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What Causes Seizures Post Lap Band Surgery?
Question: daughter had the lap band post op almost 1 yr. now. She started having seizures, and had a low sugar episode was diagnosed with Hypoglycaemic? Seizures continued, now diagnosed with Epilepsy? She tends to have the seizures when she eats something with a lot of texture, or meats, such as a chicken leg?
MRI showed an infection on one side of her brain? I told her that some infections are caused by a low immune deficiency in your blood cells? I begged her to have an endoscopy to see if there are issues with her lap band? Her Lap Doctor only felt the outside of her stomach and told her everything was fine? I also begged her to have a blood test to check her cell counts. She wont listen to me! Can you advise her please?
MRI showed an infection on one side of her brain? I told her that some infections are caused by a low immune deficiency in your blood cells? I begged her to have an endoscopy to see if there are issues with her lap band? Her Lap Doctor only felt the outside of her stomach and told her everything was fine? I also begged her to have a blood test to check her cell counts. She wont listen to me! Can you advise her please?
Brief Answer:
Read below.
Detailed Answer:
I read your question carefully and I understand your concern.
Seizures can come from many different causes such as stroke, tumors, infections, traumatic injuries, metabolic abnormalities etc. In your daughter's case there are two main possibilities, the infection and a metabolic issue such as hypogyicemia episodes.
Regarding the possibility of seizures due to lap band surgery related hypoglycemia I wouldn't put it as the first hypothesis. It is true that some cases with hypoglycemia have been reported after such surgery but are rare, not as common as with other bariatric surgery types. So unless blood glucose levels have been measured and seizures have been documented to be related to low blood sugar, I do not think it likely, not when there is another factor such as the infection to look at.
So if the MRI has indeed shown an infection in her brain I would say it to be much more likely the cause for the seizures. If there is such an infection it is a very serious issue, an active brain infection is life threatening and if left untreated can lead to other disabling neurological deficits apart from the seizures. So it would require urgent admission and evaluation with spinal tap to determine the type of infection and respective treatment as well as EEG to see brain electrical activity.
Actually I am a little surprised the doctors haven't done that. In the absence of MRI report it makes me think that perhaps the infection has not been deemed active anymore, perhaps the remnant of a prior infection?....in that case then only medication for seizures according to seizure type and EEG findings is necessary.
I remain at your disposal for other questions.
Read below.
Detailed Answer:
I read your question carefully and I understand your concern.
Seizures can come from many different causes such as stroke, tumors, infections, traumatic injuries, metabolic abnormalities etc. In your daughter's case there are two main possibilities, the infection and a metabolic issue such as hypogyicemia episodes.
Regarding the possibility of seizures due to lap band surgery related hypoglycemia I wouldn't put it as the first hypothesis. It is true that some cases with hypoglycemia have been reported after such surgery but are rare, not as common as with other bariatric surgery types. So unless blood glucose levels have been measured and seizures have been documented to be related to low blood sugar, I do not think it likely, not when there is another factor such as the infection to look at.
So if the MRI has indeed shown an infection in her brain I would say it to be much more likely the cause for the seizures. If there is such an infection it is a very serious issue, an active brain infection is life threatening and if left untreated can lead to other disabling neurological deficits apart from the seizures. So it would require urgent admission and evaluation with spinal tap to determine the type of infection and respective treatment as well as EEG to see brain electrical activity.
Actually I am a little surprised the doctors haven't done that. In the absence of MRI report it makes me think that perhaps the infection has not been deemed active anymore, perhaps the remnant of a prior infection?....in that case then only medication for seizures according to seizure type and EEG findings is necessary.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Dr. Olsi Taka, Thank you for a very throughput answer! My daughter was put on antibiotics awhile back for that brain infection. But the seizures continued. The seizures have taken their toll on her, and thus she forgets things such as appts, and to ask for more medications!
She did give me proper authority, and release's in order to exchange information with Medical Doctor's/Clinical information, or make appts. of which I did with her regular Doctor. I wanted to ask her Doctor for a blood count on her white & red cells. I also wanted him to make another referral for a "Neurologist," since she missed her previous referral, and it has since expired. Do you think this is appropriate for her case? or should I/we be asking for an EEG, and spinal tap? This has affected our family big time! She is very afraid of it leading to a tumour in her brain, or worse case scenario, a cancerous tumour! Ironically her seizures had not began until after the lap band was inserted? The other factor is that she will not have an episode unless she consumes certain bulky foods? Which leads me to believe that the seizures must be related to her lap band somehow? This was also my reason for an endoscopy. I/we wanted to be sure that the lap band had not dislodged, or corroded, itself? In much appreciation for your feedback. Sincerely, Anxiously waiting for a reply, Mom
She did give me proper authority, and release's in order to exchange information with Medical Doctor's/Clinical information, or make appts. of which I did with her regular Doctor. I wanted to ask her Doctor for a blood count on her white & red cells. I also wanted him to make another referral for a "Neurologist," since she missed her previous referral, and it has since expired. Do you think this is appropriate for her case? or should I/we be asking for an EEG, and spinal tap? This has affected our family big time! She is very afraid of it leading to a tumour in her brain, or worse case scenario, a cancerous tumour! Ironically her seizures had not began until after the lap band was inserted? The other factor is that she will not have an episode unless she consumes certain bulky foods? Which leads me to believe that the seizures must be related to her lap band somehow? This was also my reason for an endoscopy. I/we wanted to be sure that the lap band had not dislodged, or corroded, itself? In much appreciation for your feedback. Sincerely, Anxiously waiting for a reply, Mom
Brief Answer:
Read below.
