My friend had a seizure and I'm trying to figure out why

[Sesshy]

So, a friend of mine seized in her Spanish class this morning. She has no history of epilepsy, although she has had several seizures as a result of benzodiazepene withdrawal; the most recent one was in 2008.

Before the seizure, she had not slept in over 48 hours, nor eaten, and had only drunk, according to her count, between 5-7oz of Gatorade during that entire period.

Her concern is that she might seize again. She wants to take benzodiazepenes (or in this case a very close analogue, etizolam) again to raise her seizure threshold and decrease the risk of it happening.

My concern is that she was a hardcore benzo addict for years, to the extent that there were periods of her life during which her memory completely blacked out for months, and that she is simply not capable of taking such drugs on a regular basis without seriously harming herself.

I tell her it's obvious that, with no history of epilepsy and considering her physical condition at the time of the seizure, the seizure was caused by severe dehydration in tandem with extreme sleep deprivation and starvation. As far as I've gleaned researching the issue, it appears that severe dehydration, in itself, can actually cause a seizure, rather than merely lowering the threshold in an already epileptic person. She says that must not be the case because the doctors didn't mention it as being a possible cause.

What do you guys think? Is there any reason to believe that this incident could be the beginning of epilepsy rather than a fluke caused by severe physical and psychosomatic distress? Or at least, reason enough for an ex-benzo addict to start taking benzos again?

 

[Silat]

Doctors not mentioning it to her doesn't mean it's not a cause.
Dehydration + Sleep Deprivation + Excessively low blood suger combined could make anyone have a seizure... I've seen it happen to a guy I was working with at a receiving dock. He came to work after not sleeping at all in a day and a half, hadn't eaten, hadn't drank anything, started lifting boxes off the truck, and seized. After he'd gotten food in him, water in him, and slept, he was fine and never had another seizure.

 

[OxyMoron]

I'm the friend! To clarify, it was 7-9oz of Gatorade, and that was the night before the seizure (which happened around 8:20am). Also, it was not the only thing i had to drink in that 48 hours, it was just the most recent. Before that, I had also had some water and maybe some other things, though I was most definitely not getting all that is recommended a person. It had been over 48 hours since I had slept, and I had eaten some but not much (kinda low-calorie vegan-ish diet).

The doctors told me that there was no clear cause for the seizure, and considering that I have nothing in the way of an epileptic past, said that it was probably a combination of things. A blood sample they took suggested I may have had a urinary tract infection, which they said also could have been a contributing factor in this matter.

Not sure why my friend is here asking if you think I have epilepsy, the doctors and myself never had that concern. His argument with me was about whether or not the benzo analogue would be worth taking, or really, if there was any concern of a seizure happening again if I were to properly feed and hydrate myself. The answer to that is, of course, that it is a possibility and that taking etizolam as a preventative measure (in that it raises seizure threshold) would be a wise choice to make.

My friend is often incapable of stating an argument plainly and without letting it become emotionally-charged, and as such he brings in some information that was not valid in our original discussion. I have in the past been something a benzo addict, but this time I know what I would be getting into and had been planning to take 1mg doses twice daily (equivalent to 1mg alprazolam/lorazepam/etc.), whereas before I was prescribed doses of 6mg alprazolam per day. The fact that I was formerly an addict has no bearing on this as an actual argument, and for him to play it up so much was really quite unreasonable.

The real point of our argument was, again, to:
1) Determine if I had anything more to worry about in regards to another seizure if I stayed hydrated and well-fed
2) If the answer to the above is yes, would taking a medication that raises seizure threshold (etizolam, in reasonable doses) be something worthwhile to do?

When you factor in the possible UTI (which can affect seizure threshold and incidence of seizure), my sporadic insomnia and the benefits of the drug, I believe the answers to both of these are yes.

 

[Silat]

Personal opinion:
I think you should try to stick to lifestyle changes first, then if it happens again, consider medication. 1 in 26 people will experience an unprovoked seizure at some point in their life, the vast majority never have another one.

Keep well hydrated, stay well-fed on the right kinds of food, and if you have insomnia try taking a melatonin supplement (anywhere from .5mg to 3mg) about an hour before you're planning to try and sleep.

You mentioned a vegan-ish diet, supplement that with a multivitamin which contains B12 & Magnesium. Vegans tend to be notorious for being defecient in both, which has been linked to seizure activity in more severe cases.

If those things don't work, then consider getting medication. However I don't believe there's a need for it now, because if you can treat it through few simple routine changes it'll be much better for you in the long run. All medications that are anti-convulsants are hard on the body, especially over time.

Alternatively, if you are dead-set on using medication regardless, try a medication that is not a benzo. You may feel the former addiction isn't an issue, however it very well could become one in the future, so it'd be best to not provoke a former addiction.

 

[LW6279]

I think it was caused by the benzodiazepene withdrawal for sure. My husband went through that and it is very hard on CNS altogther. Sleep, watching your sugar and caffinee intake should help.

