Seizure

“ In a few hours he wakes, with headache and mental confusion, not knowing he has been ill until told, and having no recollection of events just preceding the seizure, until reminded of them when they are slowly, and with painful effort, brought to mind. He is exhausted, and often vomits. ”

“ I visited her several times, as the debility which ensued seemed greater than, under ordinary circumstances, should have followed on such an attack. About a fortnight later she had a fresh seizure, of a very similar kind. This time, however, the symptoms were aggravated, and accompanied by others of a more alarming character. Of these the most conspicuous were nausea, vomiting, violent perspiration, and increasing tendency to diarrhoea. The patient also complained of great sinking of the heart, and of a terrible lowness of spirits, almost amounting to a conviction that death was at hand. ”

“ Such a victim awakes confused, but imputes his mental sluggishness to a hearty supper or "a bad night". A swollen tongue, blood-stained pillow, and urinated bed arouse suspicion as to the real cause, suspicion which is confirmed by a seizure during the day. He is more fortunate (if such a term can rightly be used of any sufferer from this malady) than his fellow victim whose attacks occur during the day, often under circumstances which, to a sensitive nature, are very mortifying. ”

“ The convulsion is generally violent, rapidly alternating from clonic to tonic spasm, without special phases or periods. Complete and profound loss of consciousness, with great distortion of face and eyes, is present. The tongue is frequently bitten. After the attack the patient passes into a deep stupor. In hystero-epilepsy usually the seizure does not begin with a scream or sudden fall, the convulsion has periods and phases, and the tongue is not bitten. ”

“ When the cataleptic seizure is at its height, there is complete suspension of consciousness, and a muscular rigidity supervenes, which causes the limbs to retain for a long time any position, no matter how awkward or irksome, in which they may be placed. ”

“ After a fit of convulsions, or an epileptic seizure, power over some limb is often lost for a time which may vary from a few minutes to some hours. In the course of some serious diseases of the brain, one of the manifestations of the mischief is the impairment or the loss of power over one arm or leg, rarely over both; and lastly, that terrible disease diphtheria is often followed by a paralysis so general that the patient is sometimes for days unable to move even a finger, although the condition may eventually pass away. ”

“ Epilepsy affects between 1 and 2 percent of the U.S. population. Of people who have epilepsy, two-thirds appear to have no structural abnormality of the brain; in the remaining third, the disease can be traced to brain damage at birth, a severe head injury, an infection that caused brain damage, or a brain tumor.
The emotional symptoms of epilepsy can involve either anxiety or depression or both. Once a person has had a convulsive seizure, he or she may live in constant apprehension that another seizure will occur. There may be occasional, transient feelings of unreality. ”

“ It usually comes on by a seizure, often sudden, of pain in one or both sides of the small of the back, of a severe cutting or stabbing character, greatly aggravated on movement of the body, especially in attempting to rise from the recumbent posture and also in the acts of drawing a deep breath, coughing or sneezing. ”

“ The imagination readily fixes upon such symptoms as foaming at the mouth and barking noises, exalts these phenomena over deeper symptoms that a physician might have detected, and finds a simple explanation of the whole complex seizure as demoniac possession or, in modern phrase, as a psychopathy. ”

“ The general condition of the patient is pitiful in the extreme. He is fully conscious of the gravity of the disease, and his mind remains clear to the end. The suffering induced by the cramp-like spasms of the muscles keeps him in a constant state of fearful apprehension of the next seizure, and he is unable to sleep until he becomes utterly exhausted. ”

“ One of the symptoms which has always been regarded as a characteristic manifestation of the hysteria of civil practice is the occurrence of convulsive seizures which are sometimes with difficulty to be distinguished from epilepsy, and share with that disease the exhibition of movements, often of a very violent kind. ”

