Monday, January 31, 2011

Medical Mondays: Seize And Desist


Welcome to today's Medical Monday! Our question today is from Stephanie, who asks:

"What kind of complication from epilepsy could land someone in the hospital?"

First, let's do a quick overview of epilepsy.
Epilepsy occurs when neurons in the higher levels of the brain fire abnormally.
There are generally two types of seizures in adults.

Partial seizures occur in only a part of the brain, usually in one hemisphere.
  • In Simple Partial Seizures, the person is usually aware of what's happening and can have symptoms such as a jerking limb, smelling something strange, belly discomfort, or fear.
  • In Complex Partial Seizures, consciousness is altered. They may exhibit staring or repetitive movements such lip-smacking and chewing. They do not remember the seizure.
Generalized seizures occur in both hemispheres of the brain, and consciousness is always impaired.
  • Grand mal (tonic-clonic) are the seizures we often see in movies or stories. The person will start off stiff, followed by jerking of the entire body.
  • In Petit mal or absence seizures, the person doesn't jerk or go stiff, but instead stares straight ahead.
After seizures, especially generalized or complex partial seizures, people often suffer from a post-ictal (post-seizure) state, with symptoms of sleepiness, confusion, nausea, or headache.

Now, what would land a person with epilepsy in the hospital? I'll give Stephanie a selection of possibilities.
  • Injury. People with epilepsy have a higher risk of injury from falls, motor vehicle accidents, and drowning. For a hospitalization, it should be a pretty serious injury. A drowning, major accident with severe head injury or multiple body injuries (broken bones that require surgery), would buy a hospitalization.
  • Psychosocial Issues. Patients are also at higher risk for depression, anxiety, and have a three-time higher risk of suicide. Severe depression or a suicide attempt would do here.
  • Drug side effect. Commonly used anti-epileptic medications such as carbamazepine, oxcarbamazepine, phenytoin, and lamotrigine can rarely cause life threatening skin reactions (Stevens-Johnsons and toxic epidermal necrolysis (TEN)) which can land someone in hospital ward, or if very severe, a burn unit for care because of the high probability of death.
  • Status Epilepticus. This is an unrelenting seizure that last for longer than 5-10 minutes, or recurrent seizure that doesn't give the person a chance to return to baseline from the post-ictal states. Causes are usually stopping anti-epileptic meds, heavy drinking or withdrawal from alcohol, prior head injury or brain damage, metabolic disturbances (abnormal electrolytes, extremely low blood sugar), medications (certain antibiotics, tricyclic antidepressants).
Hope this helps!

Please keep in mind this post is for writing purposes only and is not to be construed as medical advice (see sidebar disclaimer).

If you've got a fictional medical question, let me know! Post below or email me at
All I ask is that you become a follower and post a link on your blog when I post your answer.
Also, don't forget to check out Mental Health Mondays at Laura's Blog and Sarah Fine's The Strangest Situation!

Oh, and last shout-out: Shelli is having an amazing Pay-It-Forward Pitch contest. I'd like to thank my English teacher Mrs. Brown from RPCS who got me to write my first fantastical short story way back when! You guys should check it out, it's a great opportunity!

58 comments:

Vicki Rocho said...

Fascinating as always!

Renae said...

Love your Medical Mondays! Thanks again for another amazing post!

Laura Pauling said...

And people can end up hospitalized if their seizures last too long or are happening repeatedly. Great post!

Stina Lindenblatt said...

I love medical Mondays.

I used to think, as a kid, that I suffered from the petite mal ones because I would suddenly, without reason, feel like I had been pulled part way out of my body and could only stare while I fought back to be "whole" again. Never figured out what that is or if it's normal (still happens), but I did realize it wasn't a seizure. :D

welcome to my world of poetry said...

Being an Epilitic for well on thirty years I found this most interesting, some is very true other facts not so.
When I was daignosed with the illness I said staight from the start that Epilepsy lives with me and not me live with IT. I think it is all how you think about the illness and what kind of epilepsy you have, whether it is heraditry, or caused at birth, head injury and many more factors what has caused it.
There are side effects to the medication for instance Epanutin caused me to have liver functioning problems, and since coming off of the drug my liver is now healthy. I do get an awareness if a seizure is about.......a smell of onions.....why I don't know. Stress is a common factor and if one can stay relaxed and take life as it comes then all the better.
As for sucicide tendancies I don't agree with that, it all depends on how one looks at life whether you are epiletic or not.
I go where I like, travel from the UK to the States by plane, have travelled to Spain as my son lives there with no ill effect.
Thank you for writing about this but I as a sufferer don't agree with all of it.

