Feeling Faint - Medicine or Seizure?

[sbncmo]

Hi Everyone:hello:

I've posted several times & many of you have kindly replied & assisted me thru these difficult first weeks. I'm very thankful for all of you.

I wanted to let you know I saw my neuro again yesterday. Up to this point he has always brushed me off, minimized my symptoms, even saying I wasn't having seizures when I had been previously diagnosed with seizure disorder. When I went in yesterday, I was very frank, yet very respectful with him. I told him I have been doing a lot of research. I said I learned that seizure disorder is the term used for epilepsy now & he confirmed it. I also described the types & names of seizures that I am having and he confirmed that. He looked at me like I was a different person & started talking to me with respect. He even consulted me about the next step in treating my epilepsy. He is very concerned because Topamax is not controlling the seizures & I am having bad side effects. We discussed medications my previous neuro had used. He wants to use Lamictal, but my liver enzymes are very high, so we have to find out why & get them lowered before we can start the Lamictal. And he told me of the risks with Lamictal. This office visit was totally different. It was nice to be consulted instead of pushed aside.:woot:

However, now to my question. Sunday, around noon, I had an asthma attack. About 10 minutes later, I told my sister I felt like I was going to pass out & started falling to the floor. She caught me & put me in a chair. At first I thought it was related to the asthma. Then it happened again that evening - no asthma. Then Monday, I felt weak & slightly faint all day, and nearly passed out twice. Tuesday morning, when I was checking in for my doctor's appointment, I told the nurse I felt like I might pass out & another nurse looked up & her eyes about popped out out & they went running for a wheelchair & got me into it. This is happening several times a day. I never totally lose consciousness, but have extreme weakness & can't stand. Could this be a seizure or could it be another side effect from the Topamax. I looked up Topamax, but it didn't list anything like this for a side effect. If this is a seizure, what type is it?:dontknow:

Shelia

 

[Nakamova]

Are you making sure to stay hydrated? Dehydration can be one cause of fainting. It happened to me when I was overmedicated on Zonegran, and I ended up getting UV fluids to rehydrate. I had no idea I was dehydrated at the time.

 

[sbncmo]

Fluids aren't a problem. I drink at least 4 liters of water every day. Any other ideas?onder:

 

[Meetz1064]

4 liters

of water can be TOO much water per day, and affect your meds.

Have your med levels check, as well as potassium and other electrolytes. I will have one other person send you a PM as soon as possible that is more qualified to answer. Give me some time to get hold of him.

Although, I will say, it IS possible that they are atonic seizures.....

 

[RobinN]

allergies > seizures
Do you eat/drink cow dairy?
cow dairy > asthma
high liver enzymes > celiac disease
celiac > seizures

You can begin searching your particular symptoms, and occasionally you will hit upon some that connect a few dots....

 

[huskymom]

Could still be a side effect even if it not listed. We all react differently to our meds. Are you new to the Topamax? That does sound like a lot of water. Are maybe that does have something to do with the liver. Have you told the doctor how much water you are drinking? Do you have a dry mouth?

 

[RobinN]

Info from a liver detox group I belong to:

***

Blood testing with liver enzyme testing can tell us if the liver is damaged. Urine testing with the Liver Detox Profile (measures phase I and II detox pathways), OAT (Organic Acid Testing) and then the first morning urine pH can give us an idea of how the liver is functioning. Each one alone cannot give us a complete overview but together, they can tell us if the liver is filtering acidic waste efficiently, phase I and II are in balance and if important antioxidants necessary for proper liver function are needed.

 

[sbncmo]

Thanks for your input everyone. Let me see if I can address everyone's comments. Robin mentioned dairy - nada - lactose intolerant. High liver enzymes - never until I was put on a cholesterol medicine (went to 114), taken off for two weeks, dropped to 74, kept off for another 6 weeks, only dropped to 72. Neuro suspects ranitidine may be causing high liver enzymes, but have been on it for years with no problems. Doctor ran full panel of lab Weds., but haven't heard results yet.

