Seizure - Fear of brain tumor and more questions...
February 12, 2011 | 50,00 EUR | answered by Dr. med. Olaf Stephan
Hello,
last week I had a seizure at night and had to go to the hospital (University Hospital Mainz) in an ambulance. Now, the question of the cause of the seizure naturally arises. I am 34 years old and had a seizure once at the age of 2, but it was due to high fever. Since then, nothing like that has happened. This time, although I was quite sick (and also under a lot of work-related stress, and had been working on the computer until about 1 hour before the seizure), I did not have a fever. The seizure came on suddenly and lasted about 2 minutes, after which I was a bit confused for some time, but now I am feeling much better.
My biggest fear now is that the seizure could have been caused by a brain tumor (or something similar), because a first occurrence of epilepsy at my age is quite unusual. A CT scan (without contrast) was done that night, with no findings. Can that reassure me? Should a tumor have been visible in the scan? An EEG was also done and showed spikes every 30 seconds. An MRI is scheduled to be done in 2-3 weeks, and I will also have another neurological examination. In the meantime, I am being treated with Keppra. Should I be afraid of a tumor?
Even though I felt VERY well treated in the hospital and the doctors were very kind and empathetic, and told me that this fear is unfounded, I am a bit of an anxious type and would like to hear a second opinion.
I also have a few questions regarding my behavior in the coming weeks:
1. Can/should I continue working normally (as a programmer) or take it easy?
2. We wanted to go away for a few days at the end of next week to relax. Can I do all activities (hiking in the mountains, swimming pool, sauna, etc.)?
3. What about physical exertion in general? Can I do sports (strength training) or should I avoid it?
4. We have tickets for some events during carnival season. Should I avoid events with light shows, loud noises, etc., or is it okay to attend them?
5. Should I avoid alcohol? Or is a glass of wine or beer with a meal okay?
Thank you in advance for your answers!
Dear Inquirer,
Apparently you suffer from epilepsy, the description of the seizure suggests a so-called Grand mal seizure (major seizure), especially febrile convulsions in childhood are often precursors of epilepsy, which can then manifest itself in almost any age. In most cases, there is an endogenous (congenital) lowering of the seizure threshold in the brain, the seizures are usually triggered by psychomotional stress and especially by sleep deprivation (as described by you), in rarer cases, in adults, a brain tumor can also be the cause (as I said, very rare). After the initial event, extensive neurological diagnostics with CT (with contrast agent) or MRI and EEG should be carried out, which has so far only been partially done in your case. In a CT without contrast agent, a brain tumor cannot be definitively ruled out, but an MRI is planned for you in the near future, which is very specific in diagnosing a tumor, you have to wait for this finding to be sure, however, the description of the event in your case suggests less of a tumor, but rather of actual epilepsy, which apparently the treating neurologists have also seen this way. The treatment with Keppra is also correct, now we have to wait for the further course, i.e. whether and how often seizures occur in the future, ideally the medication should prevent the seizures prophylactically. It is recommended that you take it easy physically in the near future and also avoid stress (e.g. at work). In the next few weeks, you should also be cautious with physical exertion (such as mountain hikes, where there is also the issue of altitude stress), it still needs to be shown whether the current medication is effective, I also consider a sick leave for about two to four weeks, depending on your condition, as justified. Sauna and swimming seem harmless to me, however, in the next few weeks you should avoid loud music, longer parties, light shows, etc., as they could provoke another seizure. Alcohol is also not recommended, and it does not go well with antiepileptic medication, later on, when you are stable on medication, small amounts are allowed for example with meals or in the evening. If a tumor is ruled out with the MRI and you are stable on medication, you can lead a nearly normal life in many ways, you can also continue your work and do sports as before, but you should still avoid sleep deprivation and excessive stress (but somehow we should all do that :-)). A regular neurological check-up is definitely recommended for you. I hope that I could help you, with kind regards, O. Stephan.
