The mother of two didn’t know the warning signs of stroke, so when her symptoms began the evening before, she attributed them to muscle spasms.
Although it has been 14 years since her first epileptic seizure, Pat Scholl can recall the moments leading up to it in vivid detail, as if it happened just moments ago.
The then-44-year-old middle school math teacher was at home in Dixon tutoring a seventh-grade student. “I had just asked her
to define ‘sublimation.’ I was looking out the window and it was a sunny day. Then quick as that, it went pitch black.”
When Pat came out of her dark fog, she realized she was laying on the floor, looking into the faces of two paramedics. “All my muscles hurt, the inside of my mouth was all bitten up and I had drooled on myself. I thought, ‘what the heck?’ I was terrified and worried about who was watching the student.” She later learned she had been unconscious for an hour and a half.
Pat had experienced her first and only epileptic grand mal seizure. “It was a very weird situation,” she noted. “We don’t know what triggered it. I had never had anything like that happen before.”
Pat’s epileptic event, as disconcerting as it was, is not unusual. As many as 65 percent of people newly diagnosed with epilepsy have no obvious cause. Of the other 35 percent, common reasons for the seizures include stroke, congenital conditions, brain tumors, trauma and infection.
“Epilepsy is one of the most common neurologic disorders,” says Shahid Rehman, M.D., neurologist for NorthBay Healthcare, and it affects up to 1 percent of the U.S. population. Epilepsy is one of several neurological disorders Dr. Rehman treats in his practice at the Gateway Building in Fairfield.
An epileptic seizure occurs when brain function is altered by abnormal or excessive electrical discharges in brain cells. It is diagnosed by clinical information, a neurological exam and a thorough neurodiagnostic workup, including a brain MRI and an electroencephalogram (EEG), he explains.
Managing a patient with epilepsy is based on a number of factors, including seizure frequency and severity, the patient’s age and overall health, medical history and the seizure type. There are six general types, and the most common is the grand mal that Pat experienced, where patients become unconscious, and then experience convulsions and muscle rigidness.
Other seizure types are when a patient experiences a brief loss of consciousness (absence); sporadic jerking movements (myoclonic); muscle stiffness (tonic); loss of muscle tone (atonic); or the repetitive, jerking movements of a “clonic” seizure.
This clonic type is the second kind of seizure Pat had just three years ago. She was sitting with fellow teachers in the break room during lunch when she reached out to touch a co-worker on the arm. Instead, Pat’s hand grabbed her friend’s hand and he couldn’t stop shaking it. “I never lost consciousness. I knew exactly what was happening, but I couldn’t speak. I was hoping I wouldn’t get ill, because I had just eaten.” During other seizure types, patients may seem “out of touch” or “staring into space,” and yet they are still able to retain awareness.
Dr. Rehman has been treating Pat for her epilepsy for several years he says, and anticonvulsant medications are used to control seizure episodes. “There are a number of medications available to treat the various types of epilepsy and it may take one or two trials to find the right medicine or a combination of medicines, and then the right dosages that works best for each patient.” Side effects may include blurry vision, fatigue, sleepiness, stomach upset, liver problems, hair loss and weight gain. It may take altering the medication combinations to minimize side effects while still keeping the seizures at bay.
Once that balance is found, it’s important to keep taking the medicine, he adds. “There is a risk of having increased seizures if you stop taking them without advice.”
Pat has gone 11 years between seizures because she is hyper-diligent about taking her medications. “I never skip it. I can’t!
I usually take mine at night and if I ever forget, I wake up feeling shaky, and then I feel like a balloon-head all day. Believe me, I don’t want to feel like that!”
Pat also makes sure those close to her know she has epilepsy, just in case. Each school year, she starts out by telling her students she has the condition. “If I do start to flip around like a fish, I tell them, just stand back and call my husband. He
knows what to do.”
NorthBay Medical Center: 707-646-5000 NorthBay VacaValley Hospital 707-624-7000