I mentioned in my last blog post that Cameron had started having seizures back in the Fall of 2016. This post will discuss seizures and what we have experienced regarding Cameron's seizures.
· A seizure is temporary disruption of brain function resulting from abnormal, excessive neuronal activity. Neurons are the cells that make up your brain. There are over a billion neurons in your brain that are constantly communicating with each other. A person that has repeated seizures is diagnosed with epilepsy. Cameron's neurologist, Dr. Parker, said that any person that has multiple seizures has epilepsy, but she does not really like to use the term because many times people think of a person with epilepsy as having many frequent, uncontrolled seizures, and often times this is not the case. One interesting thing we learned is that approximately 3% of the population (United States) living to the age of 80 years are diagnosed with epilepsy. Not all seizures are the same, and seizures can results in different noticeable signs. These are called positive and negative signs.
o Positive signs: perception of a flashing light or jerking of an arm
o Negative signs: impairment of consciousness and self-awareness, transient blindness, paralysis
· The signs and symptoms of a seizure depend on the location and extent of the brain regions that are affected. There are two main types of seizures: Focal, or partial seizures (sometimes called complex partial seizures), and generalized seizures. Below are the differences between the two.
· Focal (partial) Seizures
o Originate in a small group of neurons, symptoms depend on the location of the focus within the brain
o Might include jerking with the right hand and progress to clonic movements (jerks) of the entire right arm
o Patient may or may not lose consciousness
o Onset is often preceded by symptoms called auras
o Auras include a sense of fear, rising feeling in the abdomen, or even a specific odor, and represents the earliest onset of a seizure
o The time after a seizure until a patient returns to his or her normal level of neurological function is called the postictal period
· Generalized Seizures
o Begin without an aura and involve both hemispheres
o Can be further divided into convulsive and nonconvulsive types
o Most common type of nonconvulsive generalized seizure in children is the typical absence seizure
§ Normally last less than 10 seconds, associated with a cessation of all motor activity, and results in a loss of consciousness but not posture
§ Patient may appear to be in a trance
We first noticed Cameron having what we originally called "spells" back in the Fall of 2016. He would get really quiet and then have a distant stare on his face for about 30 seconds. Afterwards, he would be highly emotional or agitated, and them complain of being tired (this was the postictal period). Cameron has never had jerking or convulsions with his seizures. It is a common misconception that all seizures involve some form of jerking or convulsions, which they do not. I think that is due to the way seizures are depicted on TV and in the movies. At first we were not sure what was going on, but after talking with his Kindergarten teacher, we thought he might be having seizures. We called his neurologist and they immediately started him on seizure medication and scheduled him for an EEG. Neurologists can use EEG (electroencephalography) to look at brain activity and detect abnormal activity that is associated with a seizure.
Cameron had his first EEG at UMMC in November of 2016. It only lasted 30 minutes and did not show any abnormal activity. His neurologist told us that did not mean he was not having seizures, he just did not have any during that 30 minute time period, which was good. She believed that he was having seizures (focal seizures), and wanted to keep him on his seizure medication. She also wanted to schedule him for a video EEG. This would require a 3 day hospital stay where he was constantly monitored using EEG and video cameras. Over the next few months, we would notice Cameron having one or two seizures a month. We saw the same signs, and he would be really tired the next few days after a seizure. His neurologist changed the type and amount of his seizure medication until we found a stable combination. Since he was still having seizures, he had the video EEG conducted at Blair Batson Children's hospital this past July. It was a very tough time for him, as you can see in the picture above, he had to wear the EEG electrodes on his head for 3 days and could not leave the hospital room. They also had to put an IV line in his hand just in case he had a seizure and they needed to give him emergency medicine quickly. While he was in the hospital, they gradually stopped his seizure medication. He did not have any of the focal seizures we had been seeing, but they thought he might have been having seizures in his frontal lobe, which are very difficult to diagnose. Dr. Parker told us the data was not conclusive, and even if he was having frontal lobe seizures, she probably wouldn't change his medicine. She told us again that just because he did not have any seizures in the hospital did not mean that he wasn't having them, but that he wasn't having them frequently. He is on two different seizure medications right now, she wants to gradually decrease one of the medicines and increase the other so that he only has to take one of them. He currently has to take two different medications twice a day.