The patient suffers from an The patient suffers from an undiagnosed condition, with episodes of malignant high blood pressure and regularly occurring clusters of partial complex seizures.
- Episodes of malignant high blood pressure
Both symptoms are dependent on brain poor respiration that depends on multiple factors:
- Oxygen Availability
- Oxygen partial pressure (altitude. weather changes)
- Breath Rate and Deepness (lower during the sleep)
- Asthma etc
- Carotid Sinus Syndrome Carotid Sinus Epilepsy
- Oxygen Transport
- Blood Hemoglobin
- MCV (high MCV is associated with slower flow)
- Oxygen consumption at Mitochondrial level
- Cyt. C deficiency
- iron deficiency
- heme deficiency (low estrogens)
- hypothyroidism (or resistance to TH)
- hypoalbuminemia (it affects the protein moiety of Cyt C)
- Nicotinamide, riboflavin and other B group vitamins
- Coenzyme Q deficiency (secondary to hypothyroidism)
Whilst the brain hypoxia either localized or diffuse is a well recognised risk factor for these symptoms other risk factors are not usually taken into account:
Glucose transport inside the cell is mediated by sodium gradient via carriers belonging to the family of SGLT carriers that comprises Na+-dependent glucose co-transporters (SGLT1 and SGLT2), the glucose sensor SGLT3, the widely distributed inositol and multivitamin transporters SGLT4 and SGLT6,9 and the thyroid iodide transporter SGLT5. Low sodium may result in a strong impairement of nerve and thyroid cells.
Circadian variations of liquor sodium fit with seizures ??
Low adrenals hormones
Cortisol favours gluconeogenesis and sodium reabsorption, hence plays a major role in brain health.
Urinary cortisol alone is not a good marker of daily cortisol production as other derivatives are the real final catabolites. In our lab we perform a multiple analysis that offers more reliable results.
Therefore a Cortisol deficiency is not excluded by the previous tests.
This is not a well described syndrome but we have described a patient with seizures and an altered ratio Etiocolan/androstan in the urines suggestive of a reduced synthesis of Neurosteroids : endogenous regulators of the GABAA receptor.
Low glucose or diabetes?
2011-02-20 urinalysis.pdf shows traces of ketones suggesting an unbalance between fat and carbohydrates in the diet
2012-07-09 Hemoglobin A1C immunoassay.pdf: insulin resistance by iron deficiency?
Low heme synthesis
heme synthesis depends mostly on estrogen (or at a lesser extent testosterone) and serum bilirubin can be used as an indirect marker of low heme synthesis.
Bile Pigments in Pulmonary and Vascular Disease, 2012
- This study revealed a higher risk of myocardial infarction for both men and women associated with low serum BR and low serum albumin
Antiepileptic drugs, hyperhomocysteinemia and B-vitamins supplementation in patients with epilepsy. 2012
- Elevated total Hcy levels (hyper-tHcy) have been associated with cardiovascular disease in multiple large-scale epidemiologic studies and, in particular, patients with epilepsy exhibit elevated plasma tHcy levels more frequently than the general population caused by polymorphisms in the MTHFR gene and chronic treatment with older antiepileptic drugs.
Lamotrigine can induce a profound change in sex steroid hormones. See Patient 10: Hair Loss
Additional tests required
Transferrin, Transferrin saturation, ferritin
25(OH)Vit D (I did not find the result)
Urinary loss of sodium, potassium, calcium and phosphate (possible tubular defect)
To evaluate the correctness of my metabolic interpretation of these seizures the patient should add to its diet
Vitamin B complex
Iron (if lacking)
Salted crackers (every 2 hours) to supply continuosly brain with glucose and sodium
Even a moderate improvement of symptoms could fortify the hypothesis and without any side effect