope, no cause is established or remain unclear so in that case there are certain lifestyle modifications that usually help to reduce the frequency of syncope attacks.
They are:
> Avoid potential triggers like:
hot environments, prolonged standing, dehydration, and certain medications.
> Consuming adequate fluids
> Wearing support garments or compression socks to improve your circulation.
> Stand up slowly when changing positions from sitting to standing.
> Making changes to your diet:
> eat small, more frequent meals
> increasing salt, fluid and potassium intake
> avoid caffeine
> Elevating the head of your bed while sleeping by using extra pillows.
Hope I have answered your query. If you have any further questions, I will be happy to help if not then don't forget to close the discussion and rate it.
Wishing you good health !!
Head up tilt test(HUTT) to rule out neurocardiogenic syncope.
Detailed Answer:
Hello,
Thank you for getting back with the answers. I have gone through them.
First thing that your answers told me that you still have seizure attack and its frequency is also not good(twice a week). You are on anti-epileptic medication and frequency should decrease. Repeated epileptic attack causes damage to brain which in return possesses adverse effects like syncope as well. I would suggest you to discuss with your treating doctor to either increase the dose of zonisamide or change it to other strong anti epileptic drugs.
Secondly, we need to exclude neurocardiogenic syncope. This can be done by doing a head up tilt test (HUTT). HUTT test can be done under the supervision of a cardiac electrophysiologist. You need to discuss this with him.
In about 20-30% of the cases of syncope, no cause is established or remain unclear so in that case there are certain lifestyle modifications that usually help to reduce the frequency of syncope attacks.
They are:
> Avoid potential triggers like:
hot environments, prolonged standing, dehydration, and certain medications.
> Consuming adequate fluids
> Wearing support garments or compression socks to improve your circulation.
> Stand up slowly when changing positions from sitting to standing.
> Making changes to your diet:
> eat small, more frequent meals
> increasing salt, fluid and potassium intake
> avoid caffeine
> Elevating the head of your bed while sleeping by using extra pillows.
Hope I have answered your query. If you have any further questions, I will be happy to help if not then don't forget to close the discussion and rate it.
Wishing you good health !!
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Answered by
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