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Q. Could my seizure have been provoked?

Answered by
Dr. J. Mariano Anto Bruno Mascarenhas
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Aug 30, 2016 and last reviewed on: Jul 25, 2020

Hi doctor,

I had my first tonic clonic (grand mal) seizure seven days ago at work. It lasted 1 minute 30 seconds. I bit my tongue badly, but did not have any incontinence. Beforehand, I was shaking, had a loud beating heart and had a feeling of vertigo and anxiety. Afterwards, I was confused for approximately 15 minutes. I was being very active at the time and was bending down and rising several times to tidy up a room, which may have contributed to feeling faint or having a head rush.

I am a 27 year old obese woman. My height is 5'6" and weight is 266 lbs with untreated bulimia that comes and goes in phases since the age of 15. For the previous three months, I alternated between low carbohydrate days, the days I accept as good days and bad days where I may binge and purge up to three times a day. I vomited 12 hours before my seizure and did not eat or drink anything after that. I had 5 hours of sleep and then drove an hour to work. After my seizure, my employer, who happens to be a doctor, gave me lots of water and tea and sent me to a GP. An hour later, I had a blood test and the results came back all normal, but borderline low potassium. My ECG scan is normal and nothing wrong with reflexes or balance. I do not have diabetes. I have also seen a neurologist, who has put the seizure down as isolated and unprovoked.

I have not told my GP or my neurologist about my bulimia. My MRI and EEG scans are pending, but my neurologist said that they will probably come back clear. I have never felt my aura before as any indication of epilepsy, minor seizures or myoclonic jerks. I have also scared of my bulimia now, which is a positive. I realize that I am probably clutching at straws or in denial that I may have adult onset epilepsy. My question is that could my seizure have been provoked? Thanks in advance.

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Hi,

Welcome to icliniq.com.

I have gone through your query with diligence and would like you to know that I am here to help you.

From what you have narrated, I am of the opinion that your seizures were provoked or brought on by a combination of non-diabetic hypoglycemia, lack of sleep, dehydration, messed up electrolytes or even hypoglycemic unawareness.

Your neurologist has labeled this as unprovoked seizure since he was not aware of this. Because of this, they may diagnose this as epilepsy, when it is all the more possible that you had a episode of fits due to hypoglycemia and messed up electrolytes due to bulimia.

By hiding your bulimia (eating disorder) to the neurologist and GP, you make it a risk of another worse diagnosis of epilepsy. Bulimia is a much simpler disease than epilepsy.

My suggestion would be to tell the GP and neurologist the truth and get treated for bulimia and save your future.

For further information consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist



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