Why did I have a seizure?
April 27, 2011 11:52 AM   Subscribe

Why did I have a seizure? How do I not do that again?

YANAD/YANMD - A while ago, I was at the dermatologist to have some moles removed, one of which was in my neck. I know I don't do well with needles so I brought my husband. That turned out to be good thinking because things got fuzzy and cloudy while I was receiving the anesthesia. Next thing I know, the nurse, doctor, and husband are all staring down at me while they're holding my legs up. It turns out I had a seizure.

This made me reflect on other similar incidents.
- I think I lost consciousness when I received anesthetic shots before having a wisdom tooth removed. I don't remember passing out but I remember getting shots, feeling really out of it, and then the doctors were putting cold wash cloths on my face.
- I passed out while getting my tattoo and the now-ex boyfriend who was with me at the time remembers that I was actually shaking after losing consciousness.
- I nearly passed out while getting my nose ring. I passed out the first time I cleaned my belly button ring. I started getting dizzy when a doctor did a TB test on me. Seriously, a really bad paper cut made me hyperventilate. I haven't given blood in years because I nearly passed out when I did it before.

Since my back looks like a map of the world, I've started taking Klonopin before having biopsies at the dermatologist but I went yesterday I still got wobbly, dizzy, started feeling out of it, etc.

Besides the seizure I don't think I'm epileptic but I don't know if that's like saying, besides my daily burger habit, I'm a vegetarian.

Why does my body do this? It's like when my pet rabbit played dead after we cut one of her nails too short. The Klonopin has worked lately but would beta blockers be more helpful?

Finally - and this is so far down the line it's laughable but please humor me - I think I'd like to have kids someday but I imagine that there are lots of needles involved in the appointments leading up to such a thing and I worry that there may be a conflict of interest between me exposing a fetus to Klonopin or alternatively losing consciousness while pregnant. Again, this is easily a zillion years away but it's something I wonder about so thanks in advance.
posted by kat518 to Health & Fitness (33 answers total) 1 user marked this as a favorite
What? If you had a seizure you should be asking these questions to your neurologist.
posted by Jahaza at 11:58 AM on April 27, 2011 [8 favorites]

If you had a seizure in a doctor's office, what did he or she say about it? It's really weird that you don't tell us what happened after that.

Besides the seizure I don't think I'm epileptic

The very first thing I'd do is confirm this. Neurologist, asap.
posted by desjardins at 11:59 AM on April 27, 2011 [2 favorites]

What? If you had a seizure you should be asking these questions to your neurologist.

And your dermatologist should be able to write you that referral after watching you have a seizure, despite how rare the dermatologist -> neurologist referral is.
posted by Mister Fabulous at 12:00 PM on April 27, 2011 [4 favorites]

The shaking that accompanies your loss of consciousness makes me suspect epilepsy. You'd have to see a physician to get a work-up, though; there's always the chance that it could be something that requires rapid attention. What if something like this happened while you were driving?
posted by qxrt at 12:01 PM on April 27, 2011

Why does my body do this?

This is a question you ask your GP when you're getting a referral for a neurologist, and then you ask the neuro.
posted by rtha at 12:04 PM on April 27, 2011

There are psychiatrists who can help you manage anxiety while pregnant, and beta-blockers might be a good choice for you at that point. Not that many needles involved in my prenatal care so far (just one blood draw).

This wasn't an anxiety thing though, necessarily, if it was a seizure. That's really a separate issue.
posted by the young rope-rider at 12:04 PM on April 27, 2011

This article suggests it's not entirely unheard of; I'd still suggest an appointment with a neurologist to rule out other reasons, though.
posted by infinitywaltz at 12:05 PM on April 27, 2011

Response by poster: See, that's something that confused me - no one told me I had a seizure when I regained consciousness. My dermatologist definitely did not say, you might want to get that checked out. In fact, I thought I just passed out at first. My father said to me later, "I don't think you passed out. It's pretty rare to lose consciousness when you're laying down." Then my husband said, "Yeah, you had a seizure. I know because the nurse said, 'she's having a seizure.'"

My husband said that he's not concerned about me having problems while driving because I don't drive often and I can't name a time when I was having needles jammed into my neck while driving.

