On the 16th March 2019, I experienced my first seizure. I was in a classroom filled with other students. I found the event to be extremely sudden and unexpected, leaving an impression on my teenage mind. Having been in a rather unstable condition for some months, and experiencing frequent stretches of fainting, I had been in and out of the hospital and underwent every test imaginable -- even the Rolls Royce of scans -- an MRI (1) on my brain.
At first, we were told that the route of my blackouts was an inner ear infection referred to as vestibular neuritis, which can affect the balance of organs and cause vertigo and nauseousness. During such a time of uncertainty, having a diagnosis felt comforting; don’t forget I was still a teenager wanting to be out shopping with friends and even making it to the end of a day at school. We were shuttled from ENT (2) clinics to inner ear consultants. I was even given some dystopian-like goggles and made use of unusual equipment. Unfortunately, my health did not seem to return to normal following the two weeks of recovery and therapeutic exercises advised for inner ear infections. After liaising with school administrators and ENT doctors at the hospital, we decided the most sensible option for me would be to return to school in a wheelchair, as it would prevent head injury if I fainted. I found this incredibly difficult, as I was reliant on friends to ferry me from lesson to lesson.
Following the normal protocol with any first seizure, my teacher dialled for an ambulance and the school nurse was brought to the scene. This type of seizure was classified as a grand mal (3). This classification is typical of the visualization that comes alongside the term seizure, entailing tremors (4) and unconsciousness. I had a cannula (5) inserted into my arm, allowing for the administration of anticonvulsant (6) medications. The seizures ultimately ceased, as a result of which the medical professionals managed to get me onto the ambulance.
After arriving at the hospital, we were talked through the seizure procedure. Typically, an individual has to experience two seizures before he/she progresses toward receiving an electroencephalogram (7) (or EEG) reading. Seizures, as a derivative of epilepsy, are derived from a sudden surge in electrical activity, and that is when a sufferer will show signs of seizing. After my second seizure, which also took place at school, I was taken back into the hospital and admitted in wait of undergoing an EEG scan. An epilepsy (8) specialist spoke to us about the implications of a diagnosis of epilepsy and how such could affect my life as an adult. After learning more about the disease, I was certain that I carried epilepsy. What else could it have been? However, my EEG scan returned negative, suggesting no signs of abnormal seizure activity.
The first diagnosis we received after this was a condition called postural orthostatic tachycardia syndrome (9) (or POTS). In other words, this condition entails the lack of blood circulation to the heart when transitioning from a lying down to a standing up position. Due to this interaction of circulation with gravity, POTS can result in lightheadedness, fainting, and a rapid heart rate. Treatment of such consist of medications and therapeutic management, but there is no concrete and widely effective solution. To alleviate symptoms, specialists advised me to increase the quantity of sodium in my diet, to consume beverages heavy in electrodes with the intention of normalizing my heart rhythm, and to increase caffeine consumption. After no significant effect, we waited until my next neurology appointment to engage in further discussion. A neurologist from a hospital in London was going about his business and proceeded to imply that POTS did not exist, which I found utterly convoluting. How are patients supposed to come to terms with all of these diagnoses?
My next diagnosis, in the gruelling series of many, was a non-epileptic attack disorder. Nonepileptic attack disorder is an inorganic route of seizures, or “events” as doctors prefer to term them. These seizures look almost identical to epileptic seizures, although there are slight differences that I will address. Even though I am forever indebted to the help many medical staff gave me, I was under the care of professionals who used disparaging language and approaches with regards to my diagnosis of nonepileptic seizures. Nonepileptic seizures (10) cannot result in the lack of oxygen in the brain, as do epileptic ones, but can be just as dangerous. The prevalent risk of injuring the head and neck accompanies the unconscious state that one can enter as a result of this condition. An epileptic seizure causes the muscles to tighten and the body to become stiff. Nonepileptic seizures look more uncontrollable, as legs and arms tend to flail.
