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Dr. Andrew Rynne

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What causes episodes of a vacant stare and incoherent speech from 6 months?

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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 1021 Questions

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Posted on Fri, 20 Jul 2018 in Brain and Spine
Question: MY wife just had, or is currently having another Episode which includes a vacant stare when she approaches me for help, incoherence in communication, unable to repeat her name to me, various other aspects that i may not have noticed that can be significant.
This isnt the first episode i have been made aware of, there have been several previous ones over a period of the last 6 months or so,
the 1st two, i called the local EMS which released her after an emergency evaluation at the nearest hospital that day, recommending a further check with her physician - of course by the time she was examined - the situation resolved itself.
I was suggested that she was suffering from a lack of oxygen which she ends to remove during sleep and does not use during waking hours.
the reason im posting, i am in the process at this moment caring for the latest occurrence, this time it is a much longer episode.
The 1st episode was around 10 minutes, with them getting longer as they occur - this last one has been over 2 1/2 hours so far.
she is 65, 5-5 tall - weight commensurate to the height - with a long history of medical attention before we met.
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Answered by Dr. Olsi Taka 1 hour later
Brief Answer:
Seizures should be considered, needs evaluation.

Detailed Answer:
I read your question carefully and I understand your concern.

From your account it is not clear what type of evaluation she had in the hospital, did she undergo any blood tests, ECG or head imaging. Did she check further with her physician as was suggested?

Judging from the present information I would say that the first cause to be considered would be that of seizures. That would warrant a neurological exam, brain imaging and an EEG (electroencephalography) as seizures at this age rarely come without a cause, often related to a stroke, tumor, infection etc.

Another possibility would be that of a metabolic alteration reason for which some blood tests are needed including at least blood glucose, liver and kidney function, electrolyte panel, thyroid function.

Less likely would be a drop in blood pressure due to heart issues such as arrhythmia.

If all tests result normal then a psychological origin may be considered, but that is only once other possibilities have been excluded. So if a proper evaluation hasn't been done you should contact your primary physician sooner rather than later. If the current episode persists without improvement then waiting for primary physician visit is not recommended, she should be taken to the emergency room.

I remaina t your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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