Detailed Answer:
Thank you for the additional information.
So it is not an acute infection. The MRI findings relate to remnants of the previous infection, sort of like a scar in the brain. It is common for that to be associated with seizures as this scarred areas where new abnormal connections are formed between brain cells, are prone to producing electrical discharges.
So in this case a spinal tap is not necessary, an EEG if not already done certainly is on the other hand. She certainly needs to be followed by a neurologist, epilepsy is a chronic condition so regular periodic appointments should be needed, but with proper antiepileptic medication many patients lead good quality lives, free of seizures.
As for the relationship in time with the lap band surgery....if you mean surgery causing infection I do not think that to be the case, shouldn't be any relation. As I said metabolic alterations such as hypoglycemia can be a cause of seizures, but that has to be documented by blood test around the seizure time. Otherwise in the absence of any such test to indicate such a cause, we can not ignore what is a fact and a known cause of seizures, the damage left by the infection.
Let me know if I can further assist you.
Read below.
Detailed Answer:
Thank you for the additional information.
So it is not an acute infection. The MRI findings relate to remnants of the previous infection, sort of like a scar in the brain. It is common for that to be associated with seizures as this scarred areas where new abnormal connections are formed between brain cells, are prone to producing electrical discharges.
So in this case a spinal tap is not necessary, an EEG if not already done certainly is on the other hand. She certainly needs to be followed by a neurologist, epilepsy is a chronic condition so regular periodic appointments should be needed, but with proper antiepileptic medication many patients lead good quality lives, free of seizures.
As for the relationship in time with the lap band surgery....if you mean surgery causing infection I do not think that to be the case, shouldn't be any relation. As I said metabolic alterations such as hypoglycemia can be a cause of seizures, but that has to be documented by blood test around the seizure time. Otherwise in the absence of any such test to indicate such a cause, we can not ignore what is a fact and a known cause of seizures, the damage left by the infection.
Let me know if I can further assist you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I just talked to my daughter and it turns out that her Doctor did have her get an EEG after all. She also told me that it was determined that her infection might have been caused by an ear infection that was left untreated, ad had travelled up into her brain. She continued to inform me that because she was still having the seizures, her Doctor referred her to be under the care of a "Neurologist." But as you know she did not keep her appt. and so now we have to ask for another appt/referral. I also wanted a blood test done on her blood counts to see if there might be an immune deficiency? Due to the weight loss surgery, she has not been eating properly.
Sincerely, Mom
Sincerely, Mom
Brief Answer:
Read below.
Detailed Answer:
I believe what your daughter tells you reinforces my previous opinion (perhaps you hadn't read it as your post came only seconds after mine, must have both submitted our posts at the same time), that it is the scarring from the infection which is the cause for the seizures.
As I said it is imperative that she sees a neurologists, even better if one with epilepsy as a subspecialty, in order to start treatment for her repeated seizures. There are many antiepileptics out there, choice depends on seizure type, EEG findings, considerations on potential side effects, harm to the offspring in young female patients etc, at times neurologists preferences play a role as well. Two common alternatives, especially in young females when there is a potential for pregnancy, would be levetiracetam or lamotrigine, but as I said that will be decided by neurologist based on all the data.
I hope to have been of help.
Read below.
Detailed Answer:
I believe what your daughter tells you reinforces my previous opinion (perhaps you hadn't read it as your post came only seconds after mine, must have both submitted our posts at the same time), that it is the scarring from the infection which is the cause for the seizures.
As I said it is imperative that she sees a neurologists, even better if one with epilepsy as a subspecialty, in order to start treatment for her repeated seizures. There are many antiepileptics out there, choice depends on seizure type, EEG findings, considerations on potential side effects, harm to the offspring in young female patients etc, at times neurologists preferences play a role as well. Two common alternatives, especially in young females when there is a potential for pregnancy, would be levetiracetam or lamotrigine, but as I said that will be decided by neurologist based on all the data.
I hope to have been of help.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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