Yvonne.

salarsenッ said...

This gave great insight. Thanks!

Sarah said...

You really have a gift for condensing massive amounts of info into brief, useful bites, Lydia! Thanks!

Magan said...

Let's get the facts straight here...before you write these posts do you consult with some other physicians Doctor House style and then give us the answers? Because that would be AWESOME.

Kelly said...

My daughter has epilepsy, and seeing your child have a seizure (grand mal, complex partial) is such a horrific experience. Thankfully she has been seizure free for 2 1/2 years and off her meds.
I appreciate you focusing on epilepsy so others can understand it better! (I have an infant have a febrile seizure, which you know is different than being diagnosed with epilepsy, in my middle grade novel).

Angela Felsted said...

Very interesting and helpful.

Jennee said...

Once again, you make medical stuff sound so easy! Very interesting.

E.J. Wesley said...

Fascinating stuff, Lydia! I mostly write YA material, and I've dabbled with the idea of using epilepsy in a story (mostly because of the video game warnings).

EJ

Carol Kilgore said...

You score a goal with this post. It's filled with a lot of really usable information for us mystery types :)
You made my Monday!

Justine Dell said...

My brother has this, and it can be SCARY!

~JD

B.E. Sanderson said...

Another excellent Medical Monday. Thanks, Lydia. =o)

Roland D. Yeomans said...

Thanks so much for the medical insights. You are very generous to do this for your blog friends. Have a great new week and 25 hours to each day for you to get an extra hour of sleep! LOL. Roland

Jess said...

Seizures are definitely scary, but the more knowledge you have about something like this, the better. Thanks for the informative post!

Kerri C at CK Farm said...

I had a dog that had epilepsy. One time I took her to the groomers, she laid down and had a seizure. They thought I was nuts when I said "give her a minute please she is having a seizure, don't worry it only lasts a minute and she will sleep all day." Sure enough they groomed her, put her in a crate and she slept until I picked her up.

Liza said...

I always learn here.

Old Kitty said...

My poor kitty, Tim, had epilepsy. It's very frightening at first but manageable throughout his life. Poor thing. The seizures were awful. Otherwise he was brilliant!! Very hyper, very loving. Take care
x

Clarissa Draper said...

One character in my book has Janz. An epilepsy disorder so I've had to do a lot of research. I found it fascinating along with this blog post.

Bryan Russell (Ink) said...

Great stuff. My mom's actually a nurse in an epilepsy unit, and I thought I should just mention that people are often admitted for observation and testing. They get hooked up so that all their seizures are recorded and the doctors can try and figure out what they can do for treatment, if anything.

Best,
Bryan

Munk said...

Interesting reading.

Paul S said...

My Mondays wouldn't be the same without your medical posts.
Have a nice week Lydia.

Deb Salisbury said...

Years ago, a coworker with epilepsy drowned in the bathtub from a seizure.

Hmm. I wonder if giving my MC epilepsy would perk up my WIP. Things are too easy for him now.

Lydia K said...

Yvonne, thank you so much for your helpful insights into your personal journey with epilepsy.
I wish I could write a very long post with the deeper intricacies of epilepsy because in reality, every single person who suffers with epilepsy is unique, as are their symptoms, treatments, and how they deal with it. Everyone is completely different.

I did not mean to write that all epilepsy sufferers experience depression and suicidal tendencies, but that they are at risk for it. It may never be an issue for many, like yourself.

Thanks again for your input. It is valuable and I very much appreciate it!

Lydia K said...

Hey Magan!
I occasionally consult with other doctors for these questions, but for the most part I answer them myself. The great thing about my profession is we have access to a ton of current, evidence-based information on a ton of topics.

So basically, I answer the questions and do my own research to make sure the answers are as accurate as possible.

Great question!

Alex J. Cavanaugh said...

Good information for everyone, as epilepsy is often misunderstood.

Chris Phillips said...

I had to get an EEG once to check for petit mal seizures, but it came back negative. Then they gave me an iq test. I got 57 pts! Booyah!

Meredith said...

So interesting! Thanks so much for the knowledge.

Olga said...

I love the way you present information that makes even the most difficult things seem understandable. I've read it with great interest.

Sarah said...

Great post! I just finished reading a book where one of the characters suffered from epilepsy. It talked about how misunderstood the condition was in Victorian times. Interesting stuff.

