A Question of Health: Strange days

Every five to six weeks my husband has one of his days. It comes on suddenly, usually starting with an unsettled stomach. Then he will have a hot sweat, nausea and a bad taste in his mouth. He goes briefly into a trance-like state, often repeating requests for his "usual medicine". This is often followed by vomiting. The "turn" lasts for a couple of minutes, but may recur several times during the day. By the following day the symptoms have gone, but he is left feeling very tired. All the usual investigations have been tried, but no one can say what is causing the problem.

Every five to six weeks my husband has one of his days. It comes on suddenly, usually starting with an unsettled stomach. Then he will have a hot sweat, nausea and a bad taste in his mouth. He goes briefly into a trance-like state, often repeating requests for his "usual medicine". This is often followed by vomiting. The "turn" lasts for a couple of minutes, but may recur several times during the day. By the following day the symptoms have gone, but he is left feeling very tired. All the usual investigations have been tried, but no one can say what is causing the problem.

Your husband needs to see a specialist neurologist to get a proper diagnosis. His "turns" have many of the features of a type of epilepsy called complex partial seizures (also known as temporal lobe epilepsy). Complex partial seizures are different from the type of epilepsy that causes convulsions and loss of consciousness. A typical attack comes on without any warning. The first sign is often a funny feeling in the stomach, or a sensation of fear or unreality. This then quickly leads to odd behaviour, such chewing movements or repeating things in an almost automatic way. Your husband's questions about his "usual medicine" sound like this type of speech behaviour. Attacks usually only last for a couple of minutes, and it is not unusual to get long periods without any attacks at all. If the "usual investigations" did not include an EEG (an electrical tracing to record brain activity) and a brain scan (a CT or MRI scan), he needs to have these done. This type of seizure can usually be treated successfully with anti-epileptic drugs. Until the problem is diagnosed and solved, your husband should not be driving a car, and he should inform the DVLC about his problem. For more information about all types of epilepsy, you can phone the Epilepsy Action UK Helpline on 0808 800 5050.

SORE POINT

Our 12-year-old son had quite a bad cycle accident some months ago. He made a perfect recovery, except for developing a sore and weeping patch high on the inside of one thigh, which obstinately refuses to heal. A friend has now suggested putting him into a kilt, to allow air to get to the place without the friction of trousers. Our son, very reasonably, has misgivings about this. Nothing our doctor has tried seems to help.

Your son's sore and weeping patch is probably not healing because it is infected with some bacteria. As a first step, I would ask the doctor to take a microbiological swab from the weeping patch. It is important to take the swab from a moist area. Swabs from dry scabs may not pick up the culprit organism. If no bacteria are found, the laboratory should be asked to look for unusual organisms, as sometimes the standard method of processing the swabs misses odd infections. This may reveal why the skin is not healing. Once the cause of the problem is discovered, the solution will probably be some sort of antibiotic, which may need to be taken in tablet form for a couple of weeks. I would cover the area with a dry dressing, such as Melolin, that has a shiny covering on one side to stop it sticking to the skin. Change the dressing every day and make sure that your son wears clean trousers, to prevent the trousers from re-infecting the skin.

HAVE YOUR SAY

CG writes: "In your article on Parkinson's Disease you gave the e-mail address of the Parkinson Foundation. As you stated that many more people suffer from essential tremor, please could you mention the National Tremor Foundation's website: www.tremor.org.uk. It is a wonderfully supportive group and the meetings are such fun. The next AGM is in Bournemouth on 12 October. Soup is definitely not on the lunch menu."

Please send your questions and suggestions to A Question of Health, 'The Independent', Independent House, 191 Marsh Wall, London E14 9RS; fax 020-7005 2182 or e-mail to health@independent.co.uk. Dr Kavalier regrets that he is unable to respond personally to questions