Seizure history
Treatment history
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Seizure history
Hazel has suffered several large grand mal seizures. The history is set out here, with the most recent first.
08 Aug 2007
Hazel was suffering with diarrhoea for a couple of days prior to the seizure, but was generally upbeat and in good form. On the 7th August, she suddenly became very ill, and the cause was suspected to be a virus. Blood tests were done and antibiotics administered, and for the day she remained drowsy and unresponsive.
This situation worsened on the following day. Still very drowsy and unresponsive for the afternoon, she began to show the signs that are familiar to her about impending seizure activity - this included salivation at the mouth, rigidity in the limbs, blood in the spit from the mouth and rolling or flickering eye movements.
Hazel's pulse was high (115) and her temperature was rising, topping 40 degrees in the late evening. The seizure activity continued for the whole of the evening. Her temperature continued to rise, peaking at 40.2 degrees. She was taken for a CT scan, which showed no obvious reason for a sudden deterioration. Having been reliant on lamitrogine during her stay in hospital, the clobozam having been withdrawn, she was given Phenytoin by IV at 1.05am, and sodium to address a very low blood salt level (110). The phenytoin began to have the desired effect and Hazel stabilised at around 2am on the morning of the 9th. During the 9th, the phenytoin was discontinued, and IV sodium valproate was started.
The 'virus' was later diagnosed via a lumbar puncture on the morning of the 9th as bacterial meningitis. Cefotaxime was administered, and Aciclovir and Metoclopramide were started in support.
31 May 2007
Hazel's sparkle started to fade in mid-April. She started to receive care every weekday from February, though she did begin to fit it into her routine. In mid-April, the carers started to see her mood tail off. In May that deterioration was being reflected in virtually everything she did. By mid-May, when we'd employed our own carer rather than using an agency, she was having trouble looking after herself - eating, drinking, washing, dressing in particular - and she was losing initiative, balance and co-ordination. She needed more and more help, and the loss of independence became very apparent in the last weeks of May.
On the last day of May, she had developed a cold, which was weakening her further. She was also complaining of head and neck pains, and her balance had worsened. The fear was another grand-mal was round the corner, and we didn't want to be reactive. Faced with a decision to wait to see the GP, go to A&E or call an ambulance, we called an ambulance.
The seizure never arrived, but she was admitted to the Great Western Hospital despite stabilising towards the end of the 31st May. She was taken up to Jupiter Ward a couple of days after admission, a ward dealing with stroke and neurological patients. She spent far too long on this ward, and despite the sterling efforts of the ward staff as they got to know her over the next ten weeks, it wasn't the right place for Hazel. Her time here is discussed in detail in Hazel's blog.
11 Jan 2007
Hazel was suffering with a cold over Christmas and into the New Year. She wasn't shaking it, and it was a concern, though nothing much was thought of it. It began to worsen through early January, though she still attended the Prospect Hospice on the 11th. However, she was very shaky and weak, and she looked pale.
She had been to the doctor that morning to address the cold, and the GP suggested that she may have picked up a mild pneumonia. He prescribed some amoxicillin to deal with this. I was worried about Hazel, and I arranged for her to go over to Milton Keynes until the weekend. Though she perked up in the afternoon, perhaps as a result of the antibiotics, she suffered a grand-mal seizure at about 9.45pm. An ambulance was called and she was taken to the Milton Keynes General Hospital. She was suffering with seizure for about 75 minutes, and the paramedics struggled to subdue her. Eventually, IV phenobarbitone was administered, which stopped the seizures, and clobozam and lamitrogine was started again later.
She calmed at about midnight. She was quickly given a chest x-ray and stayed on the acute ward for a couple of days. She remained unconscious for over 48 hours. This was the most severe of the seizures suffered to date, and each one she'd suffered had been worse than the one before. The cause of the seizure was put down to the cold; the weakening of her immunity because of it, and the failure of the medication to be absorbed.
This particular seizure hit Hazel hard, and she remained on the ward in Milton Keynes for almost a week. Whilst she didn't suffer the paranoia or hallucinations of the previous Milton Keynes seizure in late 2005, she was weakened by this event, and her memory took a long time to recover. She was frantic with anxious energy for a fortnight after discharge and asked questions about her life continuously for these two weeks. She spent this time with her parents in Milton Keynes, and they found her demands particularly severe and draining.
Hazel's questioning did subside as she returned to some sort of normality, but Hazel has needed an increased level of personal support and care ever since this seizure, and this event prompted greater involvement from Social Services.
