Stairway to loving

Photo by Flickr user larry&flo. Click for sourceThere’s a curious case published in the medical journal Epilepsy and Behavior of a young man who had his epilepsy triggered by the sight of stairs. This would cause seizures that would trigger “repetitive hugging and affectionate kissing of one of the people around him”.

Our patient is currently 24 years old. He is a right-handed male with a history of right temporal lobe epilepsy. He had his first seizure when he was 10 years old. His seizures usually started with an aura of a “feeling” inside his body or abdomen. This feeling, described at times as pain or nausea, lasted a few seconds or a few minutes. His eyes would then widen, he would become confused, and he would look around right and left as if wondering. The seizure would last 1 to 2 minutes with altered consciousness, spitting, and often repetitive hugging and affectionate kissing of one of the people around him.

At times this was followed by head and eye deviation to the left and, sometimes, rotation of the whole body to the left side. Occasionally, he would walk around for a few seconds. These seizures were often precipitated by looking at stairs, whether or not he was walking up the stairs. He learned to avoid looking at stairs to avoid having seizures. He also noted that looking down a flight of stairs did not precipitate his seizures.

I am constantly amazed by both how seizures can be triggered by very specific experiences (such as seeing a certain thing, or hearing a specific sound) and how they can lead to very selective actions.

This is by no means a typical effect of epilepsy but it does raise the interesting question of how these very narrow experiences lead to destabilising brain states which trigger a seizure.

I have heard anecdotal reports from several clinicians that they’ve met patients who can ‘think their way out’ of a seizure by deliberately focusing their thoughts on a specific topic, presumably which reduces the destabilising effect of their original ‘trigger experience’.

I’ve not seen this discussed in the medical literature though, so if you know of any articles that do tackle it, I’d love to hear about them.

Link to PubMed entry for stair triggered epilepsy case.

3 Comments

  1. Posted October 7, 2009 at 11:48 pm | Permalink

    My seizures were often triggered by computer games. I don’t believe it was a flashing-light phenomenon though, rather I believe there was a specific pattern or type of thinking that would cause me to go into seizure. I say this because all occurences of a seizure were with games that involved an immersive type of problem solving, and happened more frequently with slower-paced strategy games than with high frame-rate shooters (I played several genres of games about equally). Civilization, Starcraft, Stronghold, MDK, WOW, and Sins of the Solar Empire are among the games that I have been playing when a seizure occurred. (I had 11 or 12 grand mal seizures over the course of about 8 years, it has been about 18 months since my last)

  2. Jake
    Posted October 8, 2009 at 2:07 am | Permalink

    Regarding patients learning to control their seizures: I read an interview a couple years ago with Neil Young where he reported that later in life he learned to suppress an oncoming seizure by meditating in one way or another. I can’t remember the details of exactly how he focuses his thoughts, or even if he gave details.

  3. Jennifer R. Ewing
    Posted October 8, 2009 at 6:03 am | Permalink

    When I was younger, I experienced the feeling of my body having the seizure while my mind remained perfectly clear. I could not control my body movements at all, but I remained aware of my surroundings–sights, smells, conversation, etc–for the duration of the seizure.
    To this day, I can walk *up* a flight of stairs with little difficulty (assuming there’s a railing nearby), but coming *down* the stairs I either hold on to the railing for dear life, or put my arms out to my sides, almost as if I’m preparing to take flight. My neurologist tells me that doing so “shifts my center of gravity”.


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