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"Post-ictal" confusion
Wed, 01/07/2009 - 00:06Hey all,
Most of you don't know me, but, as I stated in my introductory thread, I'm new to all of this (Holy pleonasm, Batman!).
The first time I ever witnessed a seizure was during my video EEG in November. Naturally, I saw quite a number of them over the next few nights.
What has stuck with me wasn't necessarily the seizures themselves. It was the period afterwards. The doctors and nurses would begin asking a series of question to the teenager in the bed next to me. I'm sure some of you are familiar with the routine:
"What's your name?"
"David." He got that one right.
"Do you know where you are?"
"September...19th. Or 20th. I think."
So David was capable of responding to verbal cues, but he wasn't actually able to comprehend them. He knew he was being asked general questions, but he didn't know what he was being asked.
Essentially -- I think -- his brain wasn't really functioning, at least not at anything resembling a normal level for him. While it was in the process of recovering, David's brain had created a limited level of awareness. He wasn't in a seizure state, he wasn't back to normal, he was sort of in the middle somewhere, almost as if it was a survivalistic instinct. His brain had developed a third state.
The mere fact that some of you have gone through this so many times that your brain reacts this way is heart breaking. It was by far the most devastating realization of my four day stay in the hospital.
I hope this is not a breach of etiqutte as, again, I'm new to this and only suffer from absence seizures, but is this what it's really like for a lot of you? What is that recovery period like? How does all of that compare to the seizures themselves?
Comments
Re: "Post-ictal" confusion
Submitted by 3Hours2Live on Wed, 2009-01-07 - 06:21
The time period immediately following a seizure is usually labeled the "postictal" phase once the
seizure has ended. The exact dividing line between the seizure period (the "ictal") and the postictal
period is subject to interpretation; generally the ictal is a matter of minutes, while the postictal
may last for hours or more. The difference between a "physical" recovery and a "conscious" recovery is
easily confounded by observers of the postictal phase, and frequent amnesia experienced by the
sufferer adds to the confusion about "consciousness." "Comprehension" is even a more vague concept.
"Consciousness" is a concept that is not well defined, and using words like "awareness" or "responsiveness"
doesn't help much. After many of my severe partial seizures, and some of my tonic-clonic seizures,
I am conscious enough to remember medics trying to get a response from me, but my temporary inability
to speak or move, and especially with ocassional blindness, is interpreted by the medics as not
having consciousness which I would beg to differ with them if I could speak or move. Almost always
I have a strong desire to just go to sleep after a seizure, but paradoxically, once I was labeled
unconscious, while I heard and remembered a lot, and one nurse was arguing that I was "faking" it
shortly after a seizure. (Some of these experiences were also verified by others when I related it
to them, so I know its not just dreams or false memories).
Amnesia is frequently a problem, as I have had major seizures in my bathroom and managed to return
to bed, and yet when I awake later I have no memory for what hapened, but I am stiff and sore, with
bruises, torn and cut skin, a bleeding tongue, a trail of blood between the bathroom and my bed, and
my bathroom in shambles with puddles of blood.
Differentiating amongst "states of mind" poses a problem because there is not an objective and
valid scientific definition between the first two states "established," conscious and unconscious.
The time period immediately following a seizure is usually labeled the "postictal" phase once the
seizure has ended. The exact dividing line between the seizure period (the "ictal") and the postictal
period is subject to interpretation; generally the ictal is a matter of minutes, while the postictal
may last for hours or more. The difference between a "physical" recovery and a "conscious" recovery is
easily confounded by observers of the postictal phase, and frequent amnesia experienced by the
sufferer adds to the confusion about "consciousness." "Comprehension" is even a more vague concept.
"Consciousness" is a concept that is not well defined, and using words like "awareness" or "responsiveness"
doesn't help much. After many of my severe partial seizures, and some of my tonic-clonic seizures,
I am conscious enough to remember medics trying to get a response from me, but my temporary inability
to speak or move, and especially with ocassional blindness, is interpreted by the medics as not
having consciousness which I would beg to differ with them if I could speak or move. Almost always
I have a strong desire to just go to sleep after a seizure, but paradoxically, once I was labeled
unconscious, while I heard and remembered a lot, and one nurse was arguing that I was "faking" it
shortly after a seizure. (Some of these experiences were also verified by others when I related it
to them, so I know its not just dreams or false memories).
Amnesia is frequently a problem, as I have had major seizures in my bathroom and managed to return
to bed, and yet when I awake later I have no memory for what hapened, but I am stiff and sore, with
bruises, torn and cut skin, a bleeding tongue, a trail of blood between the bathroom and my bed, and
my bathroom in shambles with puddles of blood.
Differentiating amongst "states of mind" poses a problem because there is not an objective and
valid scientific definition between the first two states "established," conscious and unconscious.
Re: "Post-ictal" confusion
Submitted by srchtt3 on Sat, 2009-11-07 - 04:51
Mine can be very different depending upon the type of seizure I had. I have a wide range of seizures. Mild ones, I may just be a bit confused but never miss a beat. on the other end of the spectrum, if I go into status epilepticus, when I wake up in the hospital the IV they are trying to shove through my strained arms that wont relax is one of the most painful things I've ever experienced, it's almost as if every nerve in my body is alive and aware of every little thing happening, so that needle for the IV becomes a huge bowie knife! lol... I won't be able to talk, walk, make sense, much less understand a word you say, and I can be ... oh what is the word, um.... I guess aggressive... not really but um... disrespectfull... sorry can't think of right word... Other times when I had a grand mal I sat straight up like off a scary movie and just stare around confused, disorientated and it takes a good fifteen to twenty minutes to get me to understand anything. But after the big ones I always need sleep. LOTS of sleep. lol...