Thanks for the feedback so far!
posted by kat518 at 12:05 PM on April 27, 2011

Response by poster: And I did mention it last time I saw my GP and he blew it off.
posted by kat518 at 12:09 PM on April 27, 2011

The more I think about it, the more I suspect vasovagal response, especially since it only seems to happen when you're poked with needles (a common trigger). Again, it certainly couldn't hurt to bring it up with your GP the next time you see him, but I probably wouldn't worry too much about it. Definitely mention it next time you get an injection or venipuncture, though!
posted by infinitywaltz at 12:13 PM on April 27, 2011 [3 favorites]

I agree with infinitywaltz. Get tests done to make sure what it isn't. This will minimize stress a lot.
posted by goalyeehah at 12:16 PM on April 27, 2011

The thing that struck me is the mention of Klonopin. With most benzodiazepines (I don't know this particular one), overdose, withdrawal and some interactions with other drugs can cause seizures. Did you take the Klonopin that day, and did you mention this to the dr/anesthesiologist? I would check this out before running to the neurologist (probably talk to the Dr. that prescribed the Klonopin), especially if this is the only time you've had a seizure, or only had one under those circumstances.
posted by MuChao at 12:23 PM on April 27, 2011

Talk to the doctor who witnessed it! After working in a hospital, I've seen plenty of people pass out witnessing surgery/blood/guts/gore. The common experience tends to be feeling really hot/shut in/anxious and then kind of going down for the count. Tends to be nothing to worry about. I can't imagine any doctor, even one seeing you for a nonrelated issue would think a SEIZURE was no big deal. I'd check with the doc to see if was a seizure or a simple pass out. Husbands, friends, etc. maybe wouldn't know the difference, but your doctor should. And should be willing to help you out on how/when/if to follow up on this.
posted by troublewithwolves at 12:24 PM on April 27, 2011 [1 favorite]

Seizures have nothing to do with the kind of anxiety-induced fainting you describe. They are basically unmistakable; if you have one, it will be very obvious to everyone who witnesses it.

Most seizures are idiopathic, meaning there is no clear reason why they occur. There are specific things that can cause them—a fever, a tumor, certain drugs, etc—but usually all the neurologist can do is shrug. You need to go to a neurologist anyway. First, to rule out something like a tumor, and second, because if you did have a seizure, there's a chance you'll have another.

Having had a seizure puts you at risk of more seizures. Conversely, the longer you go without having a seizure, the less likely you'll have one in the future. Getting an EEG will tell your neurologist whether you have epileptiform (seizure-like) activity going on in your brain. If you do, you will definitely need to go on anticonvulsants for a period of time.
posted by dephlogisticated at 12:25 PM on April 27, 2011

Best answer: I entirely agree with infinitywaltz. Everything you have said sounds like nothing more than a faint.

Of course you do not describe what your husband, nurse, doctor saw after the lightheadedness, but lightheadedness rarely precedes seizures, whilst a few jerking movements are common after faints. I can factually tell you that the diagnostic usefulness of "she had a seizure" coming from a nurse (and often non-neurological doctors) is very low. Of course I'm not saying you didn't have a seizure as I don't have all the information, but you really shouldn't assume that you did. All the previous events you describe sound like simple faints (aka vasovagal syncope).

If you did have a seizure (which as I say sounds unlikely) then you are only epileptic if you have another one (epilepsy is the tendency to recurrent seizures). If clinically your neurologist is convinced by the actual description of the seizure then you would require an MRI scan (as new-onset epilepsy in adults is usually symptomatic of something else) and an EEG.

The very obvious answer is that you need to be seen and assessed by a neurologist in a formal environment, ideally with a witness to the event there.

(I am a neurologist)
posted by inbetweener at 12:27 PM on April 27, 2011 [6 favorites]

I often pass out when getting shots, and I have twice had seizures while unconscious. I don't remember them, but the nurses have told me about them after I come to. I've been told that this is a thing that happens and I don't need to worry about it.

I'd still see a doctor just to be sure, but you're not alone, anyway.
posted by rosa at 12:28 PM on April 27, 2011

Response by poster: MuChao: I hadn't taken Klonopin that day. I only take it for anxiety, frequently related to flying, or when I've had trouble sleeping. No more than 5x a month, I'd say.
posted by kat518 at 12:28 PM on April 27, 2011

FWIW, regarding possible future pregnancy, I only got stuck with a needle once during the course of my entire pregnancy, labor and birth, for the blood draw at one of my early prenatal appointments.

Of course, if you end up having labor induction or an epidural or something, of course those are given by those needles that stay in for a while. Maybe strongly consider doing a non-hospital birth with a midwife, as that will GREATLY reduce your chances of being stuck with needles.
posted by rabbitrabbit at 12:32 PM on April 27, 2011

Since all of theses episodes center around needles and blood, it seems likely that they are related. Needle phobia is a very real thing, but it can be overcome with exposure, time, and/or therapy.

By all means get checked out neurologically, if only to allay your anxiety. It seems unlikely that you have magic needle-induced epilepsy, though.

