I’ve been away from blogging for a while thanks to exams and finishing my BSc – finally! So let’s come back with a big topic: Let’s talk about seizures.
When people hear the word “seizure”, most will think of the dramatic “fitting” style seizure, where the patient loses all motor control and succumbs to violent, jerking movements.
I’ve had seizures. I think. And not once have I lost any control of my limbs. Chances are, many of you reading have had small seizures too, as that phenomenon of deja vu? That’s actually a mild temporal lobe seizure.
Sadly (for medical students who have to learn the difference), it’s not as black and white as the above – there are many, many different types of seizures which present in many, many different ways. Technically the definition of a seizure is:
“Uncontrolled electrical activity in the brain, which may produce a physical convulsion, minor physical signs, thought disturbances, or a combination of symptoms”
They can present in many different ways, depending on where the electrical activity starts. If the electrical activity starts in the part of the brain that controls motor function, well, then you get the stereotyped jerking tonic clonic seizure. If it starts in a different part, the motor system might not be involved.
Since my stroke last year, I have noticed myself going through something strange about once a month. The pattern is always the same. It starts with an almost nauseous, warm sensation in my abdomen that rises up my body. As it gets to my throat a sequence of memories start playing in my head – a sequence of all consuming, overwhelming and overpowering memories that I can neither stop nor change. I don’t even know if they’re my own memories, something my mind has created or something I saw in a film or TV show. What even is a memory? Whilst they’re playing, I’m not quite sure if what’s going on in my head is reality, or if real life, is reality. It’s very odd and very disconcerting to say the least. I think the easiest analogy to make is to say it’s like deja vu, that lasts for several minutes. Whilst it’s happening, I wouldn’t be able to say what’s going through my head – and afterwards I wouldn’t be able to remember what went through my head either. But I can hold a conversation throughout – unless if I said something was happening, there would be no other indication. After it’s over I do tend to become rather quiet, a little bit disorientated and withdrawn, but nothing major.
When it first started happening, I thought major of it. It started the month after I was discharged, and it just made me feel quite uncomfortable, but I was back to normal soon enough after it ended. It wasn’t until it started happening more regularly that I started keeping a symptom diary and noticed it tended to happen once a month. At some point last summer I was reading through old university notes (as you do) and came across my notes for temporal lobe seizures. My “funny feelings” ticked every box. The matching of descriptions was uncanny. So off to my nurse I went, armed with my new insight.
That was the end of summer last year. Since then, I have had an EEG (which again, was interesting to see from a patient’s perspective – but so annoying trying to get the glue used for the electrodes out afterwards!). And that’s about it. The EEG showed nothing abnormal… but as I pointed out to the technician, I didn’t have a “seizure” during the EEG so of course it would appear normal. My neurosurgeon seems quite hesitant to investigate this; I get the impression that he thinks I’m overthinking symptoms, perhaps as a result of being a med student and having too much insight. However my nurse does agree that this should probably be followed up and I’m being referred to a neurologist. I really just want somebody to tell me what on earth this is, because it certainly wasn’t there before my stroke. However, I really don’t want to be diagnosed with temporal lobe epilepsy. Even though the actual “seizures” don’t bother me, don’t affect my awareness or my motor function, a diagnosis like that would probably strip me of my driving license and subject me to a lifetime of anti-epileptic medication, neither of which are particularly appealing to me. I guess for now, like with everything, I need to wait and see what happens.