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Harvard Health Blog
Quick injection helps stop epileptic seizures
- By Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing
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What if the convulsions and the blackout are an emergency reaction to life threatening cerebral hypoglcaemia resulting from reactive hypoglycaemia?
If there is ONE mechanism central to understanding schizophrenia, migraine, epilepsy etc. it is THIS. Muscle cells cannot release glucose back into the bloodstream as they do not express the enzyme Glucose-6-phosphatase, whereas the liver does. With liver pathology the muscles have to take over the role of glucose storage but because they cannot release it as glucose have to ferment it to lactic acid needed by the liver to make glucose via gluconeogenesis. Adrenalin is required to increase the metabolic rate of the muscles and dilate the blood vessels to wash the lactic acid out, but the dilated blood vessels supply oxygen which stops fermentation. Alternatively noradrenalin does constrict the blood vessel, but has no metabolic effect on muscle cells and of course restricts blood flow. Enter muscle spasm, hot and cold flushes as the two hormones alternate.
NORADRENALIN is associated with extreme fear, but it’s not fear in response to an external perceived threat. The threat is internal and NOT understood, The crisis is life threatening cerebral hypoglycaemia which can only be alleviated by increased lactic acid synthesis by the muscles. Liver pathology means not just impaired glycogen storage but also impaired gluconeogenesis thereby necessitating even more secretion of adrenalin and noradrenalin ‘Panic attack’ exacerbated by not understanding what on Earth is going on. ‘I must be going mad (and all that entails). The brain metabolises 40% of the bodies glucose. The more neural activity, the more glucose consumption. The more glucose consumption, the worse the cerebral hypoglycaemia and with it the greater the secretion of adrenalin and noradrenalin. ‘Jesus, I’m going to die’ Enter HYPERSUGGESTABILITY plus religion, almost universal in schizophrenia. ‘I’m going to burn in Hell. I AM IN HELL. TERROR. Now frozen stiff. Catatonia. Noradrenalin now predominates to shut down blood supply to skeletal muscles persistently, along with immobility to conserve energy. Ketone adaption now kicking in as enzyme induction takes place?
Now add black out and convulsions as an alternative to the above. The blackout shuts off the panic cascade thereby conserving glucose and the convulsions PUMP lactic acid out of the skeletal muscles. Veins have non return valves along them so that by the convulsions stretching and contracting them they act as a series of pumps to speed up the delivery of lactic acid back to the liver.
Brain tumours don’t trigger seizures. They use a lot of glucose the more malignant they become (the Warburg effect)and so exarcerbate the cerebral hypoglycaemia.
Mine are also ignored! I brow-beat her on enssmeger daily, telling her to stay home and get better and that she needs rest. I also told her to leave her bike at work and take a cab home one day last week!She is wayyyy too stubborn with too much will-power.
It is also worth noting that after a brain injury the brain may be much more sensitive to the side effects of drugss, especially those which have a sedative effect.
RE: Heather riding her bike .in the mlidde of winter in order to break her 212 day record of last year. Fear to jeopordise this record as she’s only on day 12 and fighting some nasty recurring disease means she wants to ride to work every day. What are your thoughts because mine are being ignored. Signed: Concerned friend.ps: Heather scored a goal today by bouncing the puck off the goalie’s head. This is in no way indicative of her health.
Doctor, I wan’t to know if taking phenobarbital can give a obesity pacient any issues like depression and loss of energy daily.
I take 100mg of phenobarbital daily for 42 year.
Ps:I hope You answer me, Thank You.
My doctor say’s I have tonic clonit seizures.What is that?
Steve — A tonic-clonic seizure is one that involves the whole body. Another name is grand mal seizure. It can happen once, or as part of epilepsy or other chronic condition. You can read more about tonic-clonic seizure here: http://www.nlm.nih.gov/medlineplus/ency/article/000695.htm
It seems a mystery that a vet cnoant do much about the seizures and it makes it so hard to know the best course of action. All I could do was to cuddle my dog and give him the assurance that I was there with him. But I don’t know about those times that I am not home when it happens. so far, we haven’t had too many episodes.
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