Conscious through seizure?

Re: Conscious through seizure?

Submitted by 3Hours2Live on Fri, 2013-05-24 - 04:21

Hi Collegeboy312, Yeah, I have had plenty of events like that for a few decades. Fortunately, Keppra is keeping most of my daily seizures limited to simple partial seizures, with some partial seizures during my about monthly clusters of seizures tending more toward a few complex partial seizures, but no secondarily generalized tonic-clonics for about 50 months now, thanks to Keppra. (Both related and unrelated Migraines are a remaining problem). Piece-meal amnesia resulting for brief time periods around and during a few stronger partial seizures in a cluster adds to "suddenly" finding myself in a bloody mess on the floor (which was typical for me after a strong tonic-clonic seizure in a cluster). Cluster seizures sometimes involve "Acute Repetitive Seizures". Dr. Gloor might have addressed the problems of the concept of "consciousness in epileptology" most directly: http://www.ncbi.nlm.nih.gov/pubmed/3720710 Epilepsia. 1986;27 Suppl 2:S14-26. Consciousness as a neurological concept in epileptology: a critical review. Gloor P. Abstract This essay explores the usefulness of the concept of consciousness in epileptology and concludes that it does not further the understanding of seizure mechanisms and brain function. The reasons for this are both theoretical and empirical. Consciousness cannot be adequately defined. This may explain why attempts at accounting for it in neurobiological terms have failed. Epistemological and scientific arguments are reviewed which suggest why a satisfactory explanation of consciousness is not now and may never be possible. There are, however, aspects of conscious experience such as perception, cognition, memory, affect, and voluntary motility that are open to neurobiological research. Careful observations of epileptic seizures with "loss of consciousness" often reveal that only some components of consciousness are impaired. "Loss of consciousness" during a seizure, often presenting as unresponsiveness, may be due to aphasia, inability to perform voluntary movements, ictal or postictal amnesia (sometimes with preservation of memory during the ictus itself), or to diversion of attention by a hallucinated experience. A plea is made to observe accurately and interact with the patient during an attack in order to distinguish between these various behavioral disturbances masquerading as "loss of consciousness." Trying for a dividing line based on "consciousness" between simple and complex partial seizures (and more generalized/stronger seizures) is put in terms of "Loss of contact and impairment of consciousness" in the book at: http://books.google.com/books?id=Z3eX0Mu4KdQC&pg=PA55&lpg=PA55&dq=20162+Munari+%22loss+of+contact%22&source=bl&ots=Odu40KcVoc&sig=9DAJvbd60efWc1Ayg63QLL_S7l4&hl=en&sa=X&ei=MBefUe2pOobqiwKzxIDoBA&sqi=2&ved=0CCsQ6AEwAA#v=onepage&q=20162%20Munari%20%22loss%20of%20contact%22&f=false Possible "Todd's Paralysis" as a post-ictal phenomena should be carefully distinguished from the ictal and/or the infrequent convuslive and non-convulsive status epilepticus ictals: http://www.ninds.nih.gov/disorders/toddsparalysis/toddsparalysis.htm My wordy discussion of concerns is: The dividing line between simple partial seizures and complex partial seizures is the impairment of consciousness. Unfortunately, there is no objective and valid definition of consciousness anywhere. Just about everyone will claim to know the definition of "consciousness," but all the definitions are just jumbles of synonyms that are just as vague and ambiguous. People with partial seizures that frequently cluster around the dividing line of "consciousness" often realize that this dividing line is arbitrary and is based on the subjective opinions of other people, whether or not they are "experts" or "amateurs." One official definition of impaired consciousness "is defined as the inability to respond normally to exogenous stimuli by virtue of altered awareness and/or responsiveness." My partial seizures frequently halt my speech, so I can reword this as the inability to normally make a vocal response to exogenous stimuli, so I could be labeled as having "impaired consciousness"; but, a severe sore throat could have the same result, and holding a "sore throat" as an impairment to consciousness reveals an inherent absurdity to this definition of impaired consciousness. As a skeptic, the word "normal" and the unusual word "exogenous" could be held by the rules of logic to reveal the definition as revealing an "impaired consciousness," so the word "normal" has to be used with great care. The word "exogenous" also disqualifies the notions of the internal stimuli of "thinking" and "memory" as possible lone elements in having non-impaired "consciousness." Hence, blindness, or deafness, or muteness, etc. would all meet the definition of "impaired consciousness" without extreme care with the word "normal," which would usually be held as absurd also. From Gloor, P. (1986): Consciousness as a neurological concept in epileptology: a critical review, EPILEPSIA 27(2), S14-S26: (Gloor in 1986 wondered whether) "consciousness really represents a workable neurological concept in epileptology and in neurology in general," he then concluded the terms 'loss' or 'impairment of consciousness' were inadequate. For these reasons we prefer to speak of 'loss of contact'. "Limbic Seizures In Children" edited by Avanzini, Beaumanoir, and Mira 2001, ISBN 0969-0301, Chapter 6 Mai, Francione, Cardinale, Russo, Munari. To me, the phrase "loss of contact" has even more problems than "impairment of consciousness", especially with the now ubiquity of cell phones and people suffering "loss of contact" due to the limited range of their cell phones. Somewhat like B. F. Skinner, I believe the notion of "consciousness" and all of the similiar notions are not scientific, and even in informal conversations, their use can cause great consternation to false agreement whether or not they are used carefully. By 3Hours... on Thu, 02/05/2009 - 10:50pm Tadzio