“ If several fits follow one another, or if one is very long or severe, send for a doctor.
When a seizure occurs in public, a constable should be summoned, who, being a "St. John" man, will be of far more use than bystanders brimming over with sympathy—and ignorance. If some kindly householder near by will allow the victim to sleep for an hour or two—a boon usually denied more from fear of recurrence than lack of sympathy, it is better than taking him home. If not, let someone call a cab, and deliver the victim safely to his friends. ”

“ It has recently been announced, for instance, that so-called idiopathic epilepsy,—that is, epilepsy without some directly immediate cause,—very seldom develops later in life in persons who have not had in childhood convulsive seizures as the result of some extreme irritation. This does not imply that every child that has convulsions will suffer from some serious nervous or mental condition later; but every child whose mental and nervous equilibrium is not stable, because of hereditary elements of weakness, will almost certainly suffer. ”

“ For epilepsy is not a form of trance; it is, however, a mixed mental and spasmodic seizure, much allied to trance. Those who suffer from its attacks are found to be among the most susceptible of induced trance.
But let me again ask, what then is trance?
Trance is a peculiar mental seizure, (totally distinct from insanity, with which again, however, it may be97 combined,) the patient taken with which appears profoundly absorbed or rapt, and as if lost more or less completely to surrounding objects or impressions, or at all events to the ordinary mode of perceiving them ”

“ When the fit returns it is not uncommon for one seizure to be followed by another within a few hours or days. Occasionally there occurs a constant succession of attacks extending over many hours, and with such rapidity that the patient appears as if he had never come out of the one fit. ”

“ It is impossible to determine {53} the prognosis in particular cases, but a large number of quickly recurring convulsive seizures, with a weak, thready pulse, and a high temperature usually indicate a fatal ending. Apoplexy, oedema of the lungs, and paralysis also, as a rule, end in death. ”

“ I content myself with adding here, that we may expect a very confluent and dangerous Pock, is, at the very Time of seizure, the Patient is immediately attacked with many violent Symptoms; more especially if his Eyes are extremely quick, lively, and even glistening, as it were; if he vomits almost continually; if the Pain of his Loins be violent; and if he suffers at the same Time great Anguish and Inquietude: If in Infants there is great Stupor or Heaviness ”

“ Unless seizures are severe, no one should be called in; if they cause alarm, ask a discreet male neighbour to assist when necessary, leaving when the convulsions abate so that the victim is not aware of his presence. Avoid the word "fit" and "epilepsy", and if reference to the attack be necessary, refer to it as a "faint" or "turn".
Living with a man liable to have a fit at inopportune times is a tremendous strain, and the soundest advice one can offer a woman thinking of marrying such a one is Punch's—"DON'T!" ”

“ Early physical symptoms are headache, sensations of fulness and pressure in the head, followed by a feeling of dizziness, fatigue, exhaustion, debility, etc. Sooner or later, following a seizure of some kind, neurological signs appear—drooping of the mouth, lateral deviation of the tongue, weakness of an arm, dragging of one leg, loss of sensation on one side, ankle clonus, an increase, decrease or inequality of the patellar reflexes, and sometimes a Babinski reflex. The pupils are very likely to be unequal and sluggish in reaction. ”

“ The symptoms do not usually develop immediately, and after the surgeon is led to indulge in the hope that danger is past, proper reaction sets in, healthy granulations develop—nay, the wound may close and be undergoing cicatrization—then the patient complains of feeling faint or drowsy, and with or without this premonition he has convulsive movements of one side, sometimes involving both extremities and the corresponding side of the face. Consciousness is usually preserved, but the spells recur, and the patient is noted to be absent-minded during and after the convulsive seizure. ”

“ There are many stories of men in the midst of a severe asthmatic seizure being suddenly roused by the cry of fire, or an alarm of some {367} kind near them, having the spasmodic conditions disappear as if by magic. ”

“ Absolutely involuntary attacks with unconsciousness constitute what are commonly called hystero-epileptic seizures, and will be described under Hystero-epilepsy.
The voluntary, impelled, or induced hysterical fit may be ushered in in various ways—sometimes with and sometimes without warning, sometimes with wild laughter or with weeping and sobbing. The patient's body or some part of it is then usually thrown into violent commotion or convulsion; the head, trunk, and limbs are tossed in various directions. Frequently the arms are not in unison with each other or with the legs. ”

