This article is not meant to diagnose or provide medical advice—that responsibility lies with physicians. The author is not a licensed medical professional.
I woke to this weird gurgling. Reaching out, I felt my wife shaking, juddering. I flicked on the light: she was pale, her lips were blue, her breathing irregular, her jaw clenched. My first thought was, heart attack, so I started CPR and scrambled for the phone. I kept shouting her name, panicking. She wouldn’t respond. I was losing my girl.
The EMTs were mercifully quick. The actual event only lasted a few minutes, but she was out cold for 20 after that. “You’ve had a fit,” one medic explained casually, addressing her sleepy bewilderment at a bedroom full of strange men. She was confused for a good half-hour.
“Fit” is a colloquial label for an epileptic convulsion (in this case, a tonic-clonic seizure). Fortunately, the doctors can’t find any underlying issues, but that’s pretty standard. Don’t convulsions and epilepsy mean something is really wrong? If I’d have known more, things would have been much easier. Welcome to the seizure, our scariest medically humdrum oddity.
Imagine the brain is a football stadium, the fans are neurons. There’s a ridiculous play—the crowd goes wild—everyone gets caught up in The Wave. Sometimes a few fans have had one too many beers beforehand and excite up a wave all by themselves. A seizure is just like that; it’s a self-propagating wave of electrical activity in the brain.
There are many different types of seizures, with symptoms ranging from full-blown convulsions to just vacantly staring off into space for a few seconds. A tonic-clonic (grand mal) is the classic epileptic event. It’s characterized by a period of rigidity followed by convulsive twitching. The person loses consciousness, and when they wake up they have no clue what’s going on.
Everyone has the potential for a seizure. Some have naturally lower thresholds than others; margins lessen due to binge drinking, illnesses, medications, drug abuse, lack of sleep, irregular blood-sugar levels and a host of other factors. In some instances, structural abnormalities in the brain are to blame—that includes tumors or damage, but usually this isn’t the case.
In 60 to 70 percent of seizure patients, testing does not reveal a cause. But an estimated one in 26 people will be diagnosed with an epileptic seizure over the course of their life.
The diagnosis of epilepsy is normally declared after multiple attacks. The first time someone has a seizure it’s important that they receive emergency treatment. If something is really wrong, it will be detected. There are several diagnostic tests, including blood work to rule out infections, an EEG (electroencephalogram) searching for the footprint of The Wave and an MRI to look at physical structure.
There’s every chance that a seizure will be a one-off event. The longer you go without another episode, the better those chances become. If all the tests come back clean, the odds start looking good. Add to that a regimen of anti-convulsive medications, and a majority of seizure patients can keep things well controlled. That’s the good news. The bad news is the uncertainty—for many it’s the hardest issue to deal with.
The unpredictability will provoke some life changes. Each state has individual epilepsy and driving laws. Sufferers tend to lose their licenses until a seizure-free period passes. Travel and insurance are further considerations out in the wide world. But the homefront calls for a little prudence, too. Showers are safer than baths. Electric ovens are better than gas. Use a guard in front of the fireplace. Don’t swim without supervision. It’s just about common sense and vigilance.
Photo by Pete Linforth/Pixabay
With the sufferer effectively out of it, witnesses to a convulsive seizure are dealt a massive slap of God’s own fear. The follow-up weeks and months instill hyper-attentiveness—you are forever knocking on bathroom doors asking if everything is OK. There are practical ways to ease these concerns like alarms and medical bracelets. Some apps even turn your smartphone into a detector.
As horrid as this all sounds, seizures are manageable; if they are well controlled, health risks are minimal. Doctors are so matter-of-fact because seizures are startlingly common. Those diagnosed with epilepsy learn to manage their lives and ease triggers. Many epileptics experience auras, telltale signals that help predict an episode and alleviate uncertainty. Between medicine and understanding, sufferers can live a perfectly normal, often seizure-free life.
An epileptic event is usually self-limiting, burning out pretty quickly. It is considered an emergency if it goes on for longer than five minutes or multiple seizures occur in tight clusters with no recovery between. This is quite rare, but left untreated, prolonged convulsions can result in potentially fatal complications. There are medicines that can stop a seizure immediately so it is important to watch symptoms closely. But remember, most attacks will stop themselves.
The age-old rule applies: remain calm. Remove any harmful objects nearby; for a first seizure, always call an ambulance straight away. For repeat episodes, call an ambulance if you believe immediate medical attention is required, the seizure goes on for longer than five minutes, or the person is injured during the event.
Start a timeline; timing the facets of a seizure can help give doctors vital clues to work with. When it stops, roll the person on to their side into the recovery position and make sure their airway is clear. Only ever do CPR if breathing does not normalize after the seizure. Stay with the person; reassure them when they wake.
Do not try to control convulsive movements. Never try to put anything between their teeth—this is a huge, seriously dangerous no-no—to avoid damage to the teeth and choking. Don’t move the patient unless they are in immediate danger; let them come to naturally, don’t try to wake them up.
There are plenty of resources out there for sufferers and bystanders alike. The American Epilepsy Society and the Epilepsy Foundation are two organizations that provide solid information. Remember, only trained professionals can diagnose or treat your health. Should you experience or witness a seizure, hopefully this guide makes things a little less scary.
Lead image by OpenClipart-Vectors/Pixabay
Benjamin Kay spends a lot of time pestering his wife in the bathroom of his home in Suffolk, England.