- Hi, my name's Dr. Derek Chong.
I'm the Vice Chair of Neurology
and Director of the Epilepsy Program
at Lenox Hill Hospital of Northwell Health.
Epilepsy is defined as somebody who has two or more seizures
that are occurring unprovoked,
so they just can happen out of the blue.
Epilepsy can be a very different experience
for many patients,
almost like snowflakes.
No two are exactly the same from patient to patient,
and part of that is because of the complexity of the brain.
So today we're gonna walk you through how epilepsy
can affect each of the five senses.
Sight. Some of the seizures can be very simple.
There will only be a light flashing,
and as a seizure progresses,
the intensity and the size
or the speed of the flashing may increase.
There will be seizures
that are a little more complicated than that
and involve colors and shapes, maybe lines.
And even more complicated than that,
there may be full visual hallucinations.
I've had patients who have described
seeing animals all around them
during their seizures.
Sound. Some patients complain of alterations in sound
during their seizures or at the beginning of their seizures.
Those seizures are likely involving the temporal lobe
where sound is being processed.
I've had patients tell me that they will hear sounds
at the beginning of their seizures,
something like a loud gong or a bell or a loud beeping,
often a repetitive beeping sound.
Some patients notice the sound will be altered,
as if they suddenly went underwater
or as if voices are just all warble,
similar to the teacher in Charlie Brown's cartoons.
[teacher warbling]
Some patients will notice
that voices sound altered, almost electronic,
as if it's in auto-tune.
They may hear a hissing sound,
like a [hisses] sound,
or something more statically,
similar to when we see snow on TV.
So similar to other seizures,
the symptom of sound may start off small,
and as the seizure progresses
and takes over more and more neurons,
the sound may get louder and louder and louder
until it's spread to other areas of the brain
and someone may lose consciousness at that point.
Smell. Patients may experience a change in smell
at the beginning of their seizures.
We refer to this as an olfactory hallucination
in that the smell is not really there,
the person just feels like it's there.
Where smell is usually supposed to come from
is through your nose, along a nerve,
into this inside here of the temporal lobe.
So a seizure that originates in that area
may produce a smell that's not actually there.
So some of the common olfactory hallucinations
that patients experience
include the smelling of burnt toast or maybe bleach.
It's often an unpleasant smell that's very memorable.
Smelling things like manure or poop,
they can also be unpleasant olfactory hallucinations.
Occasionally it might be something more pleasant like roses,
but typically it's unpleasant.
So usually the smell is fairly mild at the beginning
and as the seizure takes over more circuits
it becomes a very strong smell
and it can be very overcoming.
Taste. One of the most common tastes
that people complain about
at the beginning of their seizures
is a metallic taste,
almost like you're biting a coin
or if you had a mouthful of nails
that you're about to like hammer into the wall.
The symptoms that people are able to describe
after their seizure
are called auras.
A bitter taste is a very common aura,
sort of like
old bitter coffee, ugh.
It's something that's unusual
and sometimes they can't describe it,
but we will see patients during the seizures
licking their lips,
which we call lip smacking.
We often see patients make that face,
as if they're trying to figure out what is in their mouth,
and often it's not a pleasant looking face,
as if it's something bitter or very sour.
Touch. The types of sensory disturbances
that can happen during seizures
include things like electrical sensations,
almost like a a zapping or a shooting sensation.
It may also be like a sense of fire
or pins and needles sensation.
Some patients will complain of a sense of rising,
and that could be either an indescribable feeling
that things are going up their body
or it could be a sense of electricity going up the body,
or it may be that they feel like their stomach
is going up or down
as if they're dropping in an elevator
or going up and down on a rollercoaster
just about to go over that last crest
and they feel that their stomach is turning.
In addition to feeling extra sensations in your body,
you may feel the absence of sensation,
as if you've just been to the dentist.
Things can feel completely numb
or can feel like it doesn't even belong to you.
That's sometimes called an alien hand
or alien limb sensation
where you don't feel like that body part is actually yours.
We see that in multiple neurological conditions.
So that's one way that we can differentiate seizures
from other neurological conditions,
is that patients will return
to their baseline level of functioning.
So the sensory change is transient,
maybe two minutes long, maybe five minutes long,
but it generally should go back to completely normal.
So typically we only speak about the five senses,
but today we're gonna talk about a sixth sense,
which might be considered emotion and intuition.
A lot of patients with epilepsy
will have emotion generated by the seizure
that is part of their aura.
Examples might be a sense of fear or panic, anxiety.
Those are mostly negative emotions.
They may also have elation,
or I've had a patient who actually had orgasmic auras.
So the motion center of our brain is called the amygdala.
Seizures that involve the amygdala
can generate those false emotions.
Someone may have goosebumps on just one half of their body
because the seizure is generated from that area
and is activating the goosebump response in the body.
Right next to the amygdala, our emotion center,
is another structure that's called the hippocampus,
and the hippocampus is essential for creating new memories.
One of the common memory-related auras
is a strong sense of deja vu,
and deja vu in French means already seen,
so many people have had this feeling that,
"Oh, I've already heard this,
or I've already been here before,
or I've already kind of been through this exact situation."
That's a deja vu.
If you have frequent deja vus
and they're very intense and maybe very prolonged,
those may actually all be little auras.
People may not know that they're a seizure
until one of these deja vus eventually
gets bigger and bigger and bigger
and turns into a generalized seizure.
So we've discussed a lot about epilepsy
and how it can affect the five senses,
so if you or anyone you know is having recurrent episodes
of the symptoms that we discussed,
they may be having seizures
and it would be wise to seek neurological advice
to keep you and those around you safe.
[bright music]