This book simply consists of descriptions of the symptoms of patients with epilepsy: these patients are several of the author’s; she is a neurologist.

The symptoms are generally extremely strange and dramatic; sometimes it is not at first clear that the patient has epilepsy at all.

The author is very honest about admitting her uncertainty about her patients’ diagnoses and how often she has no clue about what is wrong with them.

Wahid is 25 and has strange attacks that wake him at night. He sits up, grunts, points at the wall, and looks scared.

Cherylin wakes in peculiar places, with no idea how she got there, She is fearful and disorientated.

She counts and shouts numbers.

Wahid and Cherylin both have what are called focal seizures but they come from different areas of the brain.

Most seizures last at most a few minutes.

Amy feels as though she’s sliding downhill, and that she’s sucked down the road. These types of fits are called Alice in Wonderland experiences by the medical community.

And in fact Lewis Carroll, the author of Alice in Wonderland, may well have suffered from epilepsy, He had two episodes of loss of consciousness that may have been due to epilepsy.

After being told that there was a possibility he could be fired from his job as school janitor, Donal had his first attack.

He saw little men about a foot tall run from behind a plant pot to a filing cabinet. They looked like the seven dwarfs, seven small brightly coloured men. What he saw was “”very, very real”, but he realizes that he is seeing things: they are cartoon characters.

Donal’s MRI scan and EEG were normal, as with many, perhaps most, of the author’s epileptic patients.

The author places her patients in the epilepsy centre where they can be observed by being videoed around the clock. Most patients stay for five days, some stay for two weeks.

Every video telemetry patient wears a minimum of 5 electrodes on their head.

Donal’s cartoon visitors may have been a memory, or perhaps he conjured them from his imagination.

His seizures went away with medication.

Maya has had epilepsy since she was ten years old. Her only experience of her seizures is waking up from them. Sometimes she finds herself lying on the ground, or misses some time.

She “just loses it for a while”. She’s just not there. But sometimes she falls over and stops breathing.

Maya had tried six different tablets, but the best they did was reduce the number of attacks.

Some drugs have horrendous side effects.

Surgeons removed a piece of Maya’s brain, and she is now totally free of seizures.

We are given details of several of the author’s patients. Some got cured, some didn’t and one died.

Scientific details are given regarding which parts of the brain are involved. All the cases diverge from each other.

The solutions to the seizures are first and foremost drugs, but also surgery, though this is generally a final option, as the risks are severe, since anything can happen as a result of brain surgery.

The book is well-written and fascinating since all the cases are different and mostly have strange/dramatic symptoms.

I previously had a boyfriend with epilepsy (which resulted from brain surgery at an early age). He took strong medicine but still had fits. I advised him to take a B-complex pill together with magnesium, which greatly reduced the number of his seizures, though he continued to take his medicine.

This was how I knew that magnesium might work for me, when I myself later had psycho-motor seizures.

My seizures happened when on the point of sleep. When falling sleep on the train on my way home from work I heard loud bangs as though bombs were being thrown on the train, but I was the only one that heard them.One time in bed, I saw fire coming from the wall, but since I had recently moved into the flat, I thought that this must be due to a fault in the electrical installations. Once the whole inside of my brain was lit up.

I did not consult a doctor but began to take a strong magnesium tablet together with a strong B-vitamin complex pill. The seizures continued so I consulted a naturopath who advised me to double the amount of magnesium, which I did; consequently the seizures stopped.

This was years go; today the only thing remaining of the seizures is a few clicks every nght when I’m on the point of falling asleep; they seem to come from a bedside lamp or another electrical installation.

However, since magnesium and B-vitamins worked for my boyfriend and later myself, I am sure they might work for others. The author, being a doctor, of course, apparently had no knowledge of the effectiveness of magnesium and/or B-vitamins, (I believe it is B6 that is the crucial B-vitamin, but B-vitamins should not be taken separately, as this might create an extra need for the other B-vitamins not taken.

