You don't just pass out for no reason!

September 18, 2006 6:28 AM

The other night my brother suddenly passed out for a split second while we were in the car. It's very strange, I'm pretty worried about him, and of course there's

Here's the full story: We were driving home from a dinner/movie night, my brother was sitting in the middle of the back seat next to his girlfriend and our cousin. We were discussing wisdom tooth removal experiences. All of a sudden, my brother says "I don't feel good". I look at him in the rearview mirror (thinking he's about to puke) and see his head roll back and hear him kind of gurgling (not quite choking on his saliva). I asked if he was okay, his girlfriend tells me he's just playing. Then he says "Don't touch me", followed a few seconds later by "What just happened?". We finally figured out that he had passed out for a second or two and took a few more seconds to get his bearings (hence the "Don't touch me"). He was fine for the rest of the ride home.
So my question is: what could have caused this? To answer some questions ahead of time, he had eaten a full meal before the move, we had all been sitting in the car for about 15 minutes so there was no reason for a sudden change in blood pressure, he has no history of this happening before (although he passed out once watching my grandpa have fluid drained from his knee). He said he hadn't had any recent head injuries, and I checked his pupils when we got home (equal and properly dilated). As a side note, I don't live with him, so for all I know this could have happened before (though he claims it doesn't). He is a healthy 19 year old who doesn't use drugs or drink. I just don't understand it.
I know you are not doctors, but if anyone has any ideas, clues or experiences, I'd apprecate it. I'm worried about the kid.

posted by denimflavored to Health & Fitness (22 answers total)

Was the discussion gory? Some of us are just a bit sensitive to that sort of stuff.
posted by handee at 6:30 AM on September 18, 2006

Epilepsy? I recommend seeing a doctor.
posted by exogenous at 6:33 AM on September 18, 2006

From your description, it sounds like a (mild, thankfully) seizure. There's many, many things that could have caused it ranging from the relatively benign -- food allergies -- to far worse.

He needs to see a doctor immediately -- don't mess around!
posted by jacobian at 6:41 AM on September 18, 2006

It could be nothing, but it also fits the description of some kinds of epileptic seizures. The best course would be to start with his regular physician, who will check out the possibilities, and most likely refer him to a neurologist if epilepsy is suspected.

(And encourage him to call for an appointment today. Imagine if this had happened when he was behind the wheel. Epilepsy is controllable in most cases, but it's a serious condition that warrants active treatment.
posted by j-dawg at 6:42 AM on September 18, 2006

My father was passing out for no reason until he found out he needed a pacemaker. I know your brother is very young compared to my father but young people have been known to have heart problems. Any time someone passes out it is a good idea to see a doctor ASAP.
posted by JJ86 at 6:43 AM on September 18, 2006

It does sound like an epiliptic seizure. Definitely see a doctor right away.
posted by caddis at 6:43 AM on September 18, 2006

Obviously I'd see a doctor, WHY ARE YOU STILL READING THIS?! etc, but the same thing has occasionally happened to my father and a couple of other family members.

It happened to my dad at the movies after a big meal (actually it happened during the scene in The Piano where a woman's fingers or hand get cut off). The doctor said that the shock/grossness of the film made blood rush to his skin and extremities, and as he had just eaten, blood was already concentrated in his digestive system to process the meal. The combination of factors caused enough of a blood pressure drop to make him pass out. Other family members have had very similar experiences. I wouldn't be surprised if something similar happened to your brother.
posted by crabintheocean at 6:50 AM on September 18, 2006

It sounds like he got skeeved out by the wisdom tooth discussion and fainted.

I've seen people faint before, and this description is pretty similar.
posted by bshort at 6:51 AM on September 18, 2006

Short of an absence seizure it could well have been something a lot simpler. People pass out for a variety of reasons. The nausea (I'm gonna puke) could have been from dizziness. There may have been something in his positioning that constricted blood flow. It is less likely this directly constricted blood flow to his brain, but it could have been indirect such as not allowing blood flow out of his legs. Hypotension, in other words. Then there is anemia, a sudden drop in blood sugar, various (many not so serious) diseases can cause vertigo. Or if he has been on a quickie diet recently. A bad reaction to over the counter meds (generally histamine flux will pool the blood and cause a drop in pressure). In other words, it can be a lot of things. I wouldn't freak your brother out with starting the list with epilepsy.
I recommend a general check-up, look at what his hematocrit is and his blood sugar. Then he can tell his doctor about this.
posted by dances_with_sneetches at 6:51 AM on September 18, 2006

Could be a number of things--including possibly a seizure--and should get worked up. More common is probably what we call a vasovagal reaction or vasovagal syncope, where someone has a reaction to some strong experience--seeing blood, hearing about wisdom tooth extraction, fear, etc--causing lightheadedness and sometimes briefly passing out.

