Lengthy Unresponsive Episodes: Not sure why

Posted by nomsdicnadeen @nomsdicnadeen, Sep 15, 2021

My 92 yo mom has had numerous incidents of becoming completely “unresponsive to noxious stimuli” for up to 2 hours. Nobody has a clue why. Vitals are always stable. She does have a Parkinson’s diagnosis and I’m wondering if Lewy Body dementia… I’ve taken her to the ER and they often don’t believe that she was completely out if she wakes up before seen. Only once have they witnessed the episode and were shocked / admitted her, but had no diagnosis.

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Hello, and welcome to Mayo Connect, a community of people and caregivers living with a wide variety of diseases and conditions, who support each other along the way. We try to be informed medical consumers, and our own best advocates in our care. We are not medical professionals, so not able to provide medical advice. We can tell you what has worked for us (or not) and provide you with information and conversation about your questions.

I don't have direct knowledge of the unresponsive episodes you describe, but I remember how frightened my Grandad was the first time it happened to my Grandma - fortunately, they were living in a skilled nursing facility at the time, and the staff laid her down and elevated her feet, and she awoke - with no memory of the event. I was a busy new Mom at the time, so never did learn if there was a diagnosis.

Here is a related thread on Connect, it seems to suggest dehydration as a possible cause. https://connect.mayoclinic.org/discussion/parkinsons-unresponsive-episodes/
And a case study that suggests transient low blood pressure: https://clinicalmovementdisorders.biomedcentral.com/articles/10.1186/s40734-018-0068-4

Without moving your Mom, is it possible to check her blood pressure and do a "pinch test" to see if she is dehydrated when she goes into this state?
Sue

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@sueinmn

Hello, and welcome to Mayo Connect, a community of people and caregivers living with a wide variety of diseases and conditions, who support each other along the way. We try to be informed medical consumers, and our own best advocates in our care. We are not medical professionals, so not able to provide medical advice. We can tell you what has worked for us (or not) and provide you with information and conversation about your questions.

I don't have direct knowledge of the unresponsive episodes you describe, but I remember how frightened my Grandad was the first time it happened to my Grandma - fortunately, they were living in a skilled nursing facility at the time, and the staff laid her down and elevated her feet, and she awoke - with no memory of the event. I was a busy new Mom at the time, so never did learn if there was a diagnosis.

Here is a related thread on Connect, it seems to suggest dehydration as a possible cause. https://connect.mayoclinic.org/discussion/parkinsons-unresponsive-episodes/
And a case study that suggests transient low blood pressure: https://clinicalmovementdisorders.biomedcentral.com/articles/10.1186/s40734-018-0068-4

Without moving your Mom, is it possible to check her blood pressure and do a "pinch test" to see if she is dehydrated when she goes into this state?
Sue

Jump to this post

Hi Sue! My mom’s bp is always normal when this happens Along with her other vitals. IV fluids usually do help, but we have been making sure she is very hydrated lately drinking a full 32oz mug of electrolyte mix every day. She will not respond to any external painful stimuli. It is very scary, but docs have just said to let her go through it and wake up since they have no idea what is going on.

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@nomsdicnadeen

Hi Sue! My mom’s bp is always normal when this happens Along with her other vitals. IV fluids usually do help, but we have been making sure she is very hydrated lately drinking a full 32oz mug of electrolyte mix every day. She will not respond to any external painful stimuli. It is very scary, but docs have just said to let her go through it and wake up since they have no idea what is going on.

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I would find that scary too! I think this sounds a little like catatonia, and am wondering if you can talk to her Parkinson's provider about whether this is characteristic of some people with the condition. I know symptoms can differ widely from one person to another.
Sue

REPLY
@nomsdicnadeen

Hi Sue! My mom’s bp is always normal when this happens Along with her other vitals. IV fluids usually do help, but we have been making sure she is very hydrated lately drinking a full 32oz mug of electrolyte mix every day. She will not respond to any external painful stimuli. It is very scary, but docs have just said to let her go through it and wake up since they have no idea what is going on.