Huskymom asked about dry mouth - no dry mouth. I used to drink a lot of tea & ended up with an irritable bladder, was told to get off the tea, so I drink water. You also asked about being new to Topamax. This is actually the second time I have been put on it. I was put on it for a month in 2005, but was taken off of it because of complications. When I developed instant complications with Keppra & my neuro wanted to put me on Topamax, I told his nurse about the previous complications, but she didn't tell the neuro. I decided to attempt it again, with the same complications. He is taking me off of it as soon as my liver enzymes are reduced & was surprised to find out I had taken it before.

Meetz mentioned atonic seizures. I wasn't sure about this type. Having my neuro confirm six types of seizures at this time, it is a little unsettling to think about a seventh type. But, no need to borrow trouble.

In the meantime, I will wait for the test results & for any other suggestions others may have. Oh, I suppose I should say I was diagnosed with hypoglycemia 20 years ago, and apparenly still am after yesterdays glucoma test. But these faint feelings don't exactly feel like hypoglycemic lows. Anyway, I welcome your ideas.

Shelia

 

[Endless]

Sheila,

IMHO, you need to call your neurologist ASAP, as well as your primary care physician. Passing out is your brain's way of telling you something is wrong and you need to pay attention RIGHT NOW.

Topamax or any other AED could also cause just about any side effect on the sun, no matter what your neuro says. A good step is to ask your pharmacist. If they are an older one and they've been around the block a few times they'll say basically the same thing. Your oxygen level can be low without feeling athsma. There are a thousand other reasons you may feel faint. You really need a doc to figure it out.

Let us know what you find out?

 

[sbncmo]

Hi Endless. I think my neuro is suspecting the faintness as being an additional reaction to the Topamax - thus his rush to see me and his concern to get me off Topamax ASAP. I had a long consultation with my pharmacist last evening. He said that an ALT of 72 is slightly elevated, but it really isn't a dangerous level, that one doesn't have to worry about liver damage until ALT levels reach high hundreds. So he suggested that I call my neuro Monday & start changing over to the Lamictal. I am also taking milk thistle which helps liver function & lower ALT's. I really want off the Topamax. I hate all the side effects. I hate that the seizures are not being controlled in the least. I hate feeling so weak & tired & faint all the time. Some of that may be Topamax, some may not. I hope I find out soon. Sometimes I feel like I just can't go on any longer. I'm just too tired.

Shelia

 

[sandi]

I would make sure to check and make sure it is not Cardiac Related ! Have you throughly investigated the cardiac side ?

 

[drarvindr]

possibilities include:
1) drug reaction to topiramate
2) cardiac related issue - could be a syncopal attack so get yourself checked out 9 may need tilt table tests , ECGs etc.)
3) hypoglycemia can cause drowsiness
4) electrolyte ebnormalities can also cause similar problems so get you sodium , potassium and chloride levels checked out .
As for your liver function tests , they don't seem to be something to worry about at the moment :
Signs of liver failure ;
1) turning yellow ( esp your eyes)
2) spider shaped rashes on your chest
3) pain in your abdomen with enlargement of your liver
4) flapping tremors in your hand ( like waving ta-ta )
5) reversal of sleep cycle and mental changes ( hepatic encephalopathy)
Hope i've been of help
Arvind
P.S. PM if you need anyting

 

[Endless]

Sheila,

Listen to DrArvindr. Lots of things can cause your symptoms.

Please call your primary care physician, in additon to your neuro. I can't stress this strongly enough.

Neurologists are notorious for only looking at the seizure meds and the brain for a cause for anything. You need a general doc to look at the whole picture. This is probably your seizure meds, but it is serious enough that you need your PCP to take a look at it, too.

