A few weeks ago I saw a TV report: a
Brooklyn driver ran a red light and killed two children,
ages four years and one year old and injuring others, including a pregnant
woman — “It was something you see in a horror movie,” a witness said. The car
dragged one kid’s stroller more than 350 feet
at Ninth St. and Fifth Ave. in Park Slope, Brooklyn, N.Y.
According
to reports, this auto accident was caused by a driver afflicted with multiple
sclerosis, seizures and a heart condition. After the accident she said she
didn’t recall the red light or hitting anything. On-sight witnesses reported
that she seemed oblivious to what had just happened. That strongly suggests
that this person’s epilepsy caused a seizure.
Neurologists
evaluate and treat people who experience altered and loss of
consciousness. In contrast to the
epilepsy type that causes falling to the ground with convulsive shaking, I had
to include the non-convulsive type epilepsy as a possible cause of a person’s altered
behavior. This form of epilepsy can be difficult to recognize. The
non-convulsive forms include complex
partial seizures and petit mal
seizures. People suffering these common forms of blank-outs may walk about, converse
in a confused manner, turn on water faucets and eat at a table with other
people all the while they are in a mental fog—out of contact with their
environment and without memory of their actions.
Children
may suffer these seizures but teachers, families and even medical workers may
miss the correct diagnosis. These people may be considered to be “slow learners,”
or have hearing problems, attention-deficit disorders (ADD) or autism. The prime
diagnostic tool, the electroencephalogram (EEG), commonly is normal because the
epileptiform abnormalities may not occur in the brain during the hour or so
that the person is connected to the brain-wave-detecting equipment. Brain scans
routinely are normal, too. The diagnosis can be made by speaking with observers
who note these patients’ “foggy” mind-states. My novel, DINGS, is a medical
mystery story of just such a bright third-grader who is failing school because
of his unrecognized complex partial seizure-blank outs. He’s just not “keeping
up.”
Upon
seeing this report on TV two weeks ago I recognized Brooklyn’s Park Slope as a
neighborhood in which my cousins live. I sent them my opinion that the driver
must have had a seizure causing the accident of which she had no memory. “It
was murder,” they told me.
Why was this woman with epilepsy driving?
I related
that my state, California, is only one of six states where state law requires
physicians to report people with altered consciousness. New York is not one of
those six states. The other 44 states hope that people with epilepsy will
report themselves to the Department of Motor Vehicles (DMV). That’s a problem.
Some of my California epilepsy patients would become understandably belligerent
when I would caution them of their driving responsibilities and to stop driving
until sanctioned by the DMV; they were endangering their families, passengers,
the public and themselves. “No, Doc. Don’t send that report in. Are you going
to pay my mortgage?” Personal insight, personal economics and ethics all swarm in
their minds as they make decisions of giving up their driving privilege, i.e.,
their DMV license.
Upon learning
my information my Brooklyn cousin asked if he could share it with a New York
State legislator’s office. That same
week Brooklyn State legislators unveiled a bill to create a mandatory reporting
system and to authorize the DMV to evaluate pe I
shall be following New York’s action.
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.