It would be pretty uncommon for a healthy 19 year-old to start having seizures if he never had them before. A migraine might also fit the symptoms, so could an arrhythmia, or even just too tight of a necktie.
posted by gramcracker at 7:19 AM on September 18, 2006

this happened to me recently. i had just eaten dinner with friends. we were sitting around the table talking, and my sister-in-law was regaling us with tales of giving birth. i was quite fascinated & asked her to go on. then i started feeling woozy (the mucus plug!). i've fainted before & knew the signs. clammy, nauseous. i laid down on the floor & passed out for a second. then got up and was fine.

i've also fainted while giving blood (won't ever try that again!). and once i fell face-first & broke my nose. i got sent to the hospital, and they told me it was the aforementioned vasovagal syncope. so i guess it means that some people just faint. swoon!
posted by apostrophe at 7:48 AM on September 18, 2006

The advice from people here is well meaning, but he needs to go see a doctor. No one here has examined him: ergo no-one is capable of making a medical judgement as to his fitness.

Without wishing to sound melodramatic,even if this is nothing urgent now it's important that his physician has this stuff on record, so if his condition worsens or your brother is in no position to argue his case in the future, the medics treating him have his history on record: this often helps in diagnoses.
posted by lalochezia at 7:55 AM on September 18, 2006

Response by poster: I agree with everyone that he should see a doctor. However, my parents don't seem to think so. I was hoping to get a little ammo to convince them he should, and everyone is helping. Thank you.
I thought it may have been a small seizure, but I am by no means an expert. I included the part about the wisdom teeth because I figured it may have been related, but he is by no means weak stomached. He and our cousin and I regularly have gross each other out type discussions, so I don't think that was it.
crabintheocean - that sounds like a reasonable explanation. I'll look into that a little more and ask him about it.
sneetches - he didn't say he was going to puke, just that he didn't feel well. I figured he was going to, but he didn't mention nausea.
posted by denimflavored at 8:24 AM on September 18, 2006

My father also started experiencing odd blackouts in the last few years. It turns out he has an abnormal arrangement of blood vessels leading to his brain, and even small changes in blood pressure (standing up, etc) cause him migraines and blackouts. Specifically his diagnosis was 'complex migraines'.

My point is that there are a hundred things that they tested for before this diagnosis was made. Some of these things were serious, and some not so serious. All of them, though, should be diagnosed and treated by a competent professional.

Get thee to the doctors' office.
posted by WinnipegDragon at 9:22 AM on September 18, 2006

Just to reiterate what a lot of people are saying, sounds like when my boyfriend has petit mal seizures.
posted by wuzandfuzz at 9:44 AM on September 18, 2006

IANAD, but this sounds less like an epileptic seizure and almost exactly like every single case of passing out that I've seen. Petit mal (absence) seizures, in particular, generally do not present with limpness. I like crabintheocean's theory, but do think that your brother should see a doctor to be on the safe side.
posted by Plutor at 10:57 AM on September 18, 2006

Another vote for the wisdom tooth gore. Some of us with shall we say "weaker" constitutions pass out merely at descriptions of medical procedures. In my life I have passed out in a college health class during a discussion of prostate cancer, passed out looking at an MRI of my back while the doc described a surgery, passed out in a dentists office looking at an X-ray and having a root canal described to me.
posted by vito90 at 11:53 AM on September 18, 2006

Echoing others... my brother has petite mal epilepsy and that sounds exactly like what happens to him. Your brother should see a neurologist before it happens again (say, while he's driving.)
posted by chickletworks at 12:05 PM on September 18, 2006

just for the record, even if it was a seizure, they won't diagnose epilepsy until he's had a few seizures that are unexplained by other causes, and the way they will try to diagnose it will be to put him under surveillance and try to induce seizures, and then the way they will treat it is to throw various not-well-understood pharmaceuticals at it and see if he starts having fewer seizures. Which is all to say, your parents may have the right idea, really.

(This is coming from someone diagnosed with epilepsy at 13 who's gone through a lot of different opinions & experiences wrt neurology. if a doc visit will make you feel better, do it, but don't imagine they have it all figured out. they really don't. still, I shouldn't let my bias get in the way of the fact that it's possible it's due to one of the things they do have figured out, like a tumor that would show up on an MRI or whatever, so for that reason it wouldn't hurt to get a check up, to be safe...)
posted by mdn at 5:27 PM on September 18, 2006

I, too, think that this might have been an epileptic seizure, though I think it is far from certain. I think he should be checked out by a doc.

I am a neurologist and an epilepsy specialist, if that matters to you.
posted by ikkyu2 at 10:47 PM on September 18, 2006

I've had similar experiences - they were a combo of a panic attack and low iron (which made me a bit weak). I hope your brother is OK!
posted by divabat at 1:45 PM on September 19, 2006

Just to clarify, what happened to my dad (and other family members from time to time, it seems to be in our genes) was at least in part the 'vasovagal reaction' other people have talked about.
posted by crabintheocean at 4:17 PM on September 19, 2006