syncopal episodes

  1. 0
    I am going NUTS!
    My 17 year old son is having syncopal episodes. He is 130#, 6'2" tall,Pulse 65-80, BP 120/60. not hyper/hypoglycemic.
    The episodes usually start with asudden onset headache, dizziness and general malaise. He always runs an immediate high fever,102-104 during the episode. He has them about 2-3 times a year, usually no closer than 4 months apart. They have been going on since he was 6 years old. No head injury, no familial hx. of seizure/syncope.
    The original neurologist said "slow brain waves". He is NOT a vegetable but a "normal" senior in HS.
    The next neurologist said he was "faking"... Huh? How do you fake a fever?
    The next MD daid he has hypotension and it will never happen when he is sitting or lying down. WRONG!!!
    This week he was fine in school, talking and actively participating in class, then put his head down on his desk and was "gone". all within a matter of seconds. He said he was immediately so tired he couldn't keep his eyes open and put his head down on the desk.The teacher was eventually able to rouse him after repeated shaking and screaming his name(she was terrified). When he looked at her, "he wasn't there". He said "yes" when she asked if he wanted to go to the nurse and proceeded to walk towards the door sideways while looking at the wall. He collapsed 15 feet from his desk and was lowered to the flood and remained completely unresponsive for "10 minutes" according to the teacher (he has been out for us for maybe 15 seconds)During the time he was unresponsive his respirations were regular and unlabored. The teacher could not find a pulse but when the school nurse got there his bp was 130/60,p-78, even resp. He was diaphoretic wringing with sweat, white-pale with cyanotic lips. When he finally opened his eyes they were glassy and vacant. At times he could make eye contact but it faded. By the time I got to the school he was still mostly vacant but could carry on a limited conversation. I got him home and watched him. He slept soundly from 11:45am-5:30pm. before he woke I took his pulse, irregular radial, sounded like missing beats apical. He woke well rested, hungry and chipper. He slept all night, 8:30pm-6am and woke chipper and ready for the day.
    I keep getting the run-around. Has anyone ever heard of anything like this before? Please advise.
    Thank you
    Terry

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  4. 4 Comments so far...

  5. 0
    A few things. First, get a different neurologist. Actually, he needs a complete workup..including labs, drug screening (sorry), eegs and evaluation by a cardiolgist etc.,etc. Get a complete written report of this last sycopal episode at school from the school nurse. You can present this to physician-skeptics as an unbiased witnessed event. You are going to have to become an EXTREMELY squeeky wheel. No one will pursue this unless, they find something obviously wrong, so you must. Especially in a managed-care scenario, no one is going to want to spend money on alot of expensive test, on a "seemingly" healthy individual.
    And sorry to be blunt, but a post-mortem apology from a physician or an out-of-court settlement will not bring you back your son if something turns out , too late, to have been seriously wrong.
  6. 0
    Hey Terry,
    Let me start by saying, I went through a similar problem with my daughter when she a teenager. She suffered "blackouts" at times of stress and was finally diagnosed as having petit mal seizures. Medication was prescribed to prevent this and she finally outgrew them. This sounds like some sort of seizure activity your son is experiencing. It is hard for any neurologist to diagnose the problem unless they can witness the event or find some irregularity on a diagnostic test. You did not say, but I take it your son has had EMG and EEC studies and a CAT Scan. I don't understand the fever part! My best advice is to find the closest teaching hospital in your area and take your son to the neurological department along with all of his medical records and test results. I agree with Chubby's comments, you need to move on this quickly! Joe
  7. 1
    A 24hr Holter monitor may be of use also.

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    eeffoc_emmig likes this.
  8. 0
    In response to syncope:

    I agree with the others on finding a decent neurologist. for starters. Add a cardiologist also.

    I would have to say a holter monitor may be useful, but not necessary. Although you seem to think that he had an IR heartbeat and pulse at some point, it doesn't explain the fever.
    The brain is pretty complex, and a CT only shows physical defects. The biggest problem with this situation, is getting it to occur with a neurologist present.
    An EEG may not show anything, unless the event occurs.
    There are two things to consider -
    1) Some individuals will develop a fever, during and/or after a seizure.
    2) Although febrile seizures usually only happen to children < 10yrs old, I wouldn't count that out either. Which leads to the question? Does the fever or seizure come first? Most likely the seizure.
    3) Does he know when it's coming? Epileptics usually have an aura, or sense when a seizure is going to start.

    I would have to agree, that this could be some type of seizure. You said his eyes were open, but he wasn't there. This mimics post-ictal activity that seizure patients have s/p seizure. I would find a neurologist that is interested in helping you. You need to squeak loud!

    Just for the record, I had a friends son as a patient, that had a similar, one time event. He was fine, and talking to his friends one minute. He went out on them, became confused, and after was conscious, but nobody was home. He also had a fever during and after this episode. They did blood tests, MRI, CT, EEG, Drug screening, etc. Everything they could think of, and found no answer. Unfortunately, he was left with a permanent disability. His gait has been hampered slightly. However, more extensively, he cannot play sports anymore d/t this ? that occurred.

    CEN


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