Unconsciousness

Whenever my two-year-old grandson cries, he becomes unconscious, at times preceded by convulsions. However, he becomes normal after sometime. Is he epileptic?

For children aged between one and three years, sudden unconsciousness while crying is not due to an epileptic attack but a “breathholding attack”. The child normalises once he starts breathing again. No medication is necessary; only a slap on the back is needed to get him to breathe again.

Epilepsy

Sometimes, my father (54) suffers from severe jerking that radiates from the left side of his face and moves to other parts of the body, ultimately leading to unconsciousness. The doctor has diagnosed it as epilepsy.

Your father is probably suffering from complex partial epilepsy. In this, the attack occurs in a particular region of the brain and then spreads to other areas. This is a “motor focal epilepsy” where the movement of body parts is paralysed for a few minutes due to a temporary problem in the brain’s motor area. This may be due to a tumour, an inborn defect, head injury or brain diseases like encephalitis and meningitis. History of trauma or infectious brain diseases, clinical examination and certain investigations are necessary for proper diagnosis and treatment.

paralysis

I am 57 years old. I recently suffered a paralytic attack on the right side of my body. It lasted an hour after which I was normal. Please advise.

If the paralysis is for a short duration (a few minutes to a few hours), it is a Transient Ischaemic Attack (TIA). It usually occurs when blood flow to a certain area is obstructed due to a temporary blockage. Arteriosclerosis (narrowing of artery) is another major reason for TIAs and strokes. Narrowing of artery is caused mainly by deposition of fats, triglycerides, cholesterol or platelets. So the cause of arteriosclerosis and the source of the clot must be investigated for proper treatment.

Treating stroke

My uncle (70) suffered two minor cardiac strokes last year. What kind of treatment should be given to a stroke patient?

As said earlier, strokes are caused either by blockage in a particular artery or arteriosclerosis. After detecting the cause of arteriosclerosis, the condition can be treated by administering deposition lowering medicines. The deposition can also be removed immediately by surgery. If the stroke is detected within three hours of its onset, and the obstruction is not surgically approachable, we use thrombus (clot) dissolving medicine as early as possible. This will improve the situation dramatically. But if the stroke is detected after six hours, the patient should be given deposition lowering medication, which will ease collateral circulation and blood pressure.

Acute memory loss

My father (65) tends to forget things every now and then. At times, he can neither recognise relatives nor return home all by himself. Please help.

Your father may be suffering from physiological memory loss, which occurs due to ageing. Medication isn’t of any help in such cases. He needs memory training. It may also be a case of multi infarct dementia or Alzheimer’s disease. This is caused by multiple small strokes not resulting in paralysis. This can be identified by an MRI scan. Alzheimer’s disease is actually increasing dementia where loss of memory is associated with behavioural disorder, fits, sleep disturbance, etc. Your father needs to consult a neurologist for proper diagnosis and treatment.