Tue, May 20, 2008 - Page 16 News List

[ HEALTH ] Brain seizures can signal slight physical imbalance or major health risk

Senator Edward Kennedy’s recent seizure is may not result in long-term issues; but not everyone can be so lucky

By Scott Allen  /  NY TIMES NEWS SERVICE , BOSTON

US Senator Edward M. Kennedy, the younger brother of late US president John F. Kennedy, should experience no long-term harm from the seizures he suffered on Saturday, neurologists said, but doctors need to know what caused the brain disturbances 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.

Massachusetts’ senior senator, 76, was awake and talking to family members late Saturday afternoon, but doctors at Massachusetts General Hospital kept him overnight for observation.

“People should be reassured because seizures don’t hurt the brain,” explained 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.”

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, seizures 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.

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 he would want to investigate whether Kennedy’s seizures were related to blood clots or a stroke, something Kennedy is at risk of. Last October, Kennedy underwent surgery at Massachusetts General Hospital to clean out 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 on Saturday night that preliminary tests indicate the senator did not suffer a stroke.

Paul Blachman, a neurologist at South Shore Hospital in Weymouth, said, however, that it’s an encouraging sign that Kennedy was able to carry on conversations Saturday. If he had suffered a serious stroke, Blachman said, he would probably be suffering after-effects, potentially including slurred speech or weakness on one side of his body.

For at least the next two days, doctors were to conduct tests to determine what caused Kennedy’s seizures and to guide decisions about whether he needs to take antiseizure medication to reduce the risk of a recurrence. Among the tests he was likely to undergo were 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 said, however, that, sometimes seizures are a one-time event and they never fully understand why they happened in the first place.

Studies have also shown that seizures can sometimes be triggered by the artery-clearing procedure Kennedy underwent last fall, but Blachman said the seizures rarely come so long after the fact. Likewise, Kennedy’s seizures 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.

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