09 Aug 2006
The hallucinations and irritability continued through the 6-8th August. We visited the Clover Centre (out of hours centre) at the Great Western Hospital on the evening of 8th August, but were advised that nothing was neurologically wrong.
Getting no support, solutions or sympathy from the various Swindon sources who were insistent on pursuing the Keppra, Oxford Neurology - in the shape of Dr. Hart - were contacted. Dr. Hart first suggested diazepam and then retracted this suggestion and advised a small (10mg) dose of Clobozam to supplement the Lamitrogine. Dr. Hart arranged for a short stay of observation in the Oxford Radcliffe between August 9-11, and the Keppra was also stopped immediately.
Hazel slowly improved after discharge on the 11th August, but had the clobozam reduced to 5mg on 29th August following consultation with the epilepsy specialist in Oxford. Hazel enjoyed a relatively trouble free run up until the next seizure in January 2007.
Keppra has not been revisited since.
12 Jul 2006
Following hallucinations and odd stories the previous day, Hazel suffered a 40 minute grand-mal seizure at 9.05am. She stabilised and remained in the Great Western Hospital until the 17th July.
The seizure was blamed on the introduction of the Keppra in June, and the imbalances in her body at the time of the seizure. However, Dr. Wimalaratna believed it to be a good drug and wanted to persist with it.
The advice on leaving the hospital was to increase the Keppra by 250mg per week to a maximum of 1500mg.
Although there seemed to be an initial improvement, by the beginning of August, Hazel seemd very low and was discussing suicide. Hazel discussed the medication with her GP on 3rd August. The GP checked with Dr. Wimalaratna, who confirmed that anxiety was a side effect of the Keppra. Over the next couple of days, Hazel began to be irritated and anxious and looked haunted. This lead directly to the next incident.
22 Jun 2006
Hazel, unusually for the period, suffered four absences during the day. Keppra was introduced at 500mg per day from June 23rd.
19 Nov 2005
Hazel suffered a grand mal seizure on the morning of the 19th November. She was taken to Milton Keynes General Hospital, where she was admitted onto the Acute Assessment Unit and stabilised.
She was discharged the following morning, though was suffering from paranoia, a state which diminished over the course of the following 24 hours.
08 Jul 2005
Hazel suffered three seizures in one afternoon on the final day of the fifth week of radiotherapy. Hazel was in good spirits for much of her radiotherapy, and things seemed to be going normally and smoothly.
Making the return journey to Swindon with her parents on the 8th July, Hazel began to seem confused and lost some short term memory. This confusion increased until she had a seizure in the early evening. Paramedics were called and she was taken to the Great Western Hospital. During recovery, she seemed dazed and confused. She had a further grand-mal seizure in the emergency room of A&E, and had a third seizure at about 7.30pm once she had been moved into the Acute Assessment Unit.
She was retained in the Great Western for observation and completed her course of radiotherapy.
Following the completion of radiotherapy on Monday 18th July, she was introduced to 16mg of Dexamethasone and Phenytoin. Lamitrogine was increased to 300mg per day. There were no further seizures associated with this episode.
Hazel developed a rash, which was attributed to the Phenytoin, and its use was discontinued.
13 Jun 2001
Hazel suffered a second grand-mal seizure during the night in June 2001. Life between the two early seizures had been normal. Hazel occasionally had visions of an elderly lady in a familiar place (always just out of reach of recognition), though things generally carried on as normal. HEr medication didn't change, but her regular appointmnets continued. She had regular scans on her brain by this time, and what was initially described as a 'benign cyst' had been identified. This, however, was slow growing and causing no problems to normal function, but could have been the root of the seizures.
15 Jan 2000
Hazel suffered her first seizure just a few days after we moved to Swindon. It was January 2000, a normal sort of a day, and there was no warning. Hazel had her first seizure at about 6am in the morning. She was thrown from the bed onto the floor, and turned 180 degrees in the process. An ambulance was called, and she was taken to the Princess Margaret Hospital in Swindon, where she was kept for a short period. She recovered at home, and nothing seemed to happen afterwards, in terms of further seizures.
Hazel had suffered with migraines before, which had disabled her for a 24 hour period sometimes, and in our previous home in Lancashire, she had started having some unusual feelings and visions, though we attributed nothing to them.
Following this seizure, Hazel was introduced to a small dose of lamitogine (50mg per day) and she had a series of appointments with a neurologist in Swindon, Dr. Wimalaratna, and she was referred to another neurologist specialising in epilepsy in Oxford, Dr. Hart. These appointments have continued to the present day.
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