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Doctors training notes

Low blood pressure, not epilepsy

About 15 years ago, I started having complex partial seizures, also known as temporal lobe epilepsy. It was very difficult for me as a teacher since I would suddenly start talking gibberish for minutes at a time. It was also impossible for me to drive.

I consulted my GP, who referred me to a ‘specialist’. After undergoing an EEG and MRI, I was told that they had found ‘something’ that was probably a brain tumour. I spent the next two years waiting to die.

I was given carbamazepine (Tegretol), but it has never been wholly effective. I have seizures once or twice a day and lose consciousness about once every seven to 10 days. It also has several unpleasant side-effects.

Two further scans, on newer equipment, revealed that the supposed brain tumour was probably old scar tissue.

Meanwhile, I noticed that my seizures were more likely to occur at certain times, such as:

* if I slept heavily in the night and was still sleepy - then 20 minutes after getting up
* if I stayed awake a long time into the night - then just as I dropped off to sleep
* between 12.30 and 13.00 - then just before lunch
* if not at that time - then just as I started to eat my lunch.

Thinking this might be linked to blood sugar or blood pressure, I recently bought a blood-sugar meter and a blood-pressure monitor. Since then, I have learned that:

* I have very low blood pressure most of the time, but it varies during the day
* the morning seizures are related to a swift drop in blood pressure
* I often have very low blood pressure and low blood sugar before a seizure
* rapid changes in blood pressure, e.g. due to emotions, can lead to a seizure.

I thought that I was alone in noticing this until I read on the Internet that the Manchester Heart Centre found that some patients diagnosed with epilepsy in fact had cardiac arrhythmias, and all had low blood pressure. Also, some cardiologists believe that difficulties with circulation may be the problem with up to 40 per cent of supposedly epileptic patients, but whose epilepsy is drug-resistant.

Having made more searches on the Net, I find that, in the US, it is recognised that low blood sugar and/or low blood pressure can trigger seizures.- Judy Tolman, Ludgershall, Buckinghamshire



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