Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

I carefully passed through your question and would explain that these episodes could be related to two main causes:

1- Epilepsy seizures. The profuse sweating is not characteristic of seizures, but it can occur in some cases. The twitching may be myoclonic jerks.

2- Vaso-vagal syncope. This is an overactivation of vagal nerve leading to low blood pressure and loss of conscience.

Hypoglycemia has been ruled out by his blood sugar levels.

So I would recommend consulting with a neurologist for a careful physical exam and an EEG to exclude possible seizures.

Further tests may be needed for vaso-vagal syncope, but this is not a serious cause of syncope and usually avoiding the triggering factors is enough to control the symptoms and prevent these episodes from occurring.

Hope you will find this answer helpful!

Kind regards,

Dr. Iliri

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Brief Answer:
My answer as follows:

Detailed Answer:
Hello again!

Thank you for the additional information.

The fact that he is able to communicate during these episodes excludes possible epilepsy seizures.

From the other hand the fact that his blood pressure is normal excludes possible vaso-vagal syncope, but not an orthostatic hypotension.

The fact that drinking or eating helps him, could be related to episodes of hypoglycemia. Have you measured his blood sugar during these episodes?

A thyroid disorder can not be excluded either.

I would recommend consulting with his GP for a careful physical exam and some tests:

- fasting glucose
- glucose tolerance test
- thyroid hormone levels for thyroid dysbalance
- complete blood count for chronic anemia
- blood electrolytes for possible electrolyte imbalance
- a Head Up Tilt test for possible orthostatic intolerance.

Hope to have been helpful!

Best wishes,

Dr. Iliri

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