 

[lynnrx52]

possibilities include:
1) drug reaction to topiramate
2) cardiac related issue - could be a syncopal attack so get yourself checked out 9 may need tilt table tests , ECGs etc.)
3) hypoglycemia can cause drowsiness
4) electrolyte ebnormalities can also cause similar problems so get you sodium , potassium and chloride levels checked out .
As for your liver function tests , they don't seem to be something to worry about at the moment :
Signs of liver failure ;
1) turning yellow ( esp your eyes)
2) spider shaped rashes on your chest
3) pain in your abdomen with enlargement of your liver
4) flapping tremors in your hand ( like waving ta-ta )
5) reversal of sleep cycle and mental changes ( hepatic encephalopathy)
Hope i've been of help
Arvind
P.S. PM if you need anyting

Hello drarvindr, I know your post about possible reasons for fainting was from a while back but have been searching for answers to my son's fainting as well as other episodes that look like he's panicking.

History: He's 32, has post hemorrhagic hydrocephalus (triple VP shunts), is impacted in several ways from the grade 4 bleed and numerous high pressure episodes and surgeries. In 2008 he had stage 3 testicular cancer and is now in remission. He has gran mal seizures that are now controlled with 100mg Zonisamide X2/day and 100mg Vimpat X2/day. The Vimpat is the one that ultimately stopped the seizures. He has many side effects that are manageable. Generally the ones that concern me the most are the sleep disturbance, speech impairment, confusion and extreme emotions he developed as soon as he started the zonisamide. That was 2 years ago - the neurologist denied these were related to the zonisamide.

My current concern: for the past 8 months he has been experiencing fainting spells as well as anxiety spells that look like he's hallucinating and panicking and does anything he can to 'escape' including pounding on windows, grabbing on to people and things and looks terrified. We have seen a cardiologist who agrees it's not his heart though we will be doing some tests just to rule it out completely (RE: the fainting). He is very strong, swims 20 olympic sized laps - eats extremely well and is well hydrated. All his labs come back normal with minor impact to his liver due to his meds.

I think it's the Zonisamide but the neurologist says she doesn't think so and that side effects don't appear after 2 years on a med (even though I believe he did initially have these symptoms just to a lesser degree). Do you have thoughts, experience with side effects escalating with time on a seizure med?

If you're still around and not too busy your input is greatly appreciated. Thanks

 

[Nakamova]

lynnrx52, has your son been tested for metabolic acidosis? It's one of the side effects of Zonisamide, and the drug carries a warning about it. See http://www.fda.gov/Drugs/DrugSafety...mationforHeathcareProfessionals/ucm095251.htm

Here's some info about metabolic acidosis, from the Wikipedia entry:

Diagnosis can be difficult unless the patient presents with clear indications for arterial blood gas sampling. Symptoms may include chest pain, palpitations, headache, altered mental status such as severe anxiety due to hypoxia, decreased visual acuity, nausea, vomiting, abdominal pain, altered appetite (either loss of or increased) and weight loss (longer term), muscle weakness and bone pains. Those in metabolic acidosis may exhibit deep, rapid breathing called Kussmaul respirations which is classically associated with diabetic ketoacidosis.

I was on Zonisamide for about 6 months, did experience cognitive side effects, so it could well be responsible for at least some of your son's issues.

 

[lynnrx52]

Wow, that's great info. I'm going to take that to the neurologist. Thanks so much!

 

[sbncmo]

Hi Everyone.

Wow! I didn't realize it has been a just over a year since I started this discussion. A lot has happened in that time. I've had 2 stays in an EMU and now have 10 confirmed types of seizures. I am finally on AED's I can tolerate, but only control 5-6 types of seizures, with occasional break-thru's of those. I started taking Zonigran & Vimpat early this year & take the max dosage and I take Valium at a lower dose in case I need it via IV to stop a seizure.

