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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Syncopal Episode, Urinary Incontinence, Scheduled For Cardiac Echo, History Of Amphetamine Abuse. What Could This Be?

My 25yo daughter has had several syncopal episodes over the last 2 months, none lasting for more than a minute but two were followed by a post-ictal type period of confusion and lethargy. Yesterday she had an episode that was followed by urinary incontinence . As a neuroscience nurse, I was active in getting her proper f/u including 8h video EEG, MRI/ MRA , EKG. She was started on Topamax one month ago and is now at a therapeutic dose. She is scheduled for a cardiac Echo in three days and an ambulatory Digitrace video EEG (3days) in 1 1/2 weeks. Will make cardiology appt in a few days also. She does have a history of amphetamine abuse 4yrs ago but has been clean since. What am I missing? What could this be?
Thu, 12 Sep 2013
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Radiologist 's  Response
THE TYPE OF SEIZURE DESCRIBED BY YOU IS A GENERALIZED TONIC CLONIC TYPE.
IF EEG POINTS TO SEIZURE ACTIVITY IN SINGLE TEMPORAL LOBE KINDLY RULE OUT MESIAL TEMPORAL SCLEROSIS ON MRI BRAIN.
EVEN OTHERWISE AN MRI BRAIN IS HIGHLY RECOMMENDED TO RULE OUT INTRA CRANIAL INFECTION/ GRANULOMA
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Syncopal Episode, Urinary Incontinence, Scheduled For Cardiac Echo, History Of Amphetamine Abuse. What Could This Be?

THE TYPE OF SEIZURE DESCRIBED BY YOU IS A GENERALIZED TONIC CLONIC TYPE. IF EEG POINTS TO SEIZURE ACTIVITY IN SINGLE TEMPORAL LOBE KINDLY RULE OUT MESIAL TEMPORAL SCLEROSIS ON MRI BRAIN. EVEN OTHERWISE AN MRI BRAIN IS HIGHLY RECOMMENDED TO RULE OUT INTRA CRANIAL INFECTION/ GRANULOMA