A seizure

Hi Dr. Agar,

I’ve been on dialysis for 18 years now, the last 9 of which have been on daily nocturnal home hemo. In the last three months, I have three instances of fainting. This happens at night after I get back from work and lie down. It is not when I stand up but when I lie down.

The last time this happened was 4 days back and I had symptoms of a seizure (body trembling, hands raised in the air and shaking and biting my tongue - I realised all this as I came back to consciousness).

I met my neph who advised a brain MRI and a neurologist consult. The neuro also got an EEG done. They say there is nothing major in these two reports. He has started me on an anti-convulsant and asked me to stop driving and swimming for a year! He said I must always have someone by my side until a year has passed without incident.

Is stopping swimming (I swim every day and absolutely love it) really necessary since I have had episodes very rarely and only at night (I swim in the morning). Any other tips/advice would also be welcome!


Dear Kamal

I would love to be able to help, here, but I have to say that the cause and effect of seizures are very much up to your local team to call the shots as they are (or appear to be) there, on the ground, in India.

If these are cerebrally-triggered events, then their instruction is correct … and it is what we MUST say … though I understand your frustration at the outcome.

One thing though … before these are accepted (as they well may be) as cerebrally-derived ‘seizures’ - and then, the ‘no drive’, ‘no swim’ instruction HAS to stand - is … have you had you BP checked at these times, and/or your heart rhythm, and/or your blood sugar!!! … and it just might that this is BP, or rhythm, or hypoglycaemia-related?

It might just be worth an ambulatory BP monitor, or a Holter, or a blood sugar level (i note that they DO occur after a long and ? sugar-low day at work) before accepting them as brain-triggered, and then, legally, you (and they) are committed to their advice.

Just a thought …