Seizures can be sign, but long-term harm rare
Senator Edward M. Kennedy should experience no long-term harm from the seizure he suffered yesterday, neurologists said, but doctors need to know what caused the brain disturbance before they give him a clean bill of health.
Though seizures rarely damage the brain, they can be a symptom of serious health problems, including blood clots in the brain or a brain tumor.
"People should be reassured because seizures don't hurt the brain," explained Dr. David Thaler, director of the stroke center at Tufts Medical Center in Boston. "He should be the same person he always has been, assuming the cause of the seizure is not more trouble."
For at least the next two days, doctors will conduct tests to determine what caused Kennedy's seizure and to guide decisions about whether he needs to take antiseizure medication to reduce the risk of a recurrence. Among the tests he is likely to undergo include an EEG, which analyzes brain waves for signs of vulnerability to seizure, and an MRI of his brain to look for abnormalities, including tumors.
Neurologists consulted by the Globe said, however, that, sometimes seizures are a one-time event, and doctors never fully understand why they happened in the first place.
Seizures are a kind of electrical storm in the brain. Either some or most of the brain cells begin firing all at once, causing symptoms that can range from a minor tingling sensation to a generalized seizure with convulsions, loss of consciousness, incontinence, and tongue-biting. Though seizures are closely associated with epilepsy, they can be triggered by many other causes, including a reaction to a new medication or even the delayed effects of a past head injury.
The seizure itself usually lasts just a few minutes, leaving the victim groggy or disoriented, but otherwise unharmed, neurologists said. Only in cases where the seizure lasts for a prolonged period is there the potential for more lasting effects. The neurologists, who were not involved in Kennedy's care, said the initial descriptions of his symptoms as strokelike suggests the seizure affected only part of his brain. Stroke symptoms can include sudden weakness, difficulty speaking, or loss of vision.
Thaler said that if he involved in the case he would want to investigate whether Kennedy's seizures were related to blood clots or a stroke, something Kennedy is at risk for. Last October, Kennedy underwent surgery at Mass. General to clear a neck artery that had become partially blocked by plaque, which is a leading cause of stroke.
In 5 percent of strokes, the first symptom is a seizure. Kennedy's personal physician, Larry Ronan, said last night that preliminary tests indicate the senator did not suffer a stroke.
Studies have also shown that seizures can sometimes be triggered by the artery-clearing procedure Kennedy underwent last fall, but Dr. Paul S. Blachman, a neurologist at South Shore Hospital in Weymouth, said such seizures rarely come so long after the fact.
Likewise, Kennedy's seizure could have been caused by scarring from a head injury that happened years ago, but both Thaler and Blachman considered it unlikely that Kennedy was suffering the lingering effects of a 1964 plane crash that left him with a bad back.
Blachman said a brain tumor is perhaps the most ominous cause of seizures, but an MRI of the brain would quickly reveal any cancer significant enough to cause a brain disturbance.
At the other extreme, Thaler said, a seizure could be brought on by something as simple as a bad reaction to a new medication. Other causes can include infections such as meningitis, alcohol intoxication or withdrawal, sleep deprivation, and low blood sugar.
Kennedy's office released no details about the exact nature of the tests he is undergoing, but indicated that there probably wouldn't be any new information about his condition for 48 hours.
Thaler said the testing could include a wide range of possibilities, including analyzing spinal fluid for signs of infection.
Blachman said the doctors probably are also monitoring his heart for any irregularities that could contribute to blood clot formation and observing whether Kennedy suffers any more seizures.
Scott Allen can be reached at firstname.lastname@example.org.