How to manage nocturnal seizures in a 50-year-old female?

Question

Hi doctor,

It has been two years since she started having convulsions. When this started, she used to get convulsions once a month. Then it turned once in three months. There are no symptoms before getting a convulsion. It always occurs when the patient is deeply asleep at night. She gets unconscious for 5-10 minutes.

Sometimes, only during convulsions, blood pressure gets high around 200/120 mmHg, but she does not have a BP problem, diabetes, or any other abnormality. After a convulsion occurs, she gets a headache, dizziness, weakness, and fever for the next three to four days and then gets back to normal.

Currently, we are not giving any medicine, but when convulsions come, we used to give the tablet Eption 100 mg tablet Amlodipine for BP. Patient is a 50-year-old female, weighing around 156 pounds. Her height is 5 feet 2 inches.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com

I understand your concern and would explain that her symptoms are typical of generalised epilepsy. For this reason, I recommend starting treatment with Valproate or Levetiracetam to help prevent seizures from occurring.

The MRI findings are not related to this issue (attachment removed to protect patient identity). Anyway, I would recommend taking Aspirin 100 mg daily for the prevention of future strokes.

The blood pressure fluctuations after the seizures are related to the body's stress. I recommend performing an EEG.

You should discuss with her doctor about the above tests and treatment options. I remain at your disposal for any further questions whenever you need.

I hope this helps.

Please revert in case of further queries.

Thank you.