Stuff You Should Know - How Epilepsy Works

Episode Date: October 23, 2018

A seizure is like an electrical overload in the brain – when it gets overwhelmed, it just shuts down and resets itself. But imagine being susceptible to these overloads, where one could come at any time with little or no warning. That is epilepsy.  Learn more about your ad-choices at https://www.iheartpodcastnetwork.comSee omnystudio.com/listener for privacy information.

On the podcast, Hey Dude, the 90s called, David Lasher and Christine Taylor, stars of the cult classic show, Hey Dude, bring you back to the days of slip dresses and choker necklaces. We're gonna use Hey Dude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s.

We lived it, and now we're calling on all of our friends to come back and relive it. Listen to Hey Dude, the 90s called on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. Hey, I'm Lance Bass, host of the new iHeart podcast, Frosted Tips with Lance Bass. Do you ever think to yourself, what advice would Lance Bass

and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help. And a different hot, sexy teen crush boy bander each week to guide you through life. Tell everybody, ya everybody, about my new podcast and make sure to listen so we'll never, ever have to say. Bye, bye, bye.

Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple Podcasts, or wherever you listen to podcasts. Welcome to Stuff You Should Know from HowStuffWorks.com. Hey, and welcome to the podcast. I'm Josh Clark. There's Charles W. Chuck Bryant,

and there's guest producer Ramsey over there. Yay, Ramsey. Guest producer on Stuff You Should Know, but straight up producer on Movie Crush. Yeah, Movie Crushers might know Ramsey's name. Hey, Ramsey. You waved. He knows the drill.

Well, the duct tape over his mouth helps, for sure. So Chuck, today we were talking about epilepsy, and this has been a long time request. We've gotten requests for this one over the years. Oh yeah? Yeah, plenty of times. And I don't know why it took us so long to do it, but I'm glad we finally did,

because it's something I didn't know about. I think it's one of those things like you're aware of epilepsy and seizures and seizure disorders, but there's almost like this cartoonishly narrow version of like what epilepsy is. Like the movie version. Yes, exactly. Which actually is kind of accurate,

depending on the type of epilepsy or the type of seizure you're having, but it's such a broad spectrum of really just kind of a physiological brain disorder that can happen in so many different ways that I had no idea. Yeah, the movie, while it's sort of like the every square is a rectangle type of thing,

like movies only display seizures in one way. The Natalie Portman way. Sort of, yeah. Yeah, the kind where you're like, you're on your back, convulsing wildly, frothing at the mouth. There's some jerk nearby with a wooden spoon. You don't want to do that. We should go ahead and say that maybe more than once.

Do you not stick a spoon or your wallet or a credit card or anything else in somebody's mouth to keep them from swallowing their tongue? No. You can't swallow your tongue. No, because it's attached. Mm-hmm. I tried, look.

Yeah, all right, stop. It's not working. I was just grabbing a wooden spoon. You don't want to do that. Keep that thing away from me. Yeah, but movies display them as one kind and that those definitely exist, but it's far more nuanced than that.

Right. Leave it to movies to get rid of nuance, you know? Yeah, but really isn't that the audience's fault? Isn't it up to the audience whether there's nuance or not? Well, what, like during a seizure scene next time, we should all just stand up and shout, this isn't real. I think they would get the picture.

All filmmakers would get the picture. How about some nuance? Well, and also movies are all about drama and a lot of seizures are not very dramatic. No, it's almost like in certain types of seizures, somebody like just kind of zones out for a second and then comes back and says, so what were we just saying?

Yeah. That constitutes a seizure. AKA chuck on any given evening. Sure. There's probably a big difference of what's going on in the brain of somebody who's actually enduring a seizure right then than you zoning out, but to the observer, it would look very similar.

All right, that's a nice intro. Let's talk a little history first, can we? Yeah. Okay. Well, I will say this, ancient medicine has always been nutty as a fruit cake, but especially when it comes to seizures from how they're diagnosed

and what people think is going on to the various treatments, it is wacky. Yeah, people with epilepsy have been stigmatized for ever since there was civilization, basically. The code of Hammurabi, the first set of laws from Mesopotamia 4,000 years ago contains a law that says, if you have epilepsy, they didn't call it that,

but they were talking about people with epilepsy, you can't get married. Yeah, they called it like the devil shakes or something. Basically, yeah. And the idea was that you were infected with some sort of demon or the devil or something like that. And what's interesting is that

by the time Hippocrates came around, he was like, no, no, no, you guys have it all wrong. This is just some sort of disorder in the brain. You could probably treat with diet and exercise and that kind of stuff, which is actually pretty good advice for somebody who was prescribing this like 2,400 years ago. And then somehow they got lost

and everybody was like, no, no, it's demons, unclean spirits, all that. And it went back to being a very stigmatized disease. Yeah, it was an unexplainable thing. And I think back then, now we try to poke around and learn like the real reasons behind something, even if it still remains unexplainable at the end.

