Seizures

I was up late at my computer the night of 23 October. Next thing I knew, I was on the floor surrounded by EMTs, in pain and very confused.

I had suffered a seizure. On top of that, somewhere between my chair and the floor, I had managed to fracture my spine.

I ended up in the hospital for a few days with three different medical teams keeping tabs on me: Neurology for the seizure, Neurosurgery for my broken back, and Infectious Disease to check me for tuberculosis infection.

hospital_after_seizure

The TB risk was incredibly small, but since I work with the stuff and I showed up at the ER with a cough and a questionable chest X-ray (turns out I had aspirated during my seizure), they decided to play it safe. There was some talk of doing a lumbar puncture, but since I had no symptoms of bacterial meningitis (apart from the seizure) I dodged that bullet. A PPD and three sputum cultures all came back negative, so no TB for me!

Meanwhile, there was still no telling what had actually triggered the seizure. An MRI showed no brain tumors or other structural abnormalities, and an EEG demonstrated fairly normal brain activity. With nothing to go on and no prior history of seizures, the neurologists decided not to start me on anti-seizure medication just yet. Hopefully this episode was just a fluke.

As for my back, though the compression fracture had robbed my sixth thoracic vertebra of at least half an inch of height, a CT scan thankfully found no great risk of damage to my spinal cord. I just had to avoid BLT (bending, lifting, or twisting) and keep the pain under control. It took some time to reach a point where I could sit upright and still be able to breathe, but the promise of a hot shower can be a powerful motivator.

And that was that. I was sent home that Wednesday night with a back brace, a prescription for oxycodone, and the hope that this seizure would be a one-time-only deal. I wouldn’t be that lucky, however. Two weeks later, the night of 9 November, I had another seizure. At least I was in bed this time, and my spine seemed to make it through without suffering much more damage. I didn’t have to stay at the hospital, but they did start me on anti-seizure medication.

I don’t remember anything before, during, or after either seizure; I completely blacked out. Judging by Sara’s reaction (she, having witnessed both seizures), I’m the more fortunate for it. It’s scary enough knowing I was helpless and in pain without needing to have seen it. Even after my awareness started to return, it was several minutes before I could correctly answer questions about how old I was or what city I lived in. (I apparently didn’t have any difficulty identifying Sara as my wife, though, so at least I have that going for me.)

This whole ordeal has been a powerful reminder of just how precious our capacity for thought and reason is. I was lucky enough to actually see some of the images of my brain from my MRI. That bit of tissue filling my skull is me. I am what I do. There is no ghost pulling the strings; my neurons and glia are on their own. Dualism, the idea that I have a soul separate from and superior to my body, is a profoundly failed hypothesis, completely discredited by all of contemporary psychology and neuroscience. My brain is not the joystick by which some psychic homunculus controls my muscles and guts. It is not some spiritual antenna channeling instructions from a ghostly counterpart in the ethereal plane. My brain itself is that which does the doing.

My brain is flawed, that much I already knew. It is prone to mistakes, it occasionally falls victim to illusions and prejudices. My brain is also fragile; any injury to it that doesn’t kill me outright could leave me a changed man. I am fallible, I am mortal, as anyone is. But on top of that, I apparently have some sort of seizure disorder. I’m malfunctioning, and that’s scary.

Since my brain is physical, I can mitigate the seizures with medicine. A regular dose of levetiracetam—taken orally, absorbed into my bloodstream, and shuttled to my brain—will discourage my neurons from engaging in the kind of rapid-fire synchronized freak-out that has twice already left me blacked out and flailing uncontrollably. Of course, the administration of that compound also leaves me more susceptible to depression as a side effect. Hopefully as we learn more about what triggered the seizures, we can adjust the treatment to optimize the benefits while minimizing the drawbacks.

This is all terrifying and humbling and fascinating at the same time.