Saturday, December 26, 2020



Wearing an “Epilepsy ID” bracelet/necklace may have prevented this tragedy on a conscious but uncommunicative person. Almost ten million dollars were awarded to this highly skilled computer worker vacationing with his teen-aged son.


“The man was acting “strangely and seemed to be suffering from some sort of mental psychosis,” the son said on his 911 call to police. Dispatched officers were alerted to a “possible serious mental health disorder needing treatment.” The dispatcher added information given by the son that “the man had a brain condition that can cause him to become dazed and unaware of his surroundings.”


The injured man later reported that he had no recollection of the sheriff deputy’s lit flashlight in the dark vacation cabin and has no memory of picking up the large fork from the counter as he paced. He did not remember waking in a hospital being told he had been shot and will never walk again. A court awarded this large sum for the Sheriff Department’s excessive force, negligence, and other alleged violations. The Sheriff claimed the man was distraught and he was shot after attempting to stab a deputy with a sharp instrument. The victim’s attorney claimed the deputy was a member of a department that was poorly trained in handling calls involving mentally ill people,


After being shot the victim was charged with assault with a deadly weapon and child endangerment. The victim ended up pleading guilty to a less serious charge of brandishing a weapon, a fork, as part of a plea deal.


These situations, i.e., situations of confused behavior and temporarily being out of touch with their surroundings is classical for epilepsy manifested by complex partial seizures, the most prevalent type of epilepsy. Most of these patients describe their transient confusion as an aura which then develops into a full-blown convulsion. But many such seizures do not progress into a convulsion; rather the confused state continues for minutes and sometimes even an hour or more where the person walks around, handles items of daily use and even mumbles speech without recollecting any of these activities when the temporary mental confusion ceases. Most of the public is not familiar with the one percent of the population afflicted by epilepsy and its different forms. Law enforcement, however, needs better training to recognize and understand the transient confusion states which could include epilepsy, illicit drug reactions or psychotic disorders.


I advise all people with epilepsy in all its forms to obtain and wear ID bracelets/necklaces that may help prevent a tragedy and even save your life.


Lance Fogan, M.D. is Clinical Professor of Neurology at the David Geffen School of Medicine at UCLA. “DINGS” is his first novel. It is a mother’s dramatic story that teaches epilepsy, now available in eBook, audiobook and soft cover editions.








Wednesday, November 25, 2020

Blog #124: Your Sex-Life and Epilepsy

Relationships contribute to who we are. Critical to all of us is our sex life. Culture and religion have determinate effects on how we express our sexual selves. I believe most of us would agree that sex is a predominant feature in our thinking.


Add epilepsy to your sex life and your fears and anxieties magnify. These color the degree of satisfaction in sexual relationships even if your sex life is minimal or inactive. Anticonvulsant medications can affect sexual desire and performance. Your physician can review medications and side-effects. The Epilepsy Society of the UK discussed this important topic at


A convulsion can be shocking and frightening to your partner who may forever have disturbing memories unless the epilepsy is discussed, and the convulsion’s transient nature is understood. For the one out of every 100 people among us who is affected with epilepsy, sharing knowledge, and understanding the safeguards during the seconds to minutes most convulsions last will be reassuring. Being forewarned about the convulsion-induced cessation of breathing with resultant bluish skin-changes, incontinence, bitten tongue and lip bleeding needs to be explained to new partners. However, these features appear more serious than they actually are.


If a seizure occurs during sexual activity, the partner needs to place you on your side to minimize aspiration. Explain that putting something between your teeth in attempting to prevent tongue-biting will cause unnecessary biting of fingers and/or broken teeth. The jaws clamp immediately as convulsions begin; if the tongue and lip escape that initial clamp they will be spared biting. “Swallowing” the tongue is impossible. Your partner may no longer want to be alone with you even after your discussions or your partner may want to drop out of the relationship.


Epilepsy-related anxiety, depression, low self-esteem, and low self-confidence can affect sexual desires and performance. They exacerbate existing epilepsy-induced anxiety, anger, fear and helplessness. It is common to view epilepsy as a personal failing; problems with sex can echo these feelings. Your partner’s fears will stress you both. Therapy exploring your anxieties about your epilepsy with your doctor and/or therapist can relieve this stress. You both will gain knowledge and confidence. Depression can be addressed. Awareness of epilepsy’s dangers, combined with your partner’s emotional support, can go a long way in building a stronger relationship.


