Suggest treatment for sudden onset of rolling of eyes followed by stiff hands and twisted tongue
She was kicked in her abdomen by her younger brother ( 5 yrs) after which she complained to us of being hitted & then we observed a staring blank look Â & she Â fell down flat on the face hurting her chin & when picked up immediately had uprolling of eyes, stiffness of hands and ? tongue twisting which lasted for 30-40 secs. After that she became conscious on her own, no post effects , Â was just a bit scared & did not remember anything post hit about the incident. No jerk, no tongue bite, no frothing, post ictal effect etc.
Had her normal food after the incident and was perfectly alright .
She was admitted later in the evening , tests done all reports incl. electrolytes normal except for Â EEG . The treating doctor has diagnosed to be a vaso vagal attack . She is off any medication & no further tests advised.
Need a second opinion on the same . (attached DC & EEG )
Pls let me know if any further information needed .
Hi XXXXXXX welcome to HCM.
Hi, I had gone through the problem and looked into the details attached. It looks to me like a "convulsive syncope" Convulsive syncope is a term used for any type of syncope manifesting with convulsive movements. The trigger for the syncope was the kick to the abdomen. I had a chance to look into the EEG report which says abnormal electrical activity. However it does not match with the clinical problem. I request you to get a second opinion on the EEG tracing. As it a provoked event I personally feel she does not require any medications and requires close observation and follow up to look for any new events. If these spell happen without any provocation she might require medications in the future.
So observe her and treat only if she develops new spells. I do agree with the treating doctor at this point of time. Wish her good health.
I hope this helps you.
If you have any further query, I would be glad to help you.
Dr Shiva Kumar R
Consultant Epileptologist XXXXXXX
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