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Bouts of low blood pressure

Q: I turned epileptic in 1992, when I just crossed 30 years and from then till Nov. 1995, I had about 17-20 attacks of convulsions. I always had a premonition of the attack and would feel that something is crawling up from my navel onwards and my face used to get flushed. I was put on about 800 mg of Tegretol and 300 mg of Eptoin per day. The last attack I had was in Nov. 1995. As there were no attacks, the medicines were tapered and I stopped taking Tegretol complelety in July 2001 (first week). Slowly Eptoin was also tapered and in Dec 2001 I was taking only 50 mg of Eptoin per day. In the mean time, for last three years, I turned hypertensive and was taking Atpark 50 mg per day for sometime and then Nefetlol and then Amlodipine. All of a sudden, since Dec 2001, I started having bouts of low BP and the BP was most of the times not recordable and the pulse was also not felt. I had a thorough checkup of my heart at Apollo Hospital, Hyderabad. and was told that I am cardiologically fine. Still the problem contiuned. I turned positive on Tilt Table Test at CMC, Vellore and since then I am on Metprolale (Betaloc), initially 75 mg per day and subsequently 150 mg per day. I am still not free from the trouble. At CMC, Vellore, I was told that I am free from epilepsy but am suffering from neuro- cardiac syncope. I am at a cross road and do not know what to do, where to go? I shall be grateful for a right diagnosis and medicine.

A:The present problem of bouts of low blood pressure seems unrelated to the past history of epilepsy. You have been rightly put on Betaloc in view of positive Tilt test. In case the symptoms continue, your cardiologist may consider further evaluation (Holter, EPS etc.).

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