But back then they would just say, they're possessed or they're a witch. Right, and that witch thing, it was in the Malifheas, Malifhecarum. Sure. The witch finder's handbook. It was basically in there. And either if you had epilepsy,

you were a witch or you were possessed by a demon. Or in some cases you could be possessed by like an angel or something like that. But more often than not, it was like a negative thing, like a negative spirit had possessed you. Or you were under the influence of a witch. So somebody in your village could be accused of witchcraft if you had epilepsy because they were like,

this witch over here is giving this guy epilepsy burner. That was a thing. So epilepsy has always been tied to that. And that law about people with epilepsy not being able to marry, there were laws on the books in the United States up until 1980 that said people with epilepsy can't get married.

Really? Can't get married. Yeah, but I'm sure those were, those like laws that aren't enforced, right? Or were they literally enforcing those laws? I don't know that part. I'm sure they were back in like the 20s and 30s during the eugenics movement,

but I don't know that they were up until 1980. That sounds like one of those laws where like, you can't spit on the street after sundown. Right, can't put lipstick on a horse. Oh, you can. Can't spit on the street. And then, you know, ancient treatments are exactly what you would think,

like everything from drinking blood to killing a dog and drinking its bile. If someone's having a seizure near you, pee in your shoe and give it to them to drink. Like it's a jellyfish stink. Yeah, but in the shoe? I don't know. Like what?

Is that just because they know that you have something that holds urine? That would be my guess. Okay, I didn't know if that was like, oh no. I guess you could also pee into like cupped hands, your cupped hands, and then just kind of like just drop it onto their mouth. Oh my God.

Regardless, that's another thing. Don't put a wallet or a spoon or a credit card in somebody's mouth. Don't put your urine in somebody who's having a seizure's mouth. Doesn't help. I also saw that it wasn't until the 18th century that people finally were like,

I don't think this is actually infectious. Right. One of the reasons why people with epilepsy were so shunned, just shunned and stigmatized and just kept on the outskirts of society was because people thought epilepsy was contagious and you could catch it from the breath of someone with epilepsy.

So like people with epilepsy have been treated horribly for all of time, basically. So hopefully we can kind of dispel any of the last myths around it. That's my hope with this episode, Chuck. Let's see if we can do it, okay? Well, we like to start off every episode by stating our hopes and dreams, you know?

So what's going on in the brain? We'll get to that a little bit more in detail, but kind of the way this article on our own website puts it, which this was so like 10 years ago, writing-wise. But they basically talk about a kind of traffic jam in your brain when there's confusion, when there's too much, too many neurons firing at once

and it can cause an overwhelming sensation that can eventually cause a seizure. Yeah, it's like, I've seen it compared to electrical storms where basically it's a sudden overload, an electrical overload in your brain, and your brain's just like, I'm just shutting down here for a second. And then it resets itself.

Your brain sounds like Bob Newhart. Yeah, mine does. Mine does. And you said from a bunch of neurons firing at once, not just a bunch of neurons, but those neurons that are firing fire a lot more than usual, too. Something like, so they fire 80 times a second normally,

where during a seizure, they're gonna fire like 500 times a second. Yeah, and we'll talk about the brain machines later, but one thing that's characteristic of seizures is when they look at your brain scan, they're big peaks and valleys. It's not a steady stream of do-do-do-do-do-do.

No, what did you say? I don't think it makes that noise. It's just that Bob Newhart. Right, he knew he was gonna show up. Slow and steady. That's great. But let's talk about some of the types of seizures. There are a couple of broader categories,

focal seizures or generalized seizures. Focal seizures are just in one part of the brain where generalized, and I think about 60% of people with epilepsy have the focal kind, and generalized are on both sides of the brain. Yeah, like your whole brain is under attack whereas the focal seizures, it could just be from like a lesion in a specific part,

or there's something that's hypersensitive, that's just one tiny region of your brain, but it's enough to do some wacky stuff to you. Yes, and within those groups, there are further subgroups, for instance, a simple focal seizure or a complex focal seizure, the two types of focal seizures.

