Monday, March 26, 2012

Reflex Anoxic Seizures

Overview: Reflex Anoxic Seizures (RAS) is the term used for a particular fit which is neither epileptic nor due to cyanotic breath-holding, but which rather results from a brief stoppage of the heart through excessive activity of the vagus nerve. 

Symptoms: Any unexpected stimulus, such as pain, shock, fright, causes the heart and breathing to stop, the eyes to roll up into the head, the complexion to become deathly white, often blue around the mouth and under the eyes, the jaw to clench and the body to stiffen; sometimes the arms and legs jerk. After what seems like hours, but is probably less than 30 seconds, the body relaxes, the heart starts beating (sometimes very slowly initially) and the sufferer is unconscious. One or two minutes later the person may regain consciousness but can sometimes be unconscious for over an hour. Upon recovery the person may be very emotional and then fall into a deep sleep for two to three hours and looks extremely pale with dark circles under the eyes.

Tests/Diagnosis: The symptoms of RAS share common factors with a number of conditions, with the result that RAS is often misdiagnosed as temper tantrums, cyanotic breath holding (prolonged expiratory apnoea) or epilepsy.   EEG, ECG, Seizure logs and event videos, initial diagnosis of epilepsy, and medical family history review and evaluation.

Treatments: No cure, only treatment would be a pace maker in extreme cases.  Patients experiencing RAS should be treated with seizure precautions to avoid injury.  Often no treatment is required, but some studies have suggested that the drug atropine is effective in reducing the frequency of the attacks.  RAS usually get less frequent and eventually stops during childhood. Occasionally the attacks persist into early adult life.

Lewis's Story:Even now I cannot get used to these horrific events and the other side effects and syptoms.  Every time it happens my little boy looks dead, and even though I am told breathing will resume due to a fail-safe mechanism in the brain I always panic each time willing him to breath.  What makes it worse is the rarity of the condition thus people just don't understand what Lewis and myself go through, except in on-line support groups.

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