It was a Tuesday evening when I received a call from the emergency room that a young lady had been brought in after experiencing seizures. I quickly walked over to the ER, preparing myself for what was to come. As I walked through the entrance, I could see the family of the patient huddled together, whispering to each other. The patient was lying on the hospital bed with wires attached to her chest, monitoring her vitals. The nurse filled me in on the patient’s condition – the seizures were continuing, and to ensure her airway remained clear, she needed to be intubated.
I instructed the nurse to give her some medication to help with the seizures, and I intubated her quickly to protect her airway. We also started a versed drip to prevent the recurrent seizures from happening. The patient was heavily sedated, and we could only pray that the medication would help her recover quickly. I was worried about her as she had never seen a neurologist before.
The next morning, as the respiratory therapist and I were monitoring her, the young lady started to slowly regain consciousness. Her eyes flickered open, and she looked dazed, confused. I spoke to her in calm, reassuring tones, telling her she was in a hospital and that she was safe. But as soon as she regained awareness, she began to cry inconsolably, saying that she wanted to go home. It was understandable – she wanted to be with her children.
We knew we couldn’t let the patient go home, as her condition was not fully understood. The young lady had a medical history of past seizures, but was only taking Keppra once a day. We needed to rule out any factors or triggers that may have caused the status epilepticus. Furthermore, she had just been intubated, and we were concerned about how her body would react in the coming days.
I sat down with her and her husband, explaining to them the seriousness of her condition. I told them that she was suffering from status epilepticus, a serious and life-threatening condition in which seizures do not stop. I explained to them that we needed to perform a battery of tests to find out what was causing the seizures, and that we might need to keep her here for a few days so that we could closely monitor her and provide her with the care she needed.
Over the next few days, our team worked tirelessly to find out what was causing the seizures. We performed countless tests, including blood work, CT scans, and EEGs. Each day was a challenge – the patient continued to experience seizures, and we had to quickly adjust her medication to prevent them from recurring. Her family visited her every day, with her children in tow. Seeing them trying to understand what was going on with their mother was heartbreaking.
After several days, we finally had an answer. The EEG showed an unusual spike pattern consistent with a rare genetic disorder she had not been diagnosed with before. It was a relief to finally know what was causing the seizures, but we knew that we still had a tough road ahead. The patient would need to start a new medication regimen, and we would need to carefully monitor her treatment to ensure that her seizures were under control.
Over the next few weeks, we worked closely with the patient and her family to provide the care she needed. We adjusted her medication as needed and performed numerous EEGs to monitor the activity in her brain. Slowly, but surely, the seizures started to become less frequent, and eventually they stopped altogether. The young lady was discharged from the hospital and could return home to her family.
It was a happy ending, but it was a difficult journey. It was not just our team of doctors and nurses that made it possible, but it was the patient’s determination and tenacity to get better. As doctors, we are often reminded of the incredible resilience of the human body and the human spirit.
Ton La, Jr. is a physician and can be reached on LinkedIn.