Q. From my history, please explain the problem I have.

Answered by
Dr. Rajyaguru
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Aug 10, 2016 and last reviewed on: Jul 02, 2020

Hi doctor,

I have had migraines all of my life as long as I can remember. A year ago, I suddenly fainted, hit my head on the wall and received a concussion. Right before I fainted, I was feeling like I had to burp and I had lots of saliva in my mouth. My head was hurting and I felt dizzy. Then, I felt nauseous and was gagging like I had to throw up, But, I did not. I ran to the bathroom and the nauseous feeling went away, but I fainted and was passed out for a little over a minute, from what my friend said. Then, I heard them yell my name and I slowly woke up confused. I felt fine afterwards. I went to the doctor the next day and they said I had a concussion syndrome. But, the other symptoms were red flags and so I was referred to a neurologist. After three months of tests, as my MRI came out fine without any tumors or anything of the sort, and had two EEGs, he had diagnosed me with one type of potential seizure activity while asleep and another type in another area while awake. My first question is, is that possible?

Also, the medicines prescribed earlier for migraine did no good for my daily pounding headaches, dizziness and faint spells. I only had two to three other episodes after that where I would randomly faint. Those were around 5 and 7 months ago. My new neurologist based on the other neurologist's diagnosis, prescribed Keppra (extended release) 750 mg and advised to take it daily. After three months, I need to have another EEG. What is my actual problem?



Welcome to

  • You have seizure for sure. The EEG (electroencephalogram) suggests (attachment removed to protect patient identity) localization more in the left temporal, but also generalized activity in both sides of your brain.
  • There are two possibilities. First, yours is a primary seizure disorder, where the cause is unknown. But, the treatment is known, which is antiepileptic and you are already taking.
  • I would advise you to continue taking that. It does not have much of side effects except little sleepiness. It is quite an effective medicine.
  • Second possibility would be a condition called medial temporal sclerosis where your seizure has a cause, which is treatable surgically. As of now this is not the first diagnosis I would make for you and for this, I would like to know your age.
  • I would like to know what exactly the MRI brain report, especially regarding the medial temporal area. Are there any changes there? Did they do special sequences to screen that region? Please let me know.

Revert back with the reports to a neurologist online -->

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