The Golden Eagle said...

Thank you for another informative post!

Nas Dean said...

Hi Lidia,

I love your Medical Mondays! Thanks again for another amazing post!

Lisa Gail Green said...

I had a roommate in college that didn't tell me she had epilepsy and had a grand mal seizure in the middle of the night. That was quite an experience let me tell you! I'll certainly never forget it.

Talli Roland said...

Great Medical Mondays, Lydia!

Colene Murphy said...

Interesting info!! I have a friend with epilepsy. She is definitely a strong woman to have to deal with that...wow.

Terri Tiffany said...

You get my brain moving with scenerios just reading this.

Karen Lange said...

Thanks for the info. I know where to come when I need something for my book! :)

Heather said...

Seizures can be a scary thing, and an interesting element to add into a novel. You've given me an idea, thank you!

Ann said...

Great information as usual. Thank you for an easy to understand explanation.

Paul C said...

It's a traumatic illness for everyone involved. So much helpful detail!

Ciara said...

My heart goes out to people who suffer from seizures. Great, informative post.

The Words Crafter said...

I'm so glad for all the information out there now about epilepsy. I used to go to school with a girl (way back in the 70's) who would have grand mal seizures. Her life was difficult, to say the least. Now, she's happily married, has children, and is doing well. Yay for advancements and understanding.

Loved the post.

Alleged Author said...

We have a student now who is prone to grand mal seizures. I feel so badly for him. :(

Hanny said...

Thanks for the post. It's good to hear this kind of thing from someone who's qualified.

Stephanie said...

Thanks so much for answering my question! You did such a thorough job--I have a lot to work with now!

Walt Mussell said...

In the case of the partial, it seems like a lot of things could be called seizures even if they're not. It would seem stomach discomfort or fear is something that all people deal with at one time or another.

The Red Angel said...

Yikes, these sound intense. Very interesting though. :) I'll have to incorporate some concepts from this post to my characters. :D There are so many possible sub-plots that could be created with these types of medical conditions!

~TRA

http://xtheredangelx.blogspot.com

E. Arroyo said...

The brain is an extraordinary muscle. My son goes blind while still conscious before conking out with a seizure. What lands him in the hospital?...mom's panic. He's out grown them now.

Great post!

Melissa said...

This is insanely fascinating. I love mondays... just because I get to come read your blog!

Len said...

Hi Lydia! Thanks for this. I'm glad someone asked about epilepsy as this is very rare to see in blogs. Very educational as well.

I have a son who was diagnosed with Lennox Gastaut Syndrome, a rare form of epilepsy, when he was only 4months old. His case is very different from what you described above as he is a special needs boy. He can land in the hospital even if it's not status epilepticus. Sometimes, a seizure will stop but then continues again. If it's a cluster of seizures, not necesarrily 'status', and he is not responding to the emergency medication, he will still need to be taken to the hospital. Also, if a seizure stops but he doesn't wake up after the emergency medication after some time, he will need to be taken to the hospital as well. Hope this helps.

Thanks again for this information! I heart your blog! :)

mist of the blossom rain said...

I have heard that people can go into epileptic shock when exposed to a strobe light. Is this the same thing as a seizure, or something else?
I love your Medical Mondays, they are so interesting!

Rachna Chhabria said...

I have seen people in epileptic fits in movies and heard about it. Thanks for this extremely informative post.

Lydia K said...

Hi Walt,
Yes, some partial seizures have only those symptoms but an EEG can diagnose the difference between a bad feeling and a true seizure. Often they are coupled with physical manifestations (a jerking limb) but not always. Also, it is common for one of those more subtle partial seizures to progress onto a complex partial and then a tonic-clonic type.

Hi Mist and EJ,
Yes, some people's seizures are triggered by flashing lights on TV, fluorescent lights, or videogames. Apparently there is a particular Pokemon episode with a lot of flashing images that triggered seizures in undiagnosed kids. I believe it is called photosensitive epilepsy.

LTM said...

interesting stuff. And You know, I never thought it through about epeliptics not being able to get drivers' licenses, etc. A friend of mine's little brother has it. Messes up your life. :o\

Thanks, Dr. K~

Holly Ruggiero said...

The petit mal sounds pretty scary to me.

Patti Lacy said...

Lydia, this blog is SO amazing. But it's not fair you have such dual functionality in your brain:)

Just think, if I were you, I wouldn't have needed TWO medical consultants on my fourth book!!

It's good to be here today.
Blessings,
P

 
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