 

[Crash]

Im with LW6279,sounds like a case off benzo withdrawal,seizures are in certain cases known to occur,hence the long taperering peroid off weeks or into even months,when done properly by you and your doctor,its harder for people already diagnosed with epilepsy,due to their low seizure threshold to go through the taper because off the risk off further seizures.I think they just do a longer taper.

A trip to the doctor would do no harm though,and at least put yours and her minds at rest.

 

[Silat]

If she went through the withdrawal in 2008, why would it still be causing problems in 2012 if she hasn't relapsed? Four years is more than enough time for the nervous system to adjust, I'd think. I've not gone through benzo withdrawal before, but any withdrawal only lasts a certain amount of time before your body adjusts...

I could see 3 weeks... maybe even 3 months if her addiction was severe... but 4 years?

 

[OxyMoron]

Yes, I haven't taken benzos seriously since my series of seizures in 2008. Once every now and then, but never enough to develop an addiction again.

Interestingly, my seizures from the withdrawal were severe and violent, and after most of them I would find myself with a dislocated right shoulder. After soooo many dislocations, they decided to operate on me.. because it was really easy to manage to dislocate it, and always so hard to get it back into place that they had to sedate me.

 

[Rae1889]

Why did you start taking the benzos in the first place? You mention that you havent taken it since the seizures in 2008. It is possible that the benzos caused a permanent lowered seizure threshold, or damage from taking them for so long/abusing them. This could very well be life-style or medication induced epilepsy.

I agree with Silat first though, that sticking to a lifestyle change is better than continuing with medication. If you have another seizure, then consider a medication that is NOT a benzo. Its likely that if you have an addictive personality, that you are using this seizure as an excuse to continue to use and/or abuse them. Especially if you are unable to control your usage of them once you have been prescribed a certain amount and abuse the dosage.

 

[OxyMoron]

Those of you that have epilepsy, or have had seizures in the past, are you ever embarrassed afterward? I'm very, very sore today, but I chose not to go back to my spanish class when I really should have, and it was more out of embarrassment than anything else. I've been told by people that it's frightening to witness me having a seizure, and I'm going crazy imagining what everyone there might think of me :/

 

[Silat]

I used to be... so I understand where you're coming from. Eventually I've reached a point where it's just everyday life, and I don't dwell on it or the fact I might have one anymore.

Initially it was pretty distressing/embarassing though. :?

 

[OxyMoron]

Why did you start taking the benzos in the first place? You mention that you havent taken it since the seizures in 2008. It is possible that the benzos caused a permanent lowered seizure threshold, or damage from taking them for so long/abusing them. This could very well be life-style or medication induced epilepsy.

I agree with Silat first though, that sticking to a lifestyle change is better than continuing with medication. If you have another seizure, then consider a medication that is NOT a benzo. Its likely that if you have an addictive personality, that you are using this seizure as an excuse to continue to use and/or abuse them. Especially if you are unable to control your usage of them once you have been prescribed a certain amount and abuse the dosage.

Oh, sorry. I took benzos for social anxiety disorder, but it got a little out of hand and I was prescribed 6mg alprozolam per day, and bought more from friends when I ran out. Yesterday was my first seizure since 2008, and I really thought after all of these years I was done with this seizure stuff

 

[Nakamova]

Interestingly, my seizures from the withdrawal were severe and violent, and after most of them I would find myself with a dislocated right shoulder. After soooo many dislocations, they decided to operate on me.. because it was really easy to manage to dislocate it, and always so hard to get it back into place that they had to sedate me.

Dislocations are relatively common with grand mal seizures -- and once it happens, there's likely to be a tear in the shoulder socket that makes future dislocations more likely. I've had two shoulder surgeries as a result, the second to graft a bone block to prevent the shoulder from popping out. Still doing PT to recover from that.

 

[Rae1889]

Oh, sorry. I took benzos for social anxiety disorder, but it got a little out of hand and I was prescribed 6mg alprozolam per day, and bought more from friends when I ran out. Yesterday was my first seizure since 2008, and I really thought after all of these years I was done with this seizure stuff

Ok this helps clarify a bit more. So here is my revised opinion. It is either one of 2, maybe 3 things.

1) The seizure was a result of permanent withdraw symptoms from the abuse and/or misuse of the medication. Similar to LSD flashbacks, because the body always remembers using substances like this

2) The seizure was psychogenic in nature due to the social anxiety disorder. The body/brain may have been overwhelmed with internal and external stressors and seized as a coping mechanism

3) The social anxiety disorder is misdiagnosed and you actually do have epilepsy. Its possible that the feelings you feel are simple partial seizures and they were misdiagnosed.

Now I am not a doctor, so you may want to bring up all these options to your doctor and/or neuro

Also, yes I do get embarrased after seizures. Ive only had them knowingly for 3 years, but I am still embarrased.

 

[Cint]

Those of you that have epilepsy, or have had seizures in the past, are you ever embarrassed afterward? I'm very, very sore today, but I chose not to go back to my spanish class when I really should have, and it was more out of embarrassment than anything else. I've been told by people that it's frightening to witness me having a seizure, and I'm going crazy imagining what everyone there might think of me :/

I've had many TC seizures in public, and yes, I used to be embarrassed. My now grown children have witnessed them also, and were scared to death at times, but we all got thru it. Educating others about seizures/epilepsy is what you can do to help eliminate that embarrassment.

