Friday, September 22, 2006

An Odd Case

Well, since my last post, we've had one or two "slow" starts, but once we've gone out, we've stayed out. Last Sunday we did ten jobs - one of the busiest days I've had at this station. Still nothing particularly interesting, apart from one job.

We were called to a 24 year old female who was apparently fitting. We found her laying on her back on the narrow landing at the top of the stairs. She was alert, but every so often her muscles went into spasm causing her whole body to jerk involuntarily, looking very much like a seizure. It crossed my mind that she might be "pseudo-fitting"- that is, pretending to fit. This happens more often than you'd think and is often used for attention seeking. It's also a favourite of shoplifters etc who have been caught by the shop's security or the police.

This time though, I didn't think she was faking it. She wasn't exactly fitting, and she wasn't pretending to be unresponsive with it. Between the huge muscle twitches, she outlined her medical history. It could have filled a text book, with a chapter before bed every night for a month, but none of it seemed to have any bearing on the current problem.

The next problem was how to get her down the stairs. We were reluctant to use the carry chair because if she experienced another generalised muscle spasm, we'd be in danger of all three of us ending up in a heap at the bottom of the stairs. The only solution we could think of was for the patient to get herself down the stairs one step at a time on her bottom, with one of us in front of her to stop her falling downstairs if she had a spasm, and one behind her. It was just as well, she had another huge spasm half way down the stairs, and between us, we prevented her sliding down the stairs.

This was the first time I'd seen anything quite like this, and I was a bit baffled by it. I asked the patient if she minded if I followed up on her diagnosis, and she agreed. She spent a few days in hospital, but the doctors hadn't been able to find a cause for the spasms - which she was still having, but had been reduced to head twitches - so they'd decided to put it down to attention seeking.

Maybe it was, but I'm not convinced. If it happens to her again, the family have been told to call an ambulance again, so she may become a regular...


Blogger parttimecommenter said...

This is really weird. I have recently helped someone out who was doing very similar in SW London. I have no medical training, but from reading this and other LAS blogs, the person did not match up to your description of an epileptic seizure, and was definitely having muscle spasm not a fit, was unresponsive during a spasm, but was not post ictal.
The one thing that it did remind me of was many years ago, we had a family friend whose little boy had very severe cerebal palsy, and he would have very similar episodes. Could these two incidents have something to do with this condition, or could it just be something in the London water at the moment that is inducung these kind of episodes in people?

11:51 pm  

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