Is my father having a seizure or a stroke?

1 answer | Last updated: Sep 30, 2016
Jillydog asked...

my 73 yr old father had a stroke 5 yrs ago. In the last 6 mos. he has 3 episodes where he wakes up in the middle of the night unable to move, yet able to communicate & speak normally- yet loses control of his bladder. These episodes last 30-45 min. and then seems to pass, and he is able to move. Is this a TIA, seizure, or something else?

Expert Answers

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

This is a tricky situation. It is not uncommon for people to suffer from neurological "spells" after a stroke without a clear cut etiology. To a first order approximation, I would guess they are seizures since they come and go without leaving any permanent deficit and have been so stereotyped. In particular, these have the sound of "nocturnal seizures", in my opinion.

A typical evaluation for this type of problem would be a non-invasive angiogram (CT angiogram probably better than MR angiogram) to make sure there is no focal artery blockage that could be causing these attacks, along with a prolonged EEG (with part of the EEG done while he is sleeping). This may better identify the cause. If all else fails, I will sometimes start people on a gentle anti-seizure medicine to see if the problem goes away. If it does, you likely have your answer.

I hope that helps. Good luck!