Jump to this post

Hello @nomsdicnadeen

Last month you were asking about your mom's unresponsive episodes. How is she doing? Any more episodes?

I would enjoy hearing from you when you have an opportunity.

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@nomsdicnadeen

I cannot be of help to you. I understand what you are going through though.

I along with my husband were main caregiver of my mama for about two years.

In my youth Mama would sometimes sleep with her blue-gray eyes open. It was a bit scary… but she usually awakened with a good shake.

It was even scarier with her with her paler blue-gray eyes in her last years. She passed away August of last year at age 92. During her episodes… Her breathing would go shallow, but her bp, heart rate and oxygen level all fine. She did have Type 2 Mobitz.. a heart condition.. bradycardia (heart rate of 40 or below for her for a few minutes at a time). She also had several strokes that caused dementia.

These episodes… might be called “zoning out”.. they became more frequent as she aged. It got to where you could not awaken her. She would just all of a sudden awaken and start talking. No doctors knew what to call the “zoning out”or what caused them. They noticed them in the nursing home she was in rehab in for another stroke.

So caused by dementia or something else?? Mama was probably in her late 30s when I noticed them. She was in her late 50s when she started having Ischemic attacks. In her early 60s with first mild stroke.

Always after these “zoning out” episodes mama was herself. She would say she was napping. While staying with me she would say I was dreaming I was talking to your daddy… or grandma or grandpa. Sometimes I wondered if she visited with them. It has been many years since all have died.

Over the years often after these “zone outs” she would tell premonitions of someone being ill, an accident happening or someone dying. A few years back she insisted I find her cousin's phone number. She said she needed to talk with Annie Ruth... she doesn't have much time and we have a lot to say to each other. They were first cousins, playmates and best friends in their youth. Thankfully Facebook exist and I found her daughter and a phone number. They had two long, wonderful phone calls before her cousin's death.

All I can say is weird things happen and we may never find out the whys. Doctors “practice” medicine because they don't know it all and never will. Mysteries will always be.

Being a caregiver was the hardest most rewarding thing that I have ever done.

Cherish this time with your mother.

ZeeGee

REPLY

Just a suggestion, use your phone to video part of the episode where you try to wake your mom and then show that to the doctor, if you have occasion to seek treatment again. It's harder to dismiss if there is visual evidence. Good luck.

REPLY
@sueinmn

Hello, and welcome to Mayo Connect, a community of people and caregivers living with a wide variety of diseases and conditions, who support each other along the way. We try to be informed medical consumers, and our own best advocates in our care. We are not medical professionals, so not able to provide medical advice. We can tell you what has worked for us (or not) and provide you with information and conversation about your questions.

I don't have direct knowledge of the unresponsive episodes you describe, but I remember how frightened my Grandad was the first time it happened to my Grandma - fortunately, they were living in a skilled nursing facility at the time, and the staff laid her down and elevated her feet, and she awoke - with no memory of the event. I was a busy new Mom at the time, so never did learn if there was a diagnosis.

Here is a related thread on Connect, it seems to suggest dehydration as a possible cause. https://connect.mayoclinic.org/discussion/parkinsons-unresponsive-episodes/
And a case study that suggests transient low blood pressure: https://clinicalmovementdisorders.biomedcentral.com/articles/10.1186/s40734-018-0068-4

Without moving your Mom, is it possible to check her blood pressure and do a "pinch test" to see if she is dehydrated when she goes into this state?
Sue

Jump to this post

I have Parkinson’s for over 27 years. Recently in December of 2022 I was admitted to the hospital for a stroke where I experienced for the first time the unresponsive episodes mentioned. All times my vitals were fine I just could not respond even when the normal pinch and rubs were applied by medical team.
Most recently I had another surgery where the same thing happened. Each occurrence lasts anywhere from 6 to 30 minutes and then I come out of it. I’ve had all types off tests and they all come up negative.
It’s a mystery.

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