Dementia
May 13, 2010 | 20,00 EUR | answered by Dr. med. Olaf Stephan
Good evening,
My father is 70 years old and has been suffering from presenile dementia (with DD meningioma) for about 10 years. For about 1.5 years, he has been living in a protected unit of a nursing home, where I feed him for about 1.5 hours every day. Last Saturday, he was taken to the hospital by ambulance due to a seizure. I was with him for about 3 hours each day at the hospital. It was impossible to talk to a doctor on Saturday, Sunday, and Monday. However, on Tuesday, I finally had the chance to speak to a doctor. She told me that a seizure can have many causes, such as dehydration, a possible infection (he had a fever of 38.5 the day before and immediately received "Rocephin iv"), or it could be related to the dementia, as the brain may not be functioning as well. They couldn't give me a definite cause. I have arranged for my father to return to the nursing home tomorrow, but I would like to know if there are any warning signs for such seizures, or what I should watch out for during my daily visits in order to recognize any potential issues in advance and act quickly. Thank you in advance. By the way, I have been working as a PTA in a public pharmacy for 22 years, so I am knowledgeable about medications and side effects.
Dear inquirer,
indeed, a seizure, especially in an older patient, can have various causes; including dehydration, febrile infection, medications (such as Theophylline, Quinolones), metabolic or electrolyte disorders, cerebral circulation disorder, apoplectic stroke, or even a brain tumor. The latter diagnoses can be well identified in a computed tomography of the skull with contrast medium, including the aforementioned differential diagnosis of meningioma. However, the sole triggering of a seizure by dementia, such as Alzheimer's dementia, seems rather unlikely. Which of the mentioned diagnoses were correct for your father, or which examinations were carried out, you will have to clarify with the treating clinic, it is certainly also included in the discharge report (epicrisis) of the inpatient stay, where you can definitely access the records through the family doctor. If your father does not have any further seizures in the near future, and there are no organic causes present, a prophylactic anticonvulsant treatment is not indicated. In case of repeated seizures or a brain organic finding, seizure prophylaxis (e.g. with Carbamazepine) may be considered in consultation with a neurologist. There are no warning signs for seizures, the seizure occurs suddenly and usually ends after two minutes (even without therapy). However, in any case, in older individuals, attention should be paid to adequate fluid intake (approximately 1.5 to 2 liters per day), furthermore, febrile infections should be recognized early and treated appropriately.
I wish your father a speedy recovery, best regards, O. Stephan.