I found the diagnosis hard to accept but grew to understand it as a result of thorough reading. Non-epileptic seizures are similar to laughter. There is no physical reason as to why we laugh; it wastes our energy and frankly makes us look rather odd, yet our bodies do it involuntarily to convey an emotion. Crying is another example. It does nothing but relax the body of stress and is difficult to control. A book titled, “It’s all in your head,” by Suzanne O’Sullivan, helped me understand the condition, psychogenic blindness, and paralysis.
In February 2020, I was diagnosed with Hashimoto’s disease (11). The condition is a result of an increase in the immune system’s production of antibodies that attack and cause the degeneration of the thyroid gland. Upon reflection, the doctors said that the seizures I had been experiencing were likely due to my underactive thyroid. The cause of seizure in relation to hypothyroidism is unknown, yet happens more commonly than may be presumed. This sudden change in diagnosis did not affect me drastically, as I had been seizure-free for roughly eight months, but I felt content with the diagnosis, because this was the first time that there was a chemical and physiological marker to provide evidence.
Looking back, I believe that it is vital that the public is educated about the various causes of seizures. The words “fits”, “convulsions,” and “seizures'' are automatically linked to epilepsy in the minds of many. Seizures can result from heart problems, such as POTs, psychological distress, such as non-epileptic attack disorder, and even hormonal imbalances, such as hypothyroidism (12). Lyme disease (13), Cushing’s disease (14), genetic mutations, upon others can lead to seizures.
Term Reference:
1. Magnetic resonance imaging (MRI), also known as nuclear magnetic resonance imaging, is a scanning technique for creating detailed images of the human body.
2. A physician specializing in medical conditions of the ear, nose, and throat.
3. A seizure marked by abrupt loss of consciousness with initially prolonged tonic muscle contractions followed by clonic muscle spasms.
4. A trembling or shaking usually from physical weakness, emotional stress, or disease.
5. A small tube for insertion into a body cavity or into a duct or vessel.
6. Used or tending to control or to prevent convulsions (as in epilepsy).
7. An apparatus for detecting and recording brain waves.
8. Any of various disorders marked by abnormal electrical discharges in the brain and typically manifested by sudden brief episodes of altered or diminished consciousness, involuntary movements, or convulsions.
9. Related to the reduced blood volume that occurs when standing up.
10. Psychogenic nonepilpetic seizures can appear outwardly like epileptic seizures, but their cause is psychological. PNES in most cases come from a psychological conflict or accompany an underlying psychiatric disorder.
11. When the immune system attacks the butterfly-shaped gland in the neck (thyroid).
12. A condition in which the thyroid gland doesn't produce enough thyroid hormone.
13. A tick-borne illness caused by the bacterium Borrelia burgdorferi.
14. A condition that occurs from exposure to high cortisol levels for a long time.
Work Cited:
Medical Terms and Abbreviations: Merriam-Webster Medical Dictionary.” Merriam-Webster. Merriam-Webster. Accessed May 2, 2020. https://www.merriam-webster.com/medical.
NHS Choices. NHS. Accessed May 2, 2020. https://www.nhs.uk/conditions/underactive-thyroid-hypothyroidism/.
“Non-Epileptic Seizures.” Epilepsy Society, April 29, 2020. https://www.epilepsysociety.org.uk/non-epileptic-seizures.
StackPath. Accessed May 2, 2020. https://www.epilepsy.org.uk/info/what-is-epilepsy.
Stream, Creative. “Postural Tachycardia Syndrome.” PoTS UK. Accessed May 2, 2020. https://www.potsuk.org/.
About the Author: Sophie Farr
Sophie Farr '14 is a student in the United Kingdom. Her ambition is to study medicine at Oxbridge and become an anaesthetist. Sophie has a passion for STEM and was a finalist for both the Big Bang Fair 2020 and the Youth Industrial Strategy Competition. Outside of her studies, Sophie enjoys reading, debating, writing, and spending time with her mother and friends.
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