Thursday, September 26, 2019

Blog #110: SHE HAD A CONVULSIVE SEIZURE. DOES THAT MEAN SHE HAS EPILEPSY?


After a first-observed convulsion causing loss of consciousness with falling and shaking, it is natural to wonder, will the person have another convulsion? If so, when? Why did it happen? Is this epilepsy or just a seizure? These are questions patients, families and doctors must deal with.

Epilepsy is diagnosed when more than one seizure occurs if the seizure is not a “reactive” seizure. Reactive seizure are caused by some transient medical condition that can disappear such as infections, toxins and drugs, or temporary loss of a body organ function (e.g., liver, kidney, lung, etc.) that then heal and further seizures do not occur. When a second convulsion occurs, even if the first and this second seizure are separated by years, epilepsy is diagnosed. Epilepsy means recurrent seizures.

Epilepsy can be caused by brain injuries, strokes, tumors, infections, degenerative diseases such as Alzheimer’s disease, Multiple Sclerosis, Parkinson’s Disease, inherited conditions, and other diseases. Recognition of genetic causes of epilepsy is rising as science improves to identify abnormal genes. However, epilepsy is not common in families. Causes for approximately 50% of epilepsy cases are never found. Currently, onset of epilepsy is no longer most common in children, rather, it most commonly occurs in those over age 60. This is because we are living longer and we are susceptible to more insults to our brains.

One percent of the world-wide population has epilepsy. Approximately half of all people with epilepsy have their seizures controlled; these people can remain seizure-free if they are on the “best” anti-epilepsy drug (AED) at the “best” dosage for that individual. They must continue this medication as they are not cures. Finding this medication is a trial-and-error process of the patient working with doctors and the AEDs. Another 30% of epilepsy patients will have a seizure every few weeks to months; they have “incomplete” control. The remaining 20% of patients have “uncontrolled” epilepsy; they experience seizures each day or every few days despite taking AEDs. Epilepsy brain surgery is the most effective treatment to decrease or even cure epilepsy for people in whom no AED works. If the brain focus causing the epilepsy can be identified on various tests then attempting its surgical removal is deemed promising for marked improvement in epilepsy control or even cure.

Brain scans (to search for abnormal areas) and electroencephalograms (EEG) may identify a seizure-causing focus. Spinal taps (if infection or other brain conditions are suspected) and blood and urine tests to screen for other conditions also help doctors identify epilepsy causes.

EEGs are normal in half of all people with epilepsy because the test of multiple wires on the scalp is done for just an hour or so and the EEG abnormalities do not always occur during that time. Ambulatory EEGs (the person has EEG wires pasted on the scalp connected to a small recording device on their body as they carry out daily activities over 24 hours) may pick up abnormalities. More sophisticated testing in special labs can be done where EEGs and video cameras are used to capture abnormalities as the monitored-person lies in bed.

Pseudoseizures-involuntary, psychological, causes of “seizures”-are not rare and can complicate epilepsy diagnosis and treatment. See my past blogs on this subject at LanceFogan.com: blog #10 (March 23, 2011); Blog#49 (August 27, 2014); Blog #99 (October 26, 2018).

The diagnosis of epilepsy depends on the clinical history of searching for, and characterizing,  “spells” patients complain of along with the above testing which commonly are all normal. Ultimately, clinical judgment and the experience of your physician are crucial.




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.

3 comments:

  1. Hello my son is 8 years old and had is first seizure at 2 years he was diagnosed with generalized epilepsy at 5 years old has been on medication since until doctor got him off and on he broke out on a seizure lasting almost 10 minutes he was put back on medication and the meds even increased ever since were back to his moody ness, tantrums, waking up every morning struggling and at night when asleep his body is constantly twitching mostly from his upper body, he had another big seizure and were still at it with all these moods. we tried different meds nothing was really working. I never stopped battling it, I’m open and supportive when looking at alternative and procedures. I saw someone comment on a website. Her daughter had seizure and she used a herbal medicine for her daughter seizure and she was seizure free. I’m glad that it was possible. I was ready to try anything that we help my son, i had a conversation with the Dr . I decided try the herbal medicine, I purchased the medicine. my son started taking the medicine. I was shocked to see my son improve, he stop having seizures. his more active and no more seizure. I’m so happy to see my son seizure free. Do as much google research as you can and do not give up on trying. If there is improvement continue, if there is no improvement stop and try something else Everyone is different. thank God my son is seizure free. you can email him on dr.lewisamenico@yahoo.com

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  2. My son was diagnosed with a rare form absence status epilepsy. His seizures show no symptoms until the seizure has lasted for hours! The only warning we had was he started acting only tired at first then gradually he started acting confused and from there for 24 hours he didn't know what year it was, where he went to school, or even what grade he was in etc. his motors skills were perfect and he talked to everyone normal the entire time, he just couldn't answer certain questions. The hospital kept him overnight and gave him fluids and in 24 hours he slowly started remembering and they said he was good and sent us home. We know now that he was having a constant seizure the ENTIRE TIME of his confusion! Almost 3 months later he begins having the same symptoms when I woke him up for his 2nd day of school. we are sent for an EEG, which revealed at 10 am he was actually having what the neurologist referred to as the worst EEG he had seen) we then were sent to a different children's hospital where they observed him until 8:00pm, all this time my son passes every test, he is talking and his motor skills are completely normal! They finally begin his EEG around 9:00pm. It reveals he is still in seizure! They are blown away. Say they have never seen an absence case like his and they quickly gave him a big dose of adavan which immediately stops the seizure and he is able to regain his memory immediately. Does anyone have a child who has these same symptoms? His neuro doctor ordered a brain glucose test, but when we went for a follow up last week they said the test had been canceled and they had no idea what happened? When I asked if they were going to draw his blood and re do the test, they said that his medicine was controlling the seizures so far so they didn't feel the need to do the test! I need advice and some direction. I searched further; visited epilepsy websites, blogs. I find info about someone having the same symptoms. I was really determined. Fortunately for me, I stumbled on a testimony of someone who had epilepsy for several years and was cured through herbal medication. I read awesome stories of people whose condition were worse . But due to numerous testimonies. I was more than willing to try it. I contacted the doctor Gabriel, and my son used the Nectar herbs. It became a miracle for my son free from rare form absence status epilepsy within 3 months. The Nectar medicine worked without any trace of side effects on my son. totally cure. I decided to share my son story to tell people out there, that there is a hope for those with epilepsy using nectar medicine and anyone who suffers from seizures can be cured. Email dr.gabriel474@gmail.com

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  3. I want to thank Dr. Oda for helping cure my little sister from CONVULTION & SEIZURE. The embarrassing and scaring attack kept worrying my little sister for years until I heard about doctor Odas’s herbal cure, i gave it a trial hence we having been battling with the ailments and seeking for solution. Behold, it was magic. Both the convulsion and seizure gone after using the medications like it never happened. Quickly reach out to him for help/solution if you have such problem. He is also good at EPILEPSY CURE. Contact: (drodasolution@gmail.com) Tel: (+234 805 761 6299)

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