I am an EMT and am working towards a nursing degree. The first time I saw an IV placed, I passed out cold. A few years later, I barely notice needles and blood doesn't affect me at all.
posted by charmcityblues at 12:34 PM on April 27, 2011

Incidentally, I should also mention that hyperventilation (as a manifestation of anxiety / panic) can make you lose consciousness directly (the hyperventilation reduces your carbon dioxide levels, makes your blood alkaline and reduces your calcium levels resulting in loss of consciousness). This is extremely common, and you describe that you hyperventilate when anxious even at papercuts.

Although if you were hyperventilating on this occasion I would imagine your husband and others would have noticed. You may also have noticed your heart racing, tingling in your fingertips or muscle spasms in your hands and feet, before passing out if this is the case.
posted by inbetweener at 12:37 PM on April 27, 2011 [1 favorite]

Go to the neurologist. Do not pass go, do not collect $200.
posted by Ironmouth at 12:40 PM on April 27, 2011

Response by poster: Thanks, all. So far this has been very helpful. For what it's worth, I have had blood drawn before without any drama. My GP has great nurses who have drawn blood without me noticing.

inbetweener, your remarks were super helpful and made me feel less like a neurologist would think I'm wasting his and my time just because I'm a wimp. Some of the incidents I mentioned (paper cut, TB test, tattoo, piercings) were in college and since then, I've been more active in running and yoga, both of which have helped me remember to keep breathing when stressed out.
posted by kat518 at 12:45 PM on April 27, 2011 [1 favorite]

You may or may not have a health condition. I'm a little concerned that the descriptions of what happened at the dermatologist's office differ and that no one followed up with you about the event or at least clarified/corrected the nurse's statement. Call them and talk to them directly about it.

Epilepsy is a rule-out diagnosis. It refers to having a lowered seizure threshold for any of a variety of reasons. Sometimes they never pinpoint the cause.

There are other reasons to have one-time seizures (a significant number of people do have single seizures and then never again) or similar-appearing events (vasovagal syncope--which can be associated with needle-sticks/blood drawing/etcetera--and other cardiac events can result in twitches/convulsions that look like epileptiform seizures).

Still, you have now had multiple technically unexplained episodes of altered consciousness.You need to have a work-up by a neurologist, including a sleep-deprived EEG. Legally, in DC you should not be operating heavy machinery or driving if you are having unexplained alterations in consciousness for any reason, epileptic seizures or not. This is not something that is for you or your husband to decide. This is a legal restriction, and although there is controversy about the extent and scope of such restrictions, it's a pretty good motivator to see someone about the episodes. So...yeah, get this checked out. If it's confirmed as vasovagal syncope that occurs under certain conditions only, which is pretty common, that's good and then you know.

There is no particular way that 'feels' like being a person with epilepsy. For me there was no moment when I suddenly felt changed or permanently different. That's an internalized view of people with a chronic health condition as not-like-me. I don't feel "like a person with epilepsy." I am a person. I have epilepsy. I feel and have always felt like me, and nothing else. Whatever I feel is how it feels to be this particular person with epilepsy.
posted by Uniformitarianism Now! at 12:46 PM on April 27, 2011

It seems really unlikely that you had seizures. I pass out when I get shots, have blood taken, get eye drops (?!) and once when I got a bruise. All of these are relatively normal.
posted by The Lamplighter at 12:50 PM on April 27, 2011

If you suspect seizures, talk to a neurologist. If they suspect you've been having them (your description fits what one sounds like), they'll schedule an EEG or similar test. Using that they'll determine if you have epilepsy. Definitely mention a) the sources of the suspected seizures and b) great detail of what happens when you suspect you're having one. Definitely bring a loved one who has observed the behavior, as your memory may be less than perfect of the incident. Basically, what Uniformitarianism Now! posted above.
posted by cellphone at 1:46 PM on April 27, 2011

Regarding the nurse's comment, boy, I've had nurses mis-"diagnose" me in all kinds of ways. The nurse saying it's a seizure doesn't make it one. A nurse isn't qualified to diagnose.

Neurologist sounds like a really good idea.

If the neurologist doesn't find anything, hey, I twitch pretty badly from time to time due to those vaso-vagal response issues that have been mentioned several times upthread. Mine's triggered by standing up, not by needles, but it can definitely cause fainting with whole-body muscle spasms that the inexperienced eye might assume is a seizure. Most of the time I just faint, but every so often it is accompanied by that pseudo-seizure-looking effect. So twitching while unconscious is not necessarily a seizure, no.
posted by galadriel at 2:10 PM on April 27, 2011

It really sounds more like a vasovagal reaction than a seizure to me, but I'm not a medical professional, just another person who's woken up in a room suddenly filled with extra nurses holding my legs in the air.