“ Epileptiform Seizures are convulsions due to causes other than epilepsy, and only a doctor can tell if an attack be epileptic or not and prescribe appropriate treatment. To give "patent" medicines for "fits", to a man who may be suffering from lead poisoning or heart disease, is criminal.
Convulsions in Children often occur before or after some other ailment. Such children need careful training, but less than 10 per cent of children who have convulsions become epileptic. Epilepsy should only be suspected if the first attack occurs in a previously healthy child of over two years of age. ”

“ In the case of young children a convulsion attends the awakening. Or the patient, while [p. 807] pursuing his ordinary avocations, may be seized with a chill, prostration, vomiting, and headache, of which symptoms the last is often intensely distressing. In this, as in other epidemic diseases, such violent seizures are most common during the earlier periods of its prevalence, but later in its course premonitory symptoms are more frequently observed. ”

“ The ordinary hysterical attack is never attended by loss of consciousness, by any of the pupillary changes so constant in epilepsy, by the mobility of the pupil between the attacks which is present in a large number of true epileptic individuals. There are never the succeeding changes of color, and the seizures are commonly produced or attended by some emotional disturbance, or are associated with ovarian disturbance. ”

“ Congestive seizures frequently last for days and may prove fatal or, on the other hand, the patient may have recurrent attacks and finally die of exhaustion or some accidental disease, such as pneumonia. In the second stage of the disease the patient eats greedily, and as the food is frequently swallowed unmasticated, choking is not an uncommon accident. ”

“ Case XXXIV. Epileptic Fits—Twelve Years’ Duration—Operation—Cure. S. F., æt. 41, single; admitted into the London Surgical Home Dec. 16, 1861.
History.—Was always ailing, and hysterical for many years. Catamenia appeared early, and always rather profuse. For the last twelve years has suffered from epileptic fits; recurring frequently every week or fortnight, and lately as often as every day. Has constant headaches; is losing memory and all power of concentrating her ideas. Has no premonition of seizure; falls down; is unconscious; has frequently bitten her tongue ”

“ The patient is extremely sensitive to any kind of external impression; a bright light, a loud noise, a breath of cool air, contact with any one, are all apt to bring on one of these seizures. But besides these suffocative attacks there also occur general convulsions affecting the whole muscular system of the body, and occasionally a condition of tetanic spasm. ”

“ The gait is weak and uncertain and the reflexes are exaggerated. In the first stage the patient, through restlessness and sleeplessness, becomes thin and haggard. As the second stage approaches sleep returns, the patient lays on flesh and becomes puffy and unhealthy in appearance. The mental symptoms are marked by greater facility and enfeeblement, while the paralysis of all the muscles steadily advances. The patient is now peculiarly liable to what are called congestive seizures or epileptiform attacks. The temperature rises, the face becomes flushed and the skin moist. ”

“ This general muscular rigidity, which at first is not constant but occasionally undergoes relaxation, is accompanied by frequently recurring convulsive seizures, which are readily excited by the slightest irritation, such as from a draught of cool air, a bright light, the closing of a door, &c. In such attacks there is great suffering and the expression of the face is indicative of agony ”

“ A man long subject to very limited epileptiform seizures may at length have seizures beginning in the same way, and becoming universal, but these are not epileptic seizures, they are only more severe epileptiform seizures. ”

“ I need not dilate upon the danger to the public when large numbers of persons suffering from this malady are at liberty amongst them, for epileptic seizures may occur at any place and at any time. In a crowded street, or on a busy railway platform they might easily be attended with disaster. ”

“ These general remarks are of course more applicable to some individuals than they are to others. In soft and weak natures, where the nervous system is subject to cataleptic seizures, mental and bodily prostration is frequently almost the normal condition. ”