But since drugs are so potentially harmful, in my view it would be beneficial to try natural supplements first. Note that I am not suggesting that people stop taking their medication.

To sum up, this is the only book I’ve read about epilepsy and I found it fascinating to read about the various forms of fits, including hallucinations. I recommend that you read the book.

I did not find this as entertaining as "It's all in your head". It is all about patients with epilepsy of different kinds and maybe that's a bit too close to home for me. Ok but not the best. ( )

Brainstorm tells fascinating stories about the many ways in which epilepsy and seizure disorders can present: convulsions and jerking (the one most people think of), memory lapses, hallucinations, perception disorders, and even total loss of muscle tone. Each chapter focuses on a different patient and uses that patient’s story as the basis to talk about the history of epilepsy treatment, advances in the field, and notable cases in the literature.

I liked that O’Sullivan was honest about when treatments didn’t work, and she explained the history and concepts clearly. I found it interesting to learn about how an EEG works, the specific pattern of electrodes on the scalp, and what EEGs (and MRIs, and fMRIs) can tell you about the brain.

I would recommend this for people who like to read popular medicine books by practising medical professionals, or books about the brain, such as Unthinkable, by Helen Thomson. ( )

It was bought for me by my wife, who shares my fascination with neurology and we enjoyed discussing respeatedly. One of the first and most important messages that Dr O'Sullivan brings up is the need to talk to the patient, this is especially true in neurology, where the history, it's subtle nuances, it's apparent digressions and its drive and progression are vital to understanding the underlying disease process.
In delineating between primary and secondary generalised seizures, ask in the history where the symptoms first affect the body, if this is generalised, and primary, there won't be an area that is affected followed by tonic clonic seizures, you'll just get a generalised seizure, but in secondary it starts in a small place and then moves outwards. That first anatomical location tells you where in the brain, the seizure originates from.
Remember temporal lobe epilepsy often affects fears, emotions, and behaviour.
Frontal one seizures affect planning and involuntary motor movements.
EEG's are a little like 24 hour tapes at times, especially for trying to find temporal lobe hallucinations. Absence seizures are often caused by frontal and parietal involvement but not always.
I quite enjoyed reviewing my Neuroanatomy again. It was helpful in looking at this, for when the author talked about possible surgical management.
There was a good section on pseudo seizures and how they manifest. Pseudo seizures are still very interesting but patients don't always react well to the thought that this has an almost psychosomatic element to it.
The limitations of EEG, in particular, with the limited, partial seizures, was very interesting. I'd naively thought that they were pretty definitive, but it's only really helpful for being over th place where the generalised siz urge starts.
Temporal lobe epilepsy provides some of the more memorable, slightly more active, physical effects with convulsions.
He discussion about SUDEP was interesting. I had net heard of the term and its presumed that the convulsions effects in the heart leads to fatal arrhythmia. It's in young people, often and especially those with multiple seizures, those with seizures happening at night and those being investigated for possible surgery. Clearly, high risk patients anyway. An autopsy shows little.
I was shocked to read about post ictal psychosis. It's rare but does happen and is a consequence of the brain GABA receptors being affected by the electrical discharge. It needs so have the convulsions controlled and if this isn't possible then use the same anti psychotic drugs as you would under other circumstances
A section on post head injury seizures was fairly unremarkable for me, but some of he figures quoted did surprise me. I wasn't aware that a serious head injury, with fracturing, haemorrhage, or significant amnesia, has a 60% chance of developing seizures.
Frontal lobe disinhibition, in this context, caused by head injury, is a debilitating and functionally crippling process. It's important to remind oneself of this. The deterioration in ADLS as a consequence is saddening for relatives, and life changing, for the patient.
Status epilepticus doesn't always end up in ITU, it can also persist, without adequate recovery between sisters. It's very significant and persistence of seizures, leads to long term memory and cognitive damage.
There was a brief section on the new research into NMDA Receptors and how they get affected by ovarian tumours which I found interesting and I think will be part of my career for time to come. ( )