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Your Good Health: Underlying cause of a seizure needs to be further investigated

Most experts in epilepsy want to see a high-resolution MRI scan to look for any brain lesions that might lead to seizures.
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Dr. Keith Roach

Dear Dr. Roach: I have been a registered nurse for 55 years. I’m writing in about my 42-year-old son who recently suffered a focal seizure while driving. He has a history of neck pain, possibly caused by his history of skateboarding on pipes during his early teen years and drumming in a band.

My daughter (also a registered nurse) read an article stating that neck nerve compression could cause a seizure. Do you have any knowledge regarding this? My son has no history of seizures, and a scan in the ER came out negative for any brain abnormalities.

L.C.

Seizures have many different causes. Anyone can have a seizure under the right conditions of stress, but epilepsy is a condition of recurrent and unprovoked seizures.

I found quite a few articles in both the lay and medical literature stating that nerve compression in the neck can cause seizures, but I am unconvinced that this is a likely cause. The peer-reviewed papers I read included case reports of people who developed focal seizures after an injury, but the injury didn’t have to be in the neck; the seizures were reported even with burn injuries to the hand.

Most of the reported cases had other risks for seizures, including having a family history of epilepsy. Many cases of epilepsy are from an unknown cause. I suspect that a person often attributes epilepsy to something that is actually unrelated, but it’s possible that there is a connection between peripheral nerve injuries and seizures, which hasn’t been well-elucidated.

It is abundantly clear that brain and spinal cord injury, whether from trauma, stroke or cancer, can be a seizure focus and lead to epilepsy. In the ER, a CT scan is often done, but most experts in epilepsy want to see a high-resolution MRI scan to look for any brain lesions that might lead to seizures.

Dear Dr. Roach: Your recent column on colds and flus made me realize that you’re the person I’ve been looking for regarding research. I’m 82 years old, and since I was in high school, I have sneezed daily. I never get a cold; although five years ago, I had pneumonia (minus cold symptoms).

Now, to be completely honest, when I came home from a cruise at the end of August with seven family members, all of whom had colds during the cruise, I experienced minimal symptoms of a cold. I haven’t gone a day without sneezing since then. My sneezes are hardy, usually two or three at a time. I generally sneeze at least twice a day.

So, Dr. Roach, is there a relationship between my daily sneezing and not catching a cold?

P.H.

Sneezing is a protective reflex to keep irritants out of your nose. In theory, frequent sneezing might somewhat reduce your exposure to germs.

In reality, I doubt that there is significant protection. Bacteria and viruses are very small and don’t trigger a sneeze response; plus, they can be infectious at very low levels.

Most older adults don’t get colds because they are seldom exposed to people with colds. The fact that you got a cold while you were with infected family members tells us you aren’t completely immune. Your sneezes might be allergic or nonallergic, and if they aren’t particularly bothering you, you don’t need to treat them. Although there are effective treatments, sneezing twice a day is in the range I’d call normal.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected]