After EEG, doctor needs to do more

Dear Dr. Gott: I had a small seizure while driving. An EEG was properly performed, but perhaps not properly interpreted because no medication or advice was given. I’m 83.

Dear Reader: In the elderly, seizures are almost never due to epilepsy, a convulsive disorder that usually begins in childhood, causes an abnormal brain wave (which is typically discovered by an EEG test), and requires long-term therapy with medication such as Dilantin.

Rather, in older folks, lapses of consciousness (which may progress to seizures) are a common consequence of brief strokes or heartbeat irregularities.

If all you had was an EEG – and no advice – you need more.

First, your doctor should examine you thoroughly and check you with blood tests for conditions such as anemia. You must have a cardiogram and, perhaps, a Holter monitor, which is a cardiogram that is recorded for 24 hours. Using this technique, doctors can often discover unsuspected cardiac arrhythmias (irregularities), such as sudden slowing, that deprive the brain of oxygen and lead to fainting.

If these basic studies are normal, you’re probably safe to drive (with someone to accompany you). Should you have another “lapse,” other testing – such as a carotid Doppler (to check the circulation in your neck) and MRI scanning (to check the brain for signs of stroke) – should be performed.

If a pulse irregularity is present on the Holter monitor, you may need medication to stabilize your heart – or even a pacemaker to overcome the arrhythmia.

In any case, your doctor has more work to do. He may choose to involve a neurologist, if necessary.

To give you related information, I am sending you copies of my Health Reports “Epilepsy: The Falling Sickness” and “Coronary Artery Disease.” Other readers who would like copies should send a long, self-addressed, stamped envelope and $2 per report to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

Dear Dr. Gott: I am concerned about my 70-year-old mother who, for many years, has been taking Xanax as a sleep aid. She refuses to discuss alternative treatment. What are the long-term side effects of this medicine?

Dear Reader: Xanax, a drug used to combat excessive anxiety, is commonly prescribed for the short-term treatment of insomnia.

By and large, it is a safe medication. However, the manufacturer warns that it can cause a drug dependence and symptoms of withdrawal, including seizures.

If your mother requires a sleep aid and you are concerned about Xanax, she might be better off taking a lower dose. For example, the drug is available in a quarter-milligram size that can be broken in half.Or she might be helped by using over-the-counter sleeping pills, such as Sominex. Ask her doctor about this and whether your mother should taper her dose of Xanax before stopping the drug.