I once passed out in a science lab at college, lost consciouness sitting at a bench, woke up on the floor in a puddle of urine. Niiice. I was told that time that it looked like I'd had a seizure, but the doctor I saw - after asking me about any epilepsy in my family, etc. - told me that in cases where people faint but don't end up horizontal (e.g. when I collapsed onto the lab bench rather than falling straight to the floor) it's quite common to look like they're fitting, apparently it's a case of unconsciously flailing around to find a position that will improve the blood flow to the brain.

These days I ask to get blood tests/injections lying down, and make sure I've eaten something beforehand so that my blood sugar's not too low. I haven't passed out when I've been able to do that.
posted by Lebannen at 2:18 PM on April 27, 2011

I had a vasovagal faint due to overheating and it was pretty much like you describe. The fact that every time it happens, it happens around needles, is a pretty good sign that it wasn't actually a seisure. Then again, if you have decent medical insurance, better safe than sorry.
posted by zug at 2:22 PM on April 27, 2011

OK, I'm going to suggest something different here: Is it possible that you have a sensitivity to epinephrine, which is often used in local anesthetics?

I, like you, don't do well with needles. But more than just a general faintness, getting an injection containing dental anesthetic with epinephrine causes symptoms in me that seem similar to what you describe. Namely, extremely rapid heartbeat, hotness/dizziness, fainting, shaking, and uncontrollable muscle spasms. I could definitely see why it would feel like a seizure. It's not an allergy, but rather a sensitivity wherein your already-high nervousness levels are pushed into overdrive by the extra dose of adrenaline in the anesthetic.
posted by vodkaboots at 2:28 PM on April 27, 2011

You did not have a seizure as commonly understood. You had a vasovagal reaction, also known as a 'common faint'. When this happens, your brain is momentarily deprived of oxygen, and this can result in very brief jerking motions. The jerking is fairly common with fainting; I have seen in on multiple occasions. Technically this is a seizure, but it's not like an epileptic seizure in the sense that it is very brief, it is always preceded by fainting, and there is a rapid (less than 1 minute, say) return to normal consciousness. Based on this, you do not need further testing. This is not a medical opinion; IANYMD.
posted by kevinsp8 at 3:40 PM on April 27, 2011

I tend to faint where needles are involved (ear piercing, blood draws, etc). I also had a baby about a year ago. I was really worried about fainting first during some of those blood draws, and also when I ended up needing to be induced ending with a C-section. I never fainted through all of that. Maybe because my blood pressure was higher from pregnancy, I really don't know, unfortunately.

For me, I have found that it is very important to a) lie down, b) tell the person that I am a fainter c) be sure to avoid seeing the needles and other equipment and d) talk about something, anything else. I have heard that for other people it can be really different, including wanting to be able to see the needle -- so it is very important that you tell the person you are working with what works best for you, I have found. Hopefully you can find out what works well for you and it will continue to work well for you if you decide to have a baby.
posted by freezer cake at 4:30 PM on April 27, 2011

Besides the seizure I don't think I'm epileptic

You're not. Epilepsy is defined by a pattern of seizures, not one incident. (Spoken as a card-carrying epileptic.)

They are basically unmistakable; if you have one, it will be very obvious to everyone who witnesses it.

This isn't true. My own seizures look like I fell asleep and would be totally mistakable to someone who didn't know me. Some types of seizures manifest akin to drunkenness. Grand mal seizures, which ARE unmistakable, are not the ONLY type of seizure.

That said, in all of my years as a seizure-haver, I've never had one induced by a specific event the way you're describing. That doesn't sound like a seizure AT ALL. Seizures come on randomly, sometimes connected to things like lack of sleep, exposure to flashing light, low blood sugar, stress... those kind of things. Getting blood drawn? It's such a quick process that it's unlikely that your brain was able to build up enough steam to cross the seizure threshold.

In addition to having seizures, I've totally fainted in doctor's offices when having stitches taken out and such. What you're describing sounds exactly like that. Your legs up is a position used to treat patients in shock to return blood to their heads. No one does that for someone having a seizure as it's completely useless in that event. Your nurse probably misspoke - I've had nurses who witness my actual seizures say that I'm faking. Nurses are amazing, don't get me wrong, I admire them - but they're not qualified to diagnose.

As for pregnancy: relax. I *do* have epilepsy and I successfully carried a perfectly healthy baby to term while taking anti-convulsants. Klonopin may not be the best drug, but you have plenty of time to figure out one that works for you and is also safe for pregnancy.

Also, seriously, Klonopin is not an anti-convulsant. If it stops your episodes, those episodes are NOT seizures.
posted by sonika at 5:28 AM on April 28, 2011 [1 favorite]

Seconding "tell people you're a fainter." I have that vasovagal thing, and I faint when I have blood drawn. Nurses/doctors really, really want to know up front that this has happened before.
posted by shopefowler at 9:24 PM on April 28, 2011

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