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Sudden Seizures / Brain Swelling
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csd52065 posted:
Greetings All- Since early November, my friend has been in 3 different hospitals because out of now where he woke up in the middle of the night screaming, and then went into convulsions. The scary part is, is that before he went into convulsions, he screamed 'The Devil is in me!' I am not sure if that would qualify as a hallucination or not, but it is really weird. The hospitals have to keep him in a coma because he brain has swollen and thus he starts having seizures again. They have performed a biopsy on the brain and they can not figure out what the problem is. They first said it was a tumor, then something else. He is now at Emory and they are unable to figure out what the problem is. He has never been sick, never been in the hospital, nothing. His status looks very grim, and I think what is hard to swallow is that no one can tell us what is wrong. Has anyone heard of anything like this?
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Lifes responded:
Although doctors have specialized education and experience, it is often shocking (and feels humbling to wise doctors) to realize there is much unknown in medicine, diagnosing, and treatment. Encephalitis is a very old diagnosis, having been observed for thousands of years. In historical periods, no one saw the problem--the swelling--unless it was in a baby where the unmatured skull became misshapen by the brain swelling. Religious meanings were attached to the symptoms (as were many medical problems), especially because in Encephalitis there is a fairly rapid change in how a person behaves. In olden times and even through the 1800s, laypersons and even some doctors would say the person was having "fits", especially with the seizures. Both of these diagnosis have been greatly misunderstood for eons. There is no religious or spiritual significance with either Encephalitis or Seizues, or with the change in personality, speech, or behavior. Encephalitis can cause a person to scream / rant "crazy" things, sentences that make no sense, or are completely out of touch with what's happening in the moment. Your friend's screaming of "the devil is in me!" likewise has no religious or spiritual meaning or implication about God / the Devil fighting for his soul. Instead, the swelling is progressively putting pressure on sensitive brain tissue. Let me use an example. Look at your pinkie finger. Run it across the front of a sink and it will feel the smooth cool enamel. Hold it near (not too near!) a lit match and it will feel the potential pain from heat. If by accident, you slammed it in a car door, your very sensitive pinkie finger would swell, maybe a little, maybe twice the size of normal. If the injury became infected or engourged with blood under the skin, the swelling could get even worse. The nerve endings inside your finger would let you know severe pain, enough that it might "torment" you so you'd moan, scream out, beg for pain meds, etc. You might get very "testy" and "mean" because of the pain, even if you are the nicest person you'd ever want to meet. Your reaction is not a spiritual, religious, or character flaw-- it is a temporary alternation of your normal personality due to pain, and the pain is due to nerves responding to the increased pressue from the swelling. Internal mechanisms are trying to "correct" and fix the problem (body sends in more blood; little macrophages come to 'eat' the bad toxins and prevent pus under the skins; etc.). Luckily, most smashed pinkie fingers recover within weeks. The brain, though, is one big mass of nerves and nerve endings. The outside skin may hurt, but in adults the skull cannot "stretch" like in infants, so the brain pushes more and more against the hard skull. The fluid has no where to go; it sits in the brain tissue, making every nerve and nerve connection "react". The person usually doesn't know immediately that the brain is in trouble. They might have a headache-- but who would think "My headache means my brain is swelling!" Instead, the fluid keeps increasing which "engourges" the brain (like a sponge), and the internal pressure keeps growing (called a mechanical change) until there's changes in personality others notice, or a seizure might happen. The chemical and mechanical changes in the brain become so severe the person might scream about the devil because it's the only way they can express "the pain" in their altered mental status. They could just as easily yell "Rats are eating my brain!" or "They planted a bomb in my head!" because of how the symptoms feel to them, just like your pinkie swelling might be so painful to say "An elephant is squasjhing my finger!" Luckily, gratefully, the person usually doesn't remember the pain they felt in encephalitis, so we can only guess how horrible it feels. see pt 2
 
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Lifes responded:
pt 2 Yes, anything with the brain is serious. Drs are likely narrowing down the cause of the Encephalitis and ruling out meningitis. It can take months to treat brain swelling; they can't just remove the fluid like sqeezing out a sponge. They may need to do surgery. He's likely receiving meds by IV for virus or infection and to stop more swelling. They keep the person in a medication-indiced coma so the brain can heal; so the person won't be combative (the person can't realize they have altered mental status); and if they have him intubated (on ventilator). It can take many months to improve even a little. Encourage patience and trust that the doctors will treat and manage his case as best as possible. He may have life-long problems, but the goal right now is to stop the fluid build up and to try to preserve as much brain functioning as they can. Hope this info helps, Lifes
 
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Lifes responded:
I have a spelling error in my last post. It should say, medication-induced coma. Lifes


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