The feeling faint did become more pronounced & is in fact the Atonic/Drop seizure. I'm glad Atonic seizures were mentioned because when the faint spells became more intense, it was easier to diagnose. I also have Tonic seizures. I have each of these at least once a month. Somewhere I read that a person usually does not have both, but I don't see how that can be true since a TC is somewhat both at the same time. My AED's do not control either of these.

My most painful is Myoclonic - almost daily, multiple times a day. I frequently feel like I'm standing in water & touching a short-circuited toaster or something. Or like I just shook hands with some jokester holding one of those gag buzzer in their hand. Or sometimes I feel like my hands are being smashed by a rubber mallet. Shocks, zaps, buzzes, vibrations, etc., going all thru my body. It hurts & again, the AED's don't help them.

Then I have the TC's. At first we thought they were one loooong seizure, but I have just had it confirmed that I am having cluster TC's. The cluster will last for 20-30 minutes. Again, AED's don't work. I have a TC 1-5 times a month.

Not that this is epilepsy related, I found out 4 months ago that I am now Type 2 Diabetic, which I control by diet alone, being allergic to the standard med. In the past 4 months, I have cut my triglycerides in half, considerable cut other cholesterol numbers, cut my liver enzymes by 2/3's & lost 40 pounds. My heart & arteries have been totally checked out & are completely clear, which pleases & surprises me immensely. I have feared my heart & artery condition each year it is checked because of the cholesterol, but it is always clear & will continue as I stay straight.

Anyway, I just wanted to let everyone know that I appreciated their comments & help when I had the question about being faint. It is nice to have an answer even if the AED's don't control it. Thanks again, everyone.

Shelia

 

[Nakamova]

Thanks for the update Shelia. I hope you find away to control the myoclonic seizures too.
Have you noticed that your dietary/nutritional changes have affected your seizures in any way?

 

[sbncmo]

I wish I could say that my diet lessened my seizures, but it hasn't. I have the most boring diet. I'm allergic to a number of foods. My husband has APS and we must keep his vitamin K intake level to prevent blood clots. Every night, it is either chicken or pork loin on a "George Foreman Grill" with a small potato or rice, and green beans, broccoli or a small salad. My breakfast is either a bagel or a breakfast buritto (eegs & very small amount of cheese on a small tortilla. I'm lactose intolerant, but if I keep the cheese to a minimum, I can handle it). Lunch is usually a small salad & some toast. Sometimes something different. All in all, very simple, not much that is pre-manufactured. Most is home made. I absolutely love melons, but I know they are a trigger & stay away from them.

Perfumes are a big trigger for me & all of my friends have stopped wearing perfume & cologne, but I can't ask the world to stop wearing it. I go into the store in fear that I will end up in a TC, but often it ends up as a Myoclonic, well an asthma attack too (no fun!).

And I avoid all the flashing lights, scrolling marquees, 3D movies, etc. Right now, I'm under considerable stress since my sister just died Sunday morning & family and close friends are concerned that the stress may bring on a major seizure. I was going to bed last night & felt a sudden intense pain in my head, closed my eyes for a couple of seconds & when I opened them, I felt I would faint, so I sat on the bed. I told my husband & went out, falling onto his chest. He thought it might be a migraine, but I've never had a migraine make me pass out. I don't know what to think of it. Probably stress.

It seems like some of my seizures have actually increased over the last year. I've had a lot of them since I was 18, sometimes several a day, at least one a day. I don't know if I have just been more aware of them over the last year because of keeping a seizure journal or if they have actually increased. Three years ago the tonic seizures greatly increased. Two years ago the myoclonics greatly increased. But I had lost my insurance & wasn't on any meds during those years. This past year when I got my insurance back & started seeing a new neuro & trying AED's that I hadn't tried before, the TC's became bad. I don't know what to think of all this. The AED's work on some seizures & I'm thankful for that, I don't want to stop them. They are the only ones I can take that I don't have a severe reaction to. I guess I'm just at the point of accepting things as they are, that nothing more can be done at this point. I just have to avoid my triggers as much as possible.

Shelia