I am 23, female. Why do I have blackout spells and seizures?

Question

Hello doctor,

I am a 23-year-old woman experiencing episodes where I suddenly stop responding and stare blankly for about 30 seconds. During these spells, people have noticed that I sometimes make chewing motions or pick at my clothes. I have also had two episodes where I collapsed and shook all over, after which I woke up confused, with a bitten tongue, and had wet myself, which was extremely embarrassing.

These episodes seem to occur more often when I am sleep-deprived or stressed. Sometimes I experience a strange rising feeling in my stomach or notice an unusual smell just before they happen. I have also been struggling with memory problems and difficulty concentrating at work, and I am afraid to drive because I never know when an episode might occur.

My grandmother experienced similar episodes when she was younger, which makes me worried this might be hereditary. Could these blackout spells and convulsions be seizures caused by abnormal electrical activity in my brain?

Kindly advise.

Answer 1

Hello,

Welcome back to icliniq.com,

I understand your concern.

The episodes you describe, brief spells of staring with unresponsiveness and automatic movements (chewing motions, picking at clothes), followed by larger events with collapse, whole-body shaking, tongue biting, and loss of bladder control, are highly suggestive of epileptic seizures caused by abnormal electrical activity in the brain.

The fact that you sometimes experience a strange rising feeling in your stomach or unusual smells just before an episode is known as an aura, which can be an early sign of focal seizures. Your family history further supports the possibility of a hereditary tendency.

Before deciding on the next steps, the following investigations are advisable:

EEG (Electroencephalogram): To look for abnormal brain electrical activity.
MRI brain: To rule out structural causes such as scars, malformations, or other lesions.
Basic blood tests: To check electrolytes, glucose, calcium, liver, and kidney function.

I would suggest the following measures:

Avoid driving, swimming alone, or operating heavy machinery until the condition is under control for safety. Good sleep, regular meals, and avoiding alcohol can help reduce seizure triggers. If seizures are confirmed, appropriate anti-seizure medications can significantly reduce or even prevent these episodes.

For prevention, since you have already experienced convulsions with loss of awareness, it is very important not to delay in care. Please arrange an appointment with a neurologist as soon as possible.

Regular follow-up with a neurologist is essential for proper monitoring and treatment adjustment.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.