Q: My wife is 58 years old and suffers from high blood pressure. She is on pills for this. Last month she had a seizure during which she lost consciousness and control of her bladder for a few minutes. The doctor thinks she might have had a slight stroke, even though she seems to be fine now and does not have any paralysis and her speaking ability has not been affected. Do you think she might have a brain tumour, or is this a form of epilepsy? The doctor has given her drugs to control the seizures and she has not had any since.
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She doesn’t drive often, as I do most of it, but will she have to give up her driver’s licence after one seizure?
A: Seizures or epileptic “fits” can occur in about 10 percent of stroke victims, so it is not uncommon. If your wife suffers from high blood pressure, she may have had a small bleed into the brain
if the hypertension was not well enough controlled with medications. She may have had a temporary surge in the pressure from a stressful situation, or perhaps because she took decongestants or sinus medication.
A slight stroke may not result in any obvious paralysis because it depends which part of the brain is affected. There is most likely some degree of damage present for her to suffer a seizure and become unconscious with a loss of bladder control.
Does her personality appear to be the same? Is she a little quieter than normal or does she do things that appear out of character, such as not caring about her physical appearance or hygiene? These types of situations can occur if the frontal lobes of the brain are affected.
All seizures that occur the first time in middle age or older should be investigated by a neurologist, as there is a slight possibility of a brain
tumour.
Brain tumours usually give the doctors some other clues. There may be severe and constant headaches and sometimes blurred or double vision. Other neurological signs may be present such as numbness or weakness in the limbs or facial
muscles.
Doctors can often see a reddening and bulging of the optic nerve at the back of the eye when they look into the eyes using an ophthalmoscope.
This is due to increased pressure inside the brain because a tumour takes up extra space inside the skull.
Although it is unlikely that your wife has a brain tumour, there is some hope on the horizon for those who do. A company called Oncolytics Biotech, located in Calgary, has just competed trials of a new drug on human subjects with malignant gliomas – a nasty type of brain tumour. The trial was satisfactory and there was no evidence of severe side effects.
The drug is known as Reolysin, and it is made from the human reovirus. It selectively targets
tumour cells when it is injected directly into the tumour using image guided surgical techniques. This drug may also be useful in treating other forms of cancer such as breast or prostate.
To find out more about Reolysin, go on-line to www.oncolyticsbiotech.com or phone 403-670-7370.
As for your wife driving, I think it would be safer for everyone if she didn’t drive for the time being. The law states that a patient should be free of seizures for at least six months before driving again, and even then it is up to the doctors to make that decision.
The doctor has a legal obligation to inform the
licensing authorities if he thinks your wife would pose a danger by continuing to drive after a seizure.
Clare Rowson is a medical doctor with a practice near Belleville, Ont. Her columns are intended for general information only. Individuals are encouraged to also seek the advice of their own doctor regarding medical questions and treatments.
