Did watching Downton give this woman a seizure How alcohol, stress and even TV can trigger blackouts in almost anyone



05:28 GMT, 13 March 2012

Was Downton Abbey to blame One minute, I was lying on the sofa rooting for Lady Mary and Matthew Crawley to get together.

The next thing I knew, I was coming to in my bedroom, my arm racked with pain as I tried to bat away an oxygen mask into which a paramedic was insisting I breathe.

As for the man beside him, I had no idea who he was. It was my husband, James, but at the time I didn’t recognise him.

Francesca Steele experienced her first seizure at the age of 29 after spending a morning watching Downton Abbey on TV

Francesca Steele experienced her first seizure at the age of 29 after spending a morning watching Downton Abbey on TV

At the age of 29, I’d had my first seizure. If my experience sounds unusual, it was not — for as I was shocked to discover, one in 20 us will have a one-off seizure, according to the charity Epilepsy Action. They can strike at any age, even if you’ve never shown any sign of epilepsy — and they can be triggered by apparently innocuous things such as sleep deprivation, alcohol, stress and even watching TV.

My seizure occurred on New Year’s Day. James and I had spent the morning in front of the TV, recovering from the excesses of the previous evening. All of a sudden, my body went stiff, my limbs started to jerk and I started frothing at the mouth. I stayed like this for two minutes, but it must have seemed like an eternity to James, who told me all this afterwards: I don’t remember a thing.

Panicking, he called an ambulance. In my blurry, post-fit daze, I kept on insisting my arm had ‘fallen off’ — in fact, I’d dislocated my shoulder. Several hours later in a manic A&E, my arm was still throbbing, but my head had returned to normal. I was slowly beginning to grasp the fact I’d had a seizure, though I still didn’t understand any of it.

After her fit Francesca re-watched the episode of Downton Abbey to see whether there were any lights that could have triggered her seizure but there weren't

After her fit Francesca re-watched the episode of Downton Abbey to see whether there were any lights that could have triggered her seizure but there weren't

If I had epilepsy, I thought, wouldn’t I know by this age The whole experience was — and frankly, still is — terrifying. But, as I discovered, one-off seizures are fairly common. Most are thought to be epileptic seizures, which are triggered by a sudden burst of excess electrical activity in the brain, causing a temporary disruption in the normal passing of messages between brain cells.

Doctors don’t always know what causes this to happen, except in cases where they can pinpoint triggers such as brain tumours, febrile convulsions (fits during fevers) and illnesses such as meningitis.
This brain disruption can cause a loss of consciousness so brief you might not notice it’s happened — to the observer, it could look as though you are daydreaming.

Indeed, it’s thought many of us could have had a seizure like this without realising, and put it down to a funny turn or ‘senior’ moment. At the other extreme are seizures such as the one I suffered, where you fall to the floor and thrash about — some people may bite their tongue or turn blue.

Like autism, epilepsy is not a single
condition, but a spectrum, with single seizures at one end and those who
have them frequently, despite being on medication, at the other. Confusingly,
it’s also possible to have a non-epileptic seizure, which can look the
same and have similar symptoms, but is caused by a physical condition
such as a heart problem (which affects blood flow to the brain).

A brief loss of consciousness, or a feeling of switching off and daydreaming, not knowing what is happening around you, is what’s known as an absence seizure.
Lip-smacking, chewing, fidgeting or other repetitive involuntary movements may be a complex partial seizure.
Sporadic jerks, usually on both sides of the body, may be a myoclonic seizure.
If someone is conscious, but experiences jerking, muscle rigidity, spasms and unusual sensations or emotional disturbances such as panicking, it may be a simple partial seizure.
Sudden loss of all muscle strength and dropping heavily to the floor is the key symptom of an atonic seizure.Unconsciousness, convulsions, muscle rigidity, teeth clenching, blueish pallor and incontinence are symptoms of a tonic-clonic seizure, the most common type. The sufferer may be left confused and exhausted.

In terms of epileptic seizures, ‘anyone with a brain can have one’, says Dr Ley Sander, professor of neurology at University College London and medical director of the Epilepsy Society. ‘We talk about the “seizure threshold” — those circumstances vary from person to person.’

A low seizure threshold, or sensitivity, makes you more prone to epileptic seizures than other people. This can be detected by an EEG (electroencephalography), a test that measures brain electrical patterns. But in theory anyone can have a seizure, triggered by sleep deprivation, dehydration, low blood sugar or drinking too much.

PR guru Max Clifford had his first seizure more than two decades ago, at the age of 46 — and at the time he was told it could have been due to stress. ‘I’d been having odd sensations for years, where people would look as if they were surrounded by smoke. The doctors couldn’t tell me what it was.’

What he had experienced was an aura, a perceptual disturbance experienced by some seizure sufferers right before a fit or occasionally without the fit occurring.

‘Eventually, I had a seizure where I fell down in a cafe, convulsed for several minutes and woke up in an ambulance,’ he says. ‘After tests, doctors said it could have been the result of stress or brain scarring from when I did boxing, but they didn’t really know.’

After several more seizures, Clifford took medication for 18 months but then stopped.

‘It was a bit of a gamble, but I’ve never had another one and I’ve never worried about it, because I never had tell-tale signs again.’ Part of the problem for the layman is that the terminology used can be confusing. Even the definition of epilepsy is unclear. Some suggest anyone who has an abnormal EEG (and therefore is more prone to seizures) is epileptic.

But full-blown epilepsy is rarely diagnosed until after a second or third seizure. From my EEG, the neurologist gauged that my seizure threshold was lower than other people’s. I am also mildly sensitive to flashing lights.
It was possible, he explained, that a hangover, lack of sleep, the light from the TV and stress — common seizure triggers — could have kick-started my episode.

But I had experienced this combination plenty of times before, so why now I still don’t have an answer to that question. I may never have another seizure again. Then again, I might. Half of people with sensitivities as mild as mine take medication that dampens down brain activity.

Whether I end up doing this or not, the hope is that when I am tested again in a couple of years’ time, my sensitivities may have lessened. Shelley Wagstaff, advice and information services manager at Epilepsy Action, says that though people’s perception of the condition has changed for the better, a lot more could be done to raise awareness of the correct response to seizures.

My dislocated shoulder was probably the result of James putting me into the recovery position, not knowing that seizure sufferers should not be moved because the jolting can cause them to injure themselves or others. So if someone starts having a seizure, the advice is to leave them where they are, make sure there’s nothing sharp or dangerous around them and, if you can, put a pillow under them. If it’s their first seizure, call an ambulance.

As for me, I find the loss of a few normal things hard to deal with. The DVLA can retain your driving licence for up to a year if you have a seizure. So for now I can’t drive, and I don’t swim or take baths without someone nearby for fear of drowning. Essentially, though, in the long-term life will be pretty much back to normal, though I will probably have fewer late nights and avoid flashing lights.

Of course, I don’t blame Downton Abbey. About a month after my fit, I re-watched the episode, partly because I could barely remember it and also to see whether there were any lights that could have set me off. There weren’t. So, no clues there. But at least I don’t have to worry when I’m watching series three.

For more information, visit epilepsy.org.uk and epilepsysociety.org.uk