instruction: hi doctor this is for my dad he has epilepsy and is now 52 years old last saturday he went on his normal routine of getting ready but did not know what happened and he walked out of the house without any clothes when we asked him if he was okay he said yes but after the whole episode when we asked him if he knew what he did he said no we do think that his epilepsy is triggered by less sleep and the only medication he takes is gabapentin we think that he is getting depressed because he has a loss of appetite loss of weight slowness in activity concentration problem and occasional mood swings his current neurologist does not do anything and all he does is keep doing a blood test each time
output: hi thank you for your question history of epilepsy and intermittent episodes of confusion with loss of memory of the episode amnesia is concerning for seizures for the workup of seizures he should get routine brain wave testing eg electroencephalogram or a long term eg monitoring to identify any abnormal brain discharges which can cause a seizure other things to look at it is head imaging like it head or mri brain if not done already as it is not uncommon for elderly patients to have blood collection around the brain subdural hematoma to present with altered awareness or confusion I agree with blood tests as an initial test to look for metabolic encephalopathy due to deranged blood electrolytes level and body metabolites such as bun blood urea nitrogen ammonia etc please do not hesitate to reply if you have any other questions or concerns