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My 74yo mom was diagnosed with vascular dementia just over 3 years ago. She functions well and has only recently required a day sitter. Twice in the last 14 days she's had "spells" where she was awake but not alert. Both times she awakened from sleep and was incoherent and unresponsive. After about 30 minutes she came back around to some degree, but still remained extremely confused. Both times she talked about a vivid, disturbing dream she just had and couldn't distinguish between the dream and reality. When she was able to speak again, it was very slow and deliberate but not slurred. She didn't have any weakness on either side. Her eyes were sensitive to light so she kept them closed. For an hour or so after she came back around, she talked with her eyes closed and would fade out again, even in the middle of the sentence. Three to four hours after the initial onset, Mama was more herself but it took about 48 hours for her to be back at her baseline.

Initial tests showed no stroke, no blockages in her carotid, no significant new atrophy or damage in her brain…so her doctor suspected a TIA. Ten days later, following the second episode, her doctor is leaning more towards a seizure. He says they're common in people who have changes in the brain. Hers would be an absent, or petit mal, seizure.

Beginning 5 days after the first episode, my sweet, laid-back mother morphed into a fire-breathing dragon. To say that she was agitated is a huge understatement. She's had periods of irritability before, but never to this degree or this long-lasting. For 6 days, until the second episode, she was confrontational, uncooperative, argumentative, and mean-spirited. All the time. A huge departure from her normal behavior.

We see her neurologist for an EEG this week. In the meantime, I'm curious if anyone else has dealt with this. Thanks for any info you can share!

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My MIL is post CVA and will blank out. This is TIA activity, I suspect your mother is the same. Damage accumulates over time, and if the area of the brain that affects personality is damaged, you will see negative changes. Brain imaging done months later will show the hole where tissue has died off. MRI and CT need to be repeated annually, with contrast. EEG is useful if there is a baseline to compare it to. A functional MRI shows what regions are active. Bloodwork for glutamate levels can indicate ischemic stroke, as glutamate levels will spike . Namenda may help lower it. Bear in mind that drug intervention for stroke has to begin within a few hours of onset.
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My mother has similar personality changes after her "spells." However, when she has these episodes, she shakes from head to foot. Afterward, she is tired and doesn't want to do anything. As you described with your mother, my mother is angry and uncooperative. She never remembers these incidences. Her doctor and her Neurologist suspect seizures, but we cancelled the appointment for a 24 hour EEG after the half hour one showed nothing, because we were told she would have to have one of these "spells" while being tested and the following week after the episode, she was wonderful.
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My 92 year old mom had something that appeared to be a stroke, but after many tests in the hospital they ruled that out, saying it had to be some sort of seizure. Mom seemed very confused throughout the night it happened and then fell. Her left side seemed to be paralyzed, which made it look like a seizure. It took 4 days in the hospital to regain the strength and talk normal. We she was able to talk normal, she seemed really out of it and hallucinated. She is currently in a rehab center and acting out. My sister and I wondered if her behavior is due to her episode.
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A couple of years after my mom had a stroke, she began having seizures. Hers were so bad that the first one she almost died from. She would stop breathing, and after awaking she was incoherent for a couple of weeks. They ha her on Keppra, up to 1500mgs a day to control the seizures. When she was getting ready to have one she would get very combative with the staff at the NH. She would be uncooperative as well. I have heard about seizures more and more with vascular dementia...so sorry you are going through this with your mom.
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My dad froze up for about 3 minutes. Thank goodness it was while he was on the scale at the cardiologists office. He was standing up, staring straight ahead, not responding to his name, verbal commands, or touch. Then he came out of it and was entirely unaware anything happened! He had is pacemaker checked, as was scheduled, and everything was ok. The very good NP who does this, was aware of the episode. I have not seen one since that one several years ago. It scared the crap out of mom and me at the time.
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My dad has a history of TIAs but recently had numerous "episodes" while he was in a nursing home. He was non responsive, collapsed and would last for 3-5 minutes. He was very tired afterwards and slept for hours. He was never really diagnosed. The dr. thought it was due to his heart, possibly "sick sinus syndrome." His blood pressure was dangerously low several times and we almost lost him. The episodes have stopped (for now) after a lot of medication adjustment and he came home from the nursing home today. Good luck with your mom.
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My mom had similar episodes and after much testing was put on seizure medication. This cut back on the seizures but she needed additional meds to stop them completely.
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Hearing from others helps more than anything--thanks! Mama has had no episodes other than the first two. They were 10 days apart and tomorrow is Day 10 following the second one so we will see... In comparison to what you've experienced, hers are mild. No tremors or jerking, no significant changes in function post-episode, definitely no life-threatening activity during the spell, and no personality changes after the second one (thank you Lord!). Her neuro suspects seizures, as does her GP. An EEG is scheduled week after next and we'll know more then. Pstegman, thanks for you detailed info. So good to know!
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i know this sounds simple, but it is easy to forget. Be sure your mom stays well hydrated. Dehydration can cause many symptoms that seem like something worse. I have to flavor my dad's water with crystal light to get him to drink it. He also likes SoBe with coconut water and flavor (vs plain).
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Thanks pip for that heads up. That's one of the first things they checked in the ER, along with UTI. No seizures in 11 days so fingers crossed!
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Mum is in hospital as we speak following what i thought was a stroke. Drop side of face and slurred speech had to be a stroke. The stroke team have done all their tests EEG ECG and CT scans etc and it is definitely NOT a stroke or a TIA - it is a seizure - a form of epilepsy. Mums behaviour has changed radically in less than 10 hours during which she has had 2 more seizures. From being a sweety with professionals (while quite the reverse with me) she actually took a swing at the doctor as she started to come round from the third one. She wont let me touch her although she hasnt a clue who I am and she didnt know my daughter either. Tonight though I get a rest for she is in hospital - guess who is going to make the most of an early night?
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My 83 year old mother is experiencing the exact same thing. However the doctor has prescribed Keppra 250mg to start off with and then increased it to 500mg twice daily. So far she has not had another seizure but is sleeping for long periods of time. Today is the first in 3 days that she has eaten soft food. I will continue to monitor her progress. The good thing is that she recognizes everyone who has come to visit her in the hospital by first and last name, and what they are wearing etc. It's just that she seems to be confused with short-term memory.
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