Latest from KCH

Department of Neurology King's College Hospital

Clinic Date: 10 February 2011 Denmark Hill

Dear Dr M
Eric Avebury,
26 Flodden Road, LONDON, SE5 9LH
I have just reviewed your patient Lord Avebury, who as you know had been seen in this clinic because of a non-specific episode of a fall associated with possible minor confusion and possible slight slurring of speech. EEG was unremarkable and showed some sharp transients over the temporal lobe which were not felt to be epileptiform in origin. He has had a 24 hour ECG and the heart rate dropped as low as 37 beats
per minute and was bradycardiac during the day as well as at night. Lord Avebury is on Bisoprolol 2.5 mg daily and when he saw Dr MA recently he was considering decreasing or even stopping this completely. In view of the bradycardia, I have asked Lord Avebury to reduce the Bisoprolol today to 1.25 mg daily. He is then due to see Dr MacCarthy next week who can make further adjustments as necessary.
His blood pressure is now better controlled at 122/54 mmHg.

I do not think that Lord Avebury would benefit from ongoing follow-up in this clinic but please do not hesitate to re-refer him should the need arise.
Yours sincerely

Dr V
Consultant Neurologist
-------------------------------------------------------

Bradycardia is a heartbeat slower than 50 beats/minute. I'm still taking the Bisoprolol and for the last week or so the rate has only dropped below 60 once