1. U3A SCIENCE GROUP 15TH JUNE 2018
FITS, FAINTS AND FALLS
-a discussion
Dr Marion Overton

2. Why the title?
FAINTS affect ¼ to ½ adult population at some time in their lives
FITS: commonest cause affects 1% of the population
FALLS in the over 65s per year 30%

3. FAINTS Temporary Spontaneous Loss of consciousness
With complete recovery

4. Causes of Faints Psychogenic Temporary lack of oxygen to the brain
a) pooling of blood in the extremities
b) heart problems –arrhythmias/ coronary artery spasm
c) reduction of oxygen in the blood

5. How can we know what the cause is?
History, including witness account
before the event
during it
during the recovery period
Personal/family history of heart disease
Medication

6. Referral to hospital? Loss of consciousness during exertion
Known heart problem
Family death from heart disease under age 40
Over 65 with no prodromal symptoms
NO DRIVING until you have been seen!

7. FITS –a tendency to Spontaneous Intermittent
Abnormal electrical activity, in part of the brain, manifest as
seizures

8. Features of Epilepsy History and witness account
Before –change in mood/behaviour -identifiable precipitants aura
During –occurs when lying down/asleep –bitten tongue –tonic/clonic phase incontinence
After the event –amnesia, confusion, sleep

9. Types of Epilepsy “Not everything that twitches is Epilepsy;
Not all Epilepsy twitches”
1) Grand mal –generalised, LOC, tonic/clonic
2) Complex Partial –starts in one area; may become generalised
3) Petit Mal/Absence –may stop talking, pause, then carry on where left off
4) Myoclonic –muscle suddenly contracts
5) Atonic –muscle suddenly relaxes

10. Causes of seizures
Epilepsy may be caused by genetic mutations or abnormalities eg tuberous sclerosis
Seizures may also be caused by
Infections –meningitis, HIV, syphilis
Tumours
Strokes (bleeds into or clots in the brain)
Subdural or extradural haemorrhages
Metabolic –low sodium/glucose; high glucose/calcium
Alcohol or drug withdrawal

11. Why does a diagnosis of Epilepsy matter?
Stigma
Implications for employment, insurance and driving (one year ban after any part of a seizure or change in medication)
Side effects of medication, including on unborn child
Sudden death in epilepsy

12. FALLS Interaction with our surroundings
Illnesses at the time of the fall,
Both acute eg faints
And chronic eg epilepsy

13. Prevention of Falls Improve balance, coordination and muscle strength
Attention to foot problems (and footwear) +other joints
Correct poor vision and lighting
Vitamin D supplements
Medication review
Safety in the home and garden
BE SENSIBLE!