So a simple focal seizure is, you just kind of have like a weird feeling. Like you're conscious the whole time. Yes, and it's also sometimes called an aura, and an aura itself, it can just be a standalone seizure, but it's kind of like seizure light, L-I-T-E, right? But that same simple focal seizure can also be the beginning of a larger complex focal seizure,

a larger seizure of either type, where it's just the aura, it's just the beginning symptoms of it. So it can be standalone, or it can lead to a larger seizure. Yeah, and you said a really cool thing, we'll get into in a second about like exactly what a seizure is like,

but quickly a complex focal seizure, the other type of focal seizure, you do lose consciousness, and if you are around someone that has one of these, you might see, it's a little bit more like what you would think of as a movie seizure, for lack of a better term. It can be like twitching, blinking,

maybe someone's just sort of seems dazed and sort of walking around. Well, that's the thing that got me, like when I think of, well, they lost consciousness, it means they fainted or whatever. That's not necessarily what that means when you're having a seizure. Like lose consciousness means like you,

you're not there, you blacked out, you're gone. You're not, your awareness is no longer functioning in the here and now, but to the people standing around you, they might see you just kind of walking slowly around in a circle or something like that, or sitting upright and just kind of with a blank look on your face or something.

Like it's not the traditional just falling over, fainting away loss of consciousness. That was new info to me. Yeah, and this aura you were talking about, it's really interesting that other document you sent was, I had no idea that you, if you're a person with epilepsy, you can sometimes, and it's different for everyone, but sometimes you can sense these seizures

coming on days ahead of time. Yeah. That's, I've never heard of that. Yeah, I think when you get, when you start having seizures, if you are an actual, if you actually have epilepsy, you will start to notice patterns. Oh, I'm sure.

Stereotypic, it means like it typically follows the same patterns, the same sensations. And an aura can be anything from seeing blinking lights to hearing a humming sound, to suddenly inexplicably experiencing panic or joy, or all number of things, but basically your brain is suddenly doing something, it's suddenly getting a jolt of electricity

that's actually not being stimulated from anything outside. You're not actually seeing bright lights, but your brain is showing you bright lights because that impulse is actually starting from the inside rather than coming from the outside in. Yeah. That could be an aura, it could also be a weird taste.

Yeah, I think a lot of times too, it's people that experience the aura have a hard time describing it in a way that people that have never experienced the aura can understand. That's sort of one of the hallmarks of it, is people like us end up stammering out a bunch of things that we can relate to, but I think if you have had this sensation,

it's sort of one of those things like you gotta kind of have it to really understand what it feels like. Sure, and the reason why is because you're, probably different parts of your brain that don't normally co-function are functioning together and the information you're getting is being merged together into just a totally novel experience

that no human has ever had before, which is pretty awesome if you think about it in that way. Yeah, so pre-seizure, a lot of different things can be happening. You can smell things, you can hear things, you could taste things, you might get blurry vision, or you might have a visual loss briefly or momentarily. Like you said, it might be a very pleasant feeling.

It can be, I just wish it was like that for everybody. Sure. I wish everybody who had epilepsy just had nothing but pleasant brain attacks. Yeah, I totally agree. So that's at the onset, sort of pre-seizure activity when you start to recognize these symptoms and that's when you might tell your friend or loved one

or whoever you're with like, hey, I may have a seizure here soon or it may be hours from now. Yeah, and this, I think this is from the Epilepsy Foundations called What Happens During a Seizure. Really interesting. Yeah, but they say like every seizure has three stages to it.

It's just some are really hard to discern. Some appear to just be the first, some have like clearly all three, but that beginning thing can technically stand alone and aura can be its own like seizure light, like I was saying. But more often than not, it will lead into the middle part of the seizure,

which is called the ictic stage of the seizure. Yes, and that's from the first time symptoms and the aura counts as a symptom. Like that's officially part of the seizure to the end of seizure activities at middle section. Yeah, and the middle section is what you usually think of as a seizure. It can be the classic movie seizure

where you can convulse, muscles might tighten suddenly and you might go rigid. You might actually lose muscle tension. And either way, what those will result in is called a drop attack where you are standing up and all of a sudden you tense up and fall over like remember the fainting goats. Yeah, I knew that word from something, my clonic goats.

And then, or you can just lose muscle tone and fall over. But either way, it can be really bad news for you because you can hit your head and you can cut yourself. It's not good to fall over with zero control over your body. No, and then the final phase is post seizure. And that is, that can be really rough. And it can take hours or days to kind of fully feel like yourself again.

And if someone, and we'll talk about what to do during a seizure, of course, if you are around someone that's having one. Don't put your wallet in their mouth. But post seizure is very important too because you need to be there and be very comforting and just sort of take things slow in general. Right, so that's called the post-ictic phase.

