Chronology of an Epileptic Attack

Stage 1: Early Aura

The aura is the period where I start to experience disturbances, e.g. flashing lights, dizziness, headaches, muscle numbness, etc in a manner that does not affect my concentration yet.

Usually this happens relatively often, but due to its harmless nature and the fact that i can still function as an intelligent person, as well as it can be controlled, it is not too much of a problem.

Basically during this period the aura may spontaneously go away, or if not, basically it may still be controlled by putting me in places with little stimuli, i.e.
1) dark places / closing my eyes - to block out visual stimuli - first sign of early aura.
2) quiet places - to block out aural stimuli
3) warm places - to ensure blood circulation (usually in air-con places)

Usually this stage of the aura might last from a few seconds or a few minutes to about two hours.

Stage 2: Late Aura

This develops from Stage 1, where the aura cannot be controlled, and it intensifies to give more complex symptoms such as increased heart rate (which i think marks the start of Stage 2). (From what i know) the seizure has spread over to more parts of the brain, i think reaching the ANS sometimes.

When heart rate increases, it means one thing: the body senses BIG trouble. The body is now in critical condition, it MUST rest, no other stimuli must be present, then only it can have a chance of controlling the seizure. The increased heart rate is suspiciously caused by increased adrenaline, as the "fight or fright" symptoms are extremely dominant. The patient gets restless, and starts chattering his teeth uncontrollably at a particular fast basal rate (about 8-10 Hz).

Usually this period means big trouble. An ambulance may be called if there is no sign of the symptoms going back to Stage 1.

Lasts for about 5-30 minutes.

Stage 3: Just before the seizure

This stage happens very fast. The seizure is now spreading like wildfire in the brain, and there is nothing you can do to control it but to let it run. Extreme visual disturbances such as seeing lights, being blinded by lights, hearing disturbances such as a faint buzzing sound, or hypersensitivity to touch occurs. To outsiders, the sufferer does not respond to much commands anymore, or is simply oblivious to his surroundings. The body starts to seize and the patient may feel an uncontrollable urge to bite something. He or she might start to salivate, and choke on the saliva produced.

Seizure stage

I dunno what happens to me during this stage as i lose consciousnss altogether. The patient hence will have absolutely no memory of this. Observers will note that the patient convulses, i.e. muscles start shaking uncontrollably. He might foam or salivate in large amounts.

Timing for seizure stage is crucial: there is a certain time frame that the seizure is allowed to proceed before brain damage occurs. Never leave a patient seizing for more than 4 minutes. I think what usually doctors do is that they will inject IV/rectal valium to the patient to stop the convulsions.

A seizure is probably a medical emergency and should be regarded as one that is life-threatening.

After the seizure: Post-Ictus

The patient recovers from the seizure with no memory of what happened during the seizure. At most he can recall Stage 3 but that's about it.

Due to the extreme forced exertion of the muscles, he might experience muscle weakness throughout the body. Also, if he has injured any part of the body, he might not notice or feel it at first.

Tongue will be bitten (one way to identify a seizure)

May have a splitting headache that is impossible to get rid of (usually takes about 2 painful hours).

May be hyperventilating.

Vomitting is not uncommon especially if he has had a meal before the seizure. Vomitting makes the person feel better. Induction of vomitting i think should not be carried out though.

Usually, the person recovers to normal after a deep sleep, although full recovery would probably take 2-3 days. The patient is advised to rest completely for at least 24 hours (i.e. nothing that will trigger a seizure, nothing mentally tiring).

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Question for Leo and Yew Sen:

Explain the possible physiological changes that happen in an epileptic's body based on this account of an epileptic attack. :p