 

[qtowngirl]

Ok this helps clarify a bit more. So here is my revised opinion. It is either one of 2, maybe 3 things.

1) The seizure was a result of permanent withdraw symptoms from the abuse and/or misuse of the medication. Similar to LSD flashbacks, because the body always remembers using substances like this

2) The seizure was psychogenic in nature due to the social anxiety disorder. The body/brain may have been overwhelmed with internal and external stressors and seized as a coping mechanism

3) The social anxiety disorder is misdiagnosed and you actually do have epilepsy. Its possible that the feelings you feel are simple partial seizures and they were misdiagnosed.

Now I am not a doctor, so you may want to bring up all these options to your doctor and/or neuro

Also, yes I do get embarrased after seizures. Ive only had them knowingly for 3 years, but I am still embarrased.

:agree: with EVERYTHING Rae has said, first and second post IMO are right on the money. Permanent withdrawal symptoms/flashbacks are definately a possibility, as is the misdiagnosis. I was misdiagnosed with Post Traumatic Stress Disorder at 15 when my brain started 'remembering' something from my past. Mental health said it was PTSD and put me on zoloft, but after grand mals started at 25 we eventually found out it had been simple partials all along. Being misdiagnosed sucks and fucks up your life - I would seriously look into it b/c if you do have E and don't know it... well... I repeat what I last said. Good luck.

And nope, I must admit, never been embarrassed. Have simples all the time in many places, and so far six grand mals (in front of boyfriends, my dad, a total stranger who was driving behind me and when I crashed he ran to the car and held my head up for me until it was done...) and it's never bothered me for a second. E brings enough problems with it we don't need to feel any sort of shame. It's like, 'Okay you just seen a grand mal seizure, if you've seen one before then it's nothing new, if you haven't well then now you know.' There's nothing wrong with people learning when others need help. And if they shy away, or glare at you (poor Stace) then to hell with them they can stay ignorant while I go soothe myself from another shitty day.

 

[Cint]

E brings enough problems with it we don't need to feel any sort of shame. It's like, 'Okay you just seen a grand mal seizure, if you've seen one before then it's nothing new, if you haven't well then now you know.' There's nothing wrong with people learning when others need help. And if they shy away, or glare at you (poor Stace) then to hell with them they can stay ignorant while I go soothe myself from another shitty day.

:agree: We all need to let others know about their "unknown" and welcome them into "our world".

 

[vallygirl]

I have a knack for having seizures in very public places (although fortunetely not that frequently), and it is very embarassing for me. The people I'm with always tell me not to be embarrassed, but its hard not to be. I just don't like getting attention for my epilepsy, plain and simple. But its kind of just one of those things you have to deal with in life. I mean, life could definitely be worse. I know I'm very lucky to have a type of epilepsy that doesn't effect me every day, or even every month. And I think its helped to join these forums and be more open and talk about my epilepsy more...I guess you guys make me feel less freakish

 

[OxyMoron]

Yes, I'm so embarrassed that I have missed class yesterday and today. Which is bad, because there is a test scheduled for tomorrow and I've mostly been unable to study for it, as my instructor was holding onto my textbook and notes and things for me. I don't really do well in social situations, and it's just weird to have people concerned over me.

My spanish instructor and classmates have been emailing me, and some of it kind of freaks me out: "May the Lord Bless You and Keep You. May His Face shine on You and give you Peace."

I'm not dying or anything, but reading all of this stuff makes me wonder just what my seizure looked like to them. It's good I don't have to remember it, or I would surely never return to class. It would be really great if everyone there could forget that anything happened; I don't know how to deal with people fawning over me and I really need to get back to class. There's a pretty high chance of me never returning, which is what normally happens when I'm faced with uncomfortable social situations at school or work.

And I'm scared that I will have a seizure while I'm driving. This one seemed to have been brought on by practically nothing, and since I already have debt collectors after me for medical bills I do not want to go see a neurologist or even my regular GP. I wouldn't expect them to tell me anything new or concrete anyway. Fear of seizing while driving is the main reason I wanted to take my etizolam, and once class ended (3 weeks), I could then wean myself off of it to ensure that I didn't hurt myself. That's not going to happen though, because of Sesshy there and his concern over my drug-addled past.

I don't have epilepsy like the rest of you; dealing with it on a long-term basis must be so much more difficult

 

[vallygirl]

I think you should go back to class. I think you will be suprised how quickly your classmates will forget about the incident. Initially when you go back you will probably get a little extra attention from your concerned colleagues, but if it doesn't happen again they probably won't bring it up in the future. At least thats what I've found from most of my experiences with having seizures in public. Once I had a seizure during a big event for a local political group I belong to. I was so embarrassed that I didn't return. One of the other group members started emailing me asking why I hadn't returned. After I confessed it was because I was embarrassed, she convinced me to come back. I did and I'm very glad I did, because no one ever brought it up again, and I would have missed many great times with them had I stayed away.

Trust me on this at least - it won't be as bad as you think it will.