And that can actually last a lot longer than either of the other two phases of a seizure. It can last 20 minutes, 30 minutes, an hour, who knows? Yeah, you could be sleepy or scared or anxious, have memory loss, difficulty talking. It's basically what it sounds like is your brain and your body has just undergone a traumatic experience and it's just rough.

Yeah, and it had to reset itself and it was a hard reset and now you're paying the price of it. Yeah, and that's not to even mention some of the physical things that is one of the real dangers of having a seizure is if you fall on a glass coffee table or all the supplementary physical injuries that can occur. One of the things that stuck out to me from this Epilepsy Foundation article

was that one of the signs and symptoms of the post-ictic phase is that the person may be frustrated, embarrassed or ashamed. I know, man. That is so sad. Yeah. That's just so sad, you know? And it comes up later on too in this article

from How Stuff Works about like the challenges of living with epilepsy, you know, one of them I'm sure is just feeling stigmatized for people. Yeah. You wanna take a break? Yeah, we'll take a break and we'll pick up with the different types of generalized seizures

right after this. If you wanna know, then you're in luck. Just listen up to Josh and Chuck, stuff you should know. On the podcast, Hey Dude, the 90s called David Lasher and Christine Taylor, stars of the cult classic show Hey Dude, bring you back to the days of slip dresses

and choker necklaces. We're gonna use Hey Dude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s. We lived it and now we're calling on all of our friends to come back and relive it. It's a podcast packed with interviews, co-stars, friends, and non-stop references

to the best decade ever. Do you remember going to Blockbuster? Do you remember Nintendo 64? Do you remember getting Frosted Tips? Was that a cereal? No, it was hair. Do you remember AOL Instant Messenger and the dial-up sound like poltergeist?

So leave a code on your best friend's beeper because you'll wanna be there when the nostalgia starts flowing. Each episode will rival the feeling of taking out the cartridge from your Game Boy, blowing on it and popping it back in as we take you back to the 90s. Listen to HeyDude, the 90s,

called on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. Hey, I'm Lance Bass, host of the new iHeart podcast, Frosted Tips with Lance Bass. The hardest thing can be knowing who to turn to when questions arise or times get tough or you're at the end of the road. Ah, okay, I see what you're doing.

Do you ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help. This, I promise you. Oh, God. Seriously, I swear.

And you won't have to send an SOS because I'll be there for you. Oh, man. And so my husband, Michael. Um, hey, that's me. Yep, we know that, Michael. And a different hot, sexy teen crush boy bander each week to guide you through life, step by step.

Oh, not another one. Kids, relationships, life in general can get messy. You may be thinking, this is the story of my life. Just stop now. If so, tell everybody, yeah, everybody about my new podcast and make sure to listen. So we'll never, ever have to say bye, bye, bye. Listen to Frosted Tips with Lance Bass

on the I Heart Radio app, Apple podcast or wherever you listen to podcasts. Stuff you should know. Stuff you should know. All right. So generalized seizures. Remember, we broke it down into the two broad categories, focal and generalized.

There are many kinds of generalized seizures. The words you won't hear anymore from a doctor are petite mall and grand mall seizures. Those are outdated terms. But what they are now referred to as is formally petite mall seizures are now known as absence seizures. And grand mall are now known as tonic-clonic seizures. And yes, they are outdated,

but they still kind of highlight the early contributions of some of the first French neurologists in the late 18th century. Dr. Grand Mall. Who, right, Stanley Grand Mall, a French neurologist. They help pull this out of the realm of superstition and you can catch it from someone with epilepsy breathing on you.

So hats off to the early French neurologists for at least studying and identifying it. But that's why there were French terms that were applied to it previously. You just stuffed your pork pie hat. I did actually a little chorus line thing. That's very nice. You can't see under the table my foot's kicking too.

So one of the, like I said, the absence seizure, formally petite mall seizure, this is usually in children. And I think overall, I don't know if we mentioned that children and people over 75 are most likely to have epilepsy, which is interesting. Yes. And you can grow out of it.

Depending on the type of epilepsy, yes. And I think you can even grow back into it in your older age. Yeah, if you're 75 or older, you're at the highest risk of developing epilepsy. So the absence seizures, like I said, are mostly in children. That's just like where they zone out all the time.

Yeah, exactly. You might see some eyelid fluttering or something like that for a twitch or two, and it might just be a few seconds long and then it's over. Right, you're like... Very hard to spot. What was just going on?

Were you thinking about Barney or were you having seizures? Yeah, we're just tired. Like it's tough to spot, I think. Clonic seizures, