I was reading though this site a while ago and there was a thread dealing with a rare seizure condition where the person was seizing but was also able to communicate with EMS simultaneously. I, for the life of me, can't find this thread again. If anyone could link me to it, or if they know what I'm talking about and can provide me with the name of the condition and anything else it would be greatly appreciated.
There are over > 100 different type of seizure activity. The common myth is unless the patient is unresponsive and incontinent; they are or did not have a seizure.. which is wrong. Sorry, I too cannot recall the name(s) of the exact type of seizures.
It all depends upon the location and type of firing of the alpha brain waves and how it is projected.
OK thanks, I was just wondering because I was involved with someone that presented with seizure type activity. The patient responded to the Valium and Ativan dosages given by the GP physician. The patient was then transfered to a specialty facility where the neurologist said that it was definitely not seizures because the pt was able to answer questions during the episode, when a limb was held during the episode, it would stop seizing to a certain extent. There was decreased coordination during a physical exam directly after, and extended period after the episode. The pt suffered substantial memory loss i.e. the ONLY thing they could remember was the correct year, not date, age, birthday, names of family etc... Pt also was also hypotensive after the episode 80s/50s. I had not seen anything quite like it and I would appreciate any thoughts.
There are certain areas and specific neuro findings that one can make a determination if there was really a seizure or not. Usually, the true diagnosis comes from a EGG and watching the wave and spikes.
I would not disagree with a neuro if it was seizures or not, they definitely are more an expert than I am.
Has anyone had any experience with anything similar in their experience? I guess that the intensivist is considering other things, there has been a psychiatric consult, an MRI is ordered They did catch an episode on the EEG and it was normal as far as they said. The patient was diagnosed with Bursilosis after a trip to Panama about 6 months ago. I'm just throwing all of this out there to you people with the hopes that something will ring a bell with you and you may have some insight, because I, frankly, have not been to impressed with the ICU's and the intensivists' handling of it so far.
I've been doing a little research on my own and I actually came across it in my college psychology book. Conversion Disorder. It would tend to fit with the seizure activity presenting with a clear EEG and the amnesia symptoms. Yes or no? I'm just tossing out ideas.
Pyschosis and seizures are not related. Other than the patient may exhibit both or they can potentiate each other. Seizures are directly related to brain wave and the neuron firings, again not the direction of psychological, albeit some may have both from such as traumatic brain injuires, etc.
There are simplistic tests that can be performed that will indicate if the patient has true seizure activity or not.
There is even a true diagnosis of psuedo seizures, representing "false seizure activity"; that is not really related to real seizure activity; rather to behavioral and pyschological problems.
That is what I was saying in my last post; they are not likely not true seizures because of the clear EEG. I am just incredibly fascinated by the potential that all of the symptoms presented are potentially psychologic in origin.
I do thank you for humoring me and discussing this with me.
this may have been one of my posts. I was sent out to a woman who was twitching. The nursing home nurses were confused because the patient was yelling help me help me. i knew immediatly she was having a seizure. I called medics and took the patient to the rig. she was able to answer me whn i yelled her name. Take into account she was having body seizures the whole time non stop. i believe the medics administered ativan and it helped a small amount. the patient had a patent airway and diddnt need any BLS or ALS skills to keep it open. when asked what she was feeling and what was going on she just said OH NO help me !!!
ill probably never see it again but it definitly was an odd thing to see.
One time, when I was still an intermediate, my paramedic partner and I responded to the local university dorm for a young male reported to be in seizure. On arrival we found the patient lying on the floor in his room in what appeared to be a full tonic clonic seizure. However, his eyes were open and he could speak to us. He kept telling us not to start an IV and give him any meds and that he had a note explaining his condition somewhere in the room. We never were able to find the note.
This guy stayed in this seizure mode for 15-20 minutes. We got medcom on the line and explained what was happening and that his dad was on the way. Though skeptical, the doc allowed us to accept a refusal, but only after his father arrived and took charge of the patient. I can't remember what his did called the condition, but it was a classic status seizure, except for the LOC. Haven't seen anything like it before or since.
Thanks! I do believe that was what I was thinking of. You wouldn't happen to remember if you ever heard any sort of diagnosis from the ER docs or from your medics as to what was specifically going on?
