Seizures? EEG Negative

liadaughter

Hi all--I'm Lia and new to this discussion group. My mother has moderate/advanced Alzheimer's and this spring she started having what seem like very short (abt 30 second?) seizures. She starts breathing hard, her eyes open really wide/roll back, her head slumps forward, she'll usually cry out that she's going to fall, and her legs will start to crumple if she's standing. This can happen multiple times in a short period. Before it starts she often seems a little withdrawn; afterwards she sometimes cries or gets really angry and accuses people of hating her or tells them not to hit her again (!) Fortunately these episodes don't happen constantly but they are pretty frequent and unpredictable.

So I took her to her neurologist, they do an EEG and she has a couple of these episodes during the EEG. The EEG shows nothing, the brain waves seem the same. The neurologist diagnoses "conversion disorder," a psychiatric problem that is the new name for hysteria. I'm not convinced and even if I were I'm not sure what to do as apparently the best treatment for conversion disorder is cognitive-behavioral therapy, which there's no way my mother can effectively complete. So what next?

A little further background. My mom did have some psychiatric symptoms right before we moved her to memory care; she was getting upset frequently, kind of paranoid, and insistent about having someone with her literally all the time (really that was why why we moved her to memory care). The psychiatric nurse practitioner in memory care put her on Seroquel, which actually helped tremendously in bringing her back to herself though I know there are issues with it. They took her off the Seroquel in case it was triggering the episodes and as there was some disagreement whether it was appropriate at all. They are now trying Zoloft and planning to adjust and try other things. I don't know if it's helped so far or not. When she started having the episodes, it was around the time she also had a UTI (treated fairly quickly) and we also saw some decline cognitive function around the same period.

BTW, I do realize this is just a forum. I'm giving a lot of medical detail but I don't expect medical advice or diagnosis. I'm just hoping some one will have had similar experiences and/or ideas.

SDianeL

welcome. So sorry about your mother. Seizures can be terrifying. They are common in dementia especially Alzheimer’s. My husband would have episodes where he went into what I called a trance, almost like he was sleep walking. He also had episodes where his blood pressure would go sky high and he would sweat and get nauseous and dizzy. They never found out why. There are anti seizure meds but they may not be indicated. Here’s what I found online: Seizures are more common in people with dementia, particularly those with Alzheimer's disease. They occur at higher rates than in healthy elderly individuals and can be associated with faster cognitive decline and increased mortality. Seizures in dementia can be subtle and difficult to diagnose, often overlapping with other dementia symptoms. 

housefinch

I don’t know how much medical testing you are interested in doing at this point, because what will you do with the information? However, I was thinking of either a short period of an abnormal heart rhythm or low blood sugar.

liadaughter

https://alzconnected.org/discussion/comment/245486#Comment_245486

Thank you—the part about the seizures often being subtle is particularly interesting, as I wonder if that's why the EEG didn't pick anything up. And I didn't realize they were common. Appreciate the info.

liadaughter

Thank you! The neurologist had initially suggested a check by a cardiologist but then when the EEG showed nothing she said not to bother. I'm not sure why, other than from the start she said it was an unlikely cause. I guess I'll ask when we meet with her again. I hadn't known low blood sugar could cause this kind of problem; definitely my mom eats poorly/irregularly. In terms of how much testing, I don't know, I have mixed feelings, the thing would be that I'd like to get rid of the seizures so I could do more with my mom but that seems unlikely to happen….

SDianeL

https://alzconnected.org/discussion/comment/245649#Comment_245649

This explains it better than I could. I wouldn't call what my husband had as seizures. I described them to the Neurologist as in a trance or sleepwalking. His Alzheimer's affected the Posterior Cortical part of his brain so that may have been the reason. When he went into these "trances" he wouldn't talk or acknowledge me at all. Sometimes they lasted for a few minutes, other times for over an hour. It was so scary. Someone on this forum mentioned that their LO did the same thing and that it was seizures. The only treatment are anti seizure medications which I didn't see necessary for my DH.

nancypaige

My husband was diagnosed with Alzheimer's by his primary care physician about three weeks ago. We haven't had our first neurologist appointment yet. Over the weekend he began having what we learned in the ER were focal seizures. Because he hasn't had his initial neuro workup for AD, the doctor would not say that the seizures were related to his new diagnosis. I am glad to read on here that seizures are fairly common in Alzheimer's patients.