Curious if others caring for loved ones have seen these things? My MIL has passout episodes after extemely "rough" days

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This is going to be long so please bear with me. My MIL is 79 soon to be 80. She had her 1st stroke in 2008, 2nd 2010. Since then no major strokes but 50 + ( doctors dont count them now) TIA's. She was not diagnosed with Dementia until Late last year. We noticed "off" behaviour starting after the 2nd stroke but at 1st attributed it to the stroke, we would have maybe 1 bad day or off day every few monthes. it quickly became once a month, to were we are now maybe 2 good days a week. She is very, very good at hiding it. Took her flipping out on nursing staff to get her diagnosed. They called in a geriatric psychiatrist and they rate her at Moderate to severe.
My question is this. Since the strange behaviour started in 2-10 or so she has passout episodes the doctors cant seem to9 figure out. BP is usually great, she will just get unresponsive stare into space, tongue comes out them she passes out. these episodes can last 20 seconds to the longest at 30 min. Wakes up, nauseaus but alert. During these "Spells" her BP will jump all over the place from 130/70 to 70/40 to 200/100 , wakes up then it tends to stay great 120/70.Then weak for several days no worse no better. These hit roughly every 3 weeks. If we see it starting and lay her down flat we seem to be able to keep her from going all the way out and she recovers much faster. The only precursers we have to the "spell" is that she will have a very bad day with her BP bouncing around abit a day or so before it happens.
Has anybody else seen anything like this?

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The only explaination they have come up with on her BP is basically one of the strokes or TIA's have made it impossible for her body to control her BP. She is on several medications to bring it up and down.
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Worried, thanks for the explanations and updates. From what you wrote, it seems to turn on the BP fluctuation; are there any clues as to why it fluctuates as it does? It seems that the cause might be finding out more about the BP fluctuation.
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Garden artist.. yep all have looked at her, and yes we chart everything, I mean everything. Cardio Doc has run every test imaginable heart is great, Neuro says Not seizures, she's had 2 strokes 50 + TIA's not much more we can do, urologist says everything working fine. They have all run stress tests, checked blood, tilt test, ect. We check her PT/INR every 10 days, run general bloodwork every 2 -3 weeks, check urine at least once a month ( Have a great nurse that comes out anytime we need tests) The only common denominator is a bad day, BP jumping about then yep gonna have one. As stated they now treat it as simply one of those unexplainable things. We literally have to fight with the hospital to keep her long enough to recover when she actually goes thru a complete episode. Kind of hard to take her home if she can't raise her head or sit up without going out. We have actually been discharged on the way to the car to have it happen then straight back to ER.
At this point she is watched by us 24/7. Never left alone in the house, Not to stand up for any reason unless someone is in the room with her. This works for the most part unless she decides to roam in the middle of the night. Bed alarms dont work with her, baby moniter doesnt work she becomes super ninja then either forgets it or flat out lies. I guess most of the question is could it be related to the dementia?
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Whoops. I didn't see Babalou's post before I wrote mine; just looked up "vaso-vagal" and see that it's a form of syncope episode, but apparently more specific.
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My first thought also would have been a type of seizure, or something directly related to the unstable blood pressure and "rough days".

What doctors have run tests? Cardio? Neurologist? Vascular?

I don't necessary suspect this might be the situation but mention it because it hasn't been discussed and because we've experienced it. It's called syncope, or syncope episodes.

It was raised as an issue after my father passed out at church, and again after he apparently passed out, fell and broke his leg.

Cardiologist, neurologist, and I believe others I don't remember now were consulted. Apparently syncope episodes don't have specific, identifiable etiologies, and after all the testing, the conclusion was that a cause for passing out couldn't be identified.

There's another remote possibility and that's an inner ear imbalance, which could cause passing out (as it did with me) but I don't know whether or not it would be preceded by blank staring. Mine eventually was traced to sinus issues.

This isn't a medical suggestion, but perhaps on the days that appear to begin roughly, you could intervene with some type of calming activity...play CDs of her favorite music, look through family photographs...whatever could calm her and redirect that anxiety and frustration or whatever causes the rough days.

Since they happen roughly every 3 weeks, have you kept track of the specific days, and spent more time with her a few days before you anticipate they might start, observing everything that she does, eats, and drinks, to begin charting possible contributory factors?
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Has she been worked up for vaso-vagal?
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Brain injury which includes strokes can result in epilepsy and other seizure disorders.
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Worried, has she been evaluated for a seizure disorder, specifically petit mal also called absence seizures? The comment about nausea especially made me think of epilepsy.
Definition: A petit mal seizure is the term given to a staring spell. It is most commonly called an absence seizure. It is a brief (usually less than 15 seconds) disturbance of brain function due to abnormal electrical activity in the brain.
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As I said these "spells' Started in 2010 after her 2nd stroke. Until the last year or so we were in the ER roughly every 3 weeks until we, not the doctors figured out how to watch for them and prevent most of them. Now when they happen if she does not go completely out she simply rests in bed for a day or 2 with the Doctors approval. As they say they have run every test imaginable it is what it is and she can be at home comfortable or lay in bed at the hospital miserable.
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Yes, yes Doctors have checked EVERYTHING,lol.
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