Shared activities add to life’s enjoyment and bring couples closer together. For example, bathing with a partner who is aware of your epilepsy can be safe; dining and cooking together will add to intimacy, especially if the patient cooks only on rear burners. This helps to avoid a seizure-induced collapse onto fire and boiling pots. Alcohol can worsen epilepsy; minimizing alcohol can help to avoid seizures.


Mutual supporting activities are so important in gaining confidence, but some people will not want to discuss their epilepsy. It takes courage to expose feelings truthfully, but, when you do other “hidden” aspects of your life may come forward. Discussing them will strengthen your relationship, too.


More than three million Americans have epilepsy. There are a lot of resources available to support them. I encourage everyone to discuss your problems with your health and psychological care providers. In my practice I urged my patient’s partner into the office for the medical appointment. This can only expand their understanding of your epilepsy.




Lance Fogan, M.D. is Clinical Professor of Neurology at the David Geffen School of Medicine at UCLA. “DINGS” is his first novel. It is a mother’s dramatic story that teaches epilepsy, now available in eBook, audiobook and soft cover editions.





Monday, October 26, 2020

Blog #123: A FAMILY DEALS WITH UNRECOGNIZED EPILPESY: Excerpted from Dr. Lance Fogan’s novel, DINGS

Chapter 24, Part 1


Conner squeezed my hand as we followed Hannah to Dr. O’Rourke’s office. I glanced at the framed art reproductions that adorned the corridor walls; several looked familiar. As soon as we entered his office, I detected the aromas of cinnamon, apple and coffee, but I couldn’t see any lunch leftovers or candles or anything.

“This is Conner Golden, Doctor.” She then turned toward us, nodded and with a face-lit smile announced, “Mr. and Mrs. Golden.” Hannah then indicated the neurologist with her open palm. “And this is Dr. O’Rourke.” She left and pulled the door closed behind her. My heart quickened.

The man whom I recognized from the website smiled, stood up and came around his desk to greet us. He was several inches shorter than Sam and only an inch or so taller than me. The doctor’s bowtie was not the same as the one in his website portrait. This one’s butterflied wings were deep red and arrayed with narrow, bright blue and yellow diagonal stripes. His temples were gray; the rest of his head was covered with dark, medium-length hair parted on the left. The crown of his head had a neat, round bald spot that reminded me of the tonsure that monks wore in paintings from the Middle Ages. The corners of his light-blue eyes wrinkled with a warm smile. A slight paunch pushed aside the edges of his unbuttoned knee-length white coat.

Dr. O’Rourke smiled even more broadly as he extended his hand to Conner. Our boy pressed against his father’s torso. Sam smiled and gently pushed Conner out in front of him with his palm. Our child’s eyes widened as he looked up at the neurologist with a guarded expression.

At Sam’s encouragement, he extended his arm and shook the doctor’s hand. He reached for mine with his other hand and looked down. His small palm was icy-cold.

The doctor leaned forward and regarded Conner’s hand. Several of the fingers were stained with blue and red ink that I couldn’t remove from his recent art project. “Hello, Conner. I’m Dr. O’Rourke. It’s very nice to meet you. I see that you’ve been doing some painting.”

Conner looked at his right hand, which was mostly enveloped in the doctor’s. Then he cast a sideways glance at the doctor and flashed a shy smile.

“I’m so sorry, Dr. O’Rourke. I couldn’t wash off all of the ink from Conner’s hands. My son is into mythology, and he likes to draw and paint Greek and Roman and Egyptian characters.”

Still leaning over Conner, he exclaimed, “Mythology! Hey, now! Wow! And you are only in the third grade? You’re eight, right?”

“I’m eight and a half.” Conner cocked his head and grinned with widened eyes. Sam and I both smiled at our son’s brisk retort.

The neurologist nodded several times and looked up at us. His broad grin exposed a small chip off his left lower-front tooth. “That’s a pretty sophisticated subject for a third-grader. You must be really smart.”

The small talk was helping our son get comfortable with this man in the white coat. I saw him turn his attention to the certificates and pictures on the walls and to the books on the shelves as we chatted.

“Do you also know the Scandinavian stories and the Native American mythology tales too, Conner?” Dr. O’Rourke cocked his head, raised his eyebrows and waited for his young patient’s response.

Conner grinned with growing enthusiasm. “Oh yeah. I know pretty much all of them. They’re on my computer. I have tons of mythology games. I play with Zeus and the Titans and the Greek Underworld. There’s some stuff about the Vikings too, but not much about the American Indian ones.” Conner waved his hands and shifted his weight from foot to foot as he described his favorite mythology games to the neurologist.

I smiled and felt a bursting feeling in my chest. Sam had a proud grin.

“That is wonderful, Conner.” The doctor indicated three matching dark-green cushioned chairs in front of his desk. “Please! Everyone have a seat. Why don’t you sit here, Conner,” he pointed to the middle chair. Dr. O’Rourke lowered himself into a cordovan-shaded leather armchair behind his large mahogany desk.

“I’ve been reading Dr. Choy’s notes, and I’ve had a look at the results of all of your lab tests, Conner. I’m pleased to say that everything seems normal.” He smiled at me and then at Sam. “That’s great news. Let me explain more about the records that I’ve seen.”

Even though the doctor’s friendly and confident demeanor was reassuring, I couldn’t relax. My jaws clamped and my hands pressed down in my lap. There was some pressure in the sides of my head and I breathed quickly.

The neurologist placed both hands on the desk and leaned toward us. Sam leaned forward too, and clasped his hands between his legs. I was aware of my rapid breathing; I tried to control it. I exhaled and sat back in my chair. I crossed my legs. Conner’s brows furrowed which added to his cautious, serious expression.

“Conner, do you want to see pictures of your brain on the CT scan? They’re really interesting.” Dr. O’Rourke angled the computer monitor so we all could see the images. “Have you studied the body and the brain in school yet?”

“No.” Conner stood up and leaned against the desk.

“That’s right. Get close so that you can see,” Dr. O’Rourke said.

Conner propped his elbows on the desk and cupped his chin and cheeks in both palms. “Gee! Wow! My brain! It looks just like on TV shows, only this is way cooler. That’s really me? That’s really my brain?”

I looked at the black, gray and white images on his computer monitor.

The neurologist smiled at Conner. “Yes, it is. This is your brain. Here are your smelling nerves, your eyes and ears.” His index finger showed us where Conner’s balancing center was and the muscles that made his eyeballs move. Then he explained how thinking, speaking, comprehending, remembering, moving, seeing, touching and feeling happened in specific parts of the brain as he indicated them.

He indicated the cerebrospinal fluid that surrounded the brain and filled the chambered ventricles. “Dr. Choy obtained some of this fluid from your lower back when he took care of you in the emergency room, Conner. It was a very important part of your examination, and it was entirely normal.”

Conner reached behind and touched his lower back. His eyes widened and his mouth opened as he turned toward me. “That’s why I had that Band-Aid on my back when I came home from the hospital, right Mom?”

I nodded and touched my son’s shoulder. He turned back to the doctor.

Sam leaned closer to the screen.

The neurologist sat back and propped his elbows on the armrests. He steepled his fingers under his chin. “Everything in your brain looks normal, Conner. Now, let’s find out how it’s working.”

Conner stiffened. “You’re not going to give me any shots, are you?” I saw his glare at a small red ball that was on the tip of a long, thin pin protruding from the lapel of the doctor’s white coat.

I touched Conner’s neck. I wondered what the neurologist did with that long pin in his lapel. I counted three pens and a small flashlight in his left breast pocket. A thin handle with a pointed end protruded from the side pocket of his white coat. I glanced over the framed diplomas and certificates on the walls. I got a sense that they were staring down at my son, and modern medical science and all of its mystery were about to scrutinize him. My hands were cold.

“Conner, right now I’m going to ask you some questions about how you’re feeling. Then we will all go into the exam room, and I’ll check you out there. Your parents can come too; there won’t be any shots or blood tests.” He smiled at Sam and me.

I appreciated how Dr. O’Rourke reassured our boy. Still, Conner anxiously snapped his head around to look at his father. Sam nodded back. Then he glanced down at the spot where his IV had been. The bruise on his arm was mostly faded and had turned a pale bluish-yellow. He rubbed his arm and looked at Dr. O’Rourke.

Sam glanced over at me. We were poised to say something or to touch our son to reassure him. However, there he was, listening and seeming to understand everything the doctor said.

“Now, do you remember the night that the seizure happened?” The doctor looked down at the papers on his desk. “When was that, about a week and a half ago?”

I nodded. “Uh-huh.”

Conner tilted his head and frowned. “I didn’t feel good.”



Lance Fogan, M.D. is Clinical Professor of Neurology at the David Geffen School of Medicine at UCLA. “DINGS” is his first novel. It is a mother’s dramatic story that teaches epilepsy, now available in eBook, audiobook and soft cover editions.

Friday, September 25, 2020


 A recent article summarized a Spanish study1 (published only on line to date) to estimate incidence and case fatality rate of patients with epilepsy and COVID-19.

It is known that patients with epilepsy are at elevated risk of respiratory diseases, especially those due to infections. This referenced investigation supports this. Spanish investigators studied 1,537 patients with COVID-19 admitted over one month in spring, 2020, including 21 with active epilepsy and 1,516 controls without active epilepsy.


A cumulative case fatality rate of 1.2 percent was found in the patients with COVID-19. The general population with COVID-19 without active epilepsy had a lower death rate due to COVID-19 of 0.5 percent. Patients with high blood pressure and with epilepsy and COVID-19 predicted even greater mortality.

We all must be attentive to safe distancing and mask-wearing at this time. My blogs #117 on April 25, 2020; #118 on May 25, 2020 and #120 on July 25, 2020 at deal with COVID-19. They discuss more helpful information on your epilepsy and staying safe during this covid-19 pandemic. Infections with COVID-19 are associated with worsening seizures in many people with epilepsy. I urge you to practice recommended safety measures to protect yourselves from COVID.


1)     P.Cabezudo-Garcia, N. Lundahl Ciano-Petersen, N.Mena-Vazquez, Incidence and case fatality rate of COVID-19 in patients with active epilepsy. Neurology 2020;95:e1417-1425 2020 Sep 8;95(10):e1417-e1425. doi: 10.1212/WNL.0000000000010033. Epub 2020 Jun 17



Lance Fogan, M.D. is Clinical Professor of Neurology at the David Geffen School of Medicine at UCLA. “DINGS” is his first novel. It is a mother’s dramatic story that teaches epilepsy, now available in eBook, audiobook and soft cover editions.


Tuesday, August 25, 2020


I have addressed epilepsy surgery before in several of my 120 monthly epilepsy blogs published at since 2011. Evidence is overwhelming that epilepsy surgery, if you are a candidate, is safe and can be tremendously beneficial in reducing, or even, curing your epilepsy.


The chief research officer and epilepsy specialist at Cleveland Clinic, Lara Jehi, MD, detailed the patient-centered pros and cons associated with epilepsy surgery, as well as the stigmas related to it. “Even before you put a patient through the surgical testing, neurologists have to identify if they’re a surgical candidate. The most cost-effective option is to send them to get that evaluation.” Jehi hopes that her study can help demystify some of the preconceived notions that surround epilepsy surgery. NeurologyLive /


A recently published study that evaluated costs found epilepsy surgery was cost effective ($328,000) compared to medical management ($423,000) in surgically eligible patients and more effective (measuring Quality Adjusted Life Year of 16.6 vs. 13.6 QALY) than medical management in the long run. The quality-adjusted life year (QALY) is a generic measure of disease burden, including both the quality and the quantity of life lived.1


The data has potential to raise eyebrows within the epilepsy community, and ultimately sway more patients to not only get the surgery, but to at least have their own surgery-eligibility evaluated. Dr. Lara Jehi feels that patients don’t fully understand the benefits that come with epilepsy surgery. She encourages those eligible to at least consider surgery knowing their less-than-effective anti-seizure medication will probably not improve their quality of life.


“There are a lot of fears out there. Some justified, but some due to misperception and misinformation that may stop someone from getting to the point of looking at brain surgery.” Jehi provides insight on the truth behind the stigmas related to epilepsy surgery and whether patient fears are legitimate. In the above video Jehi discusses moms worried about weeks long hospitalizations for testing, other family responsibilities during that time; time off work; relatives with past complications due to other types of surgeries.


Her study results confirm the positives of surgery. Epilepsy surgery is underutilized and not recommended to a large number of patients by their neurologists despite multiple studies proving its effectiveness and long-term benefit with drug-resistant temporal lobe epilepsy. Jehi hopes that her study can help demystify some of the preconceived notions that surround epilepsy surgery.


  1. Sheikh SR, Kattan MW, Steinmetz M, Singer ME, Udeh BL, Jehi L. Cost effectiveness of surgery for drug resistant temporal lobe epilepsy in the US. Neurology. Published online July 8, 2020. doi: 10/1212/WNL.0000000000010185



Lance Fogan, M.D. is Clinical Professor of Neurology at the David Geffen School of Medicine at UCLA. “DINGS” is his first novel. It is a mother’s dramatic story that teaches epilepsy, now available in eBook, audiobook and soft cover editions.