FAMILY MEDICINE® COLUMN

By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

READER’S “SPELLS” COULD BE PETIT MAL EPILEPSY

Question: I have been experiencing strange feelings where my mind seems to "freeze," and it is almost like when you get an electric shock -- there's a momentary inability to do anything except stare straight ahead and fight the feeling of immobility or whatever it is. I hate getting these “attacks” as I call them. I feel for about 10 seconds as though I am about to pass or black out. While it is going on I can think and speak, but I find the momentary "shock feeling" seems to affect something in my head. The best I can describe it is "a short-circuit." Then it subsides quickly. I get this in any situation even when just watching TV or reading. It happens without warning any time of the day. I am 59 and have no history of any problems at all.

Answer: You have certainly been experiencing some interesting symptoms. While you need to see your physician for a thorough history and physical, let me share some thoughts on one medical condition that has symptoms very similar to what you are experiencing.

Petit mal epilepsy causes seizures that involve only a brief, sudden lapse of conscious activity. Each seizure lasts only seconds or minutes, but hundreds may occur each day. These are also called absence seizures.

While it is more common for this disorder to begin in childhood, the onset of this type of seizure can occur at any age. These seizures typically involve a brief sudden absence of consciousness that can be accompanied by other manifestations. These can include staring, lip smacking, fluttering of eyelids, chewing and/or hand movements. Usually these episodes last only a few seconds and a person has full recovery.

Most people have no memory of these petit mal seizures. So, if this is indeed what you have, you would be an exception to the rule. Typically a person may have seizures for many months before a teacher, family member or friend notices them.

There are many conditions that can cause seizures. One of the most common causes is traumatic brain injury. It is not uncommon for seizures to begin after head trauma. Some seizures are caused by metabolic problems -- when there is something wrong with your "body chemistry." This can include imbalances in your electrolytes – sodium, potassium, chloride, calcium, magnesium, bicarbonate, phosphate and sulfate. Various kidney disorders can produce electrolyte imbalances.

Though brain tumors are a rare cause of seizures, it is true that a seizure is often the first symptom of a brain tumor. Birth injury may be associated with seizures in infants and children, and finally, seizures do run in families.

When you see your physician for your exam, he or she will probably order blood tests to check for metabolic imbalances. He or she may also order an MRI of your head to look for tumors or evidence of injury from trauma or strokes. The gold standard for determining the presence of seizure activity in the brain is an electroencephalogram, or EEG.

If after all of this testing it is determined that you have a seizure disorder, there are many medications that can control seizures without many side effects. If all of the testing is negative, then your physician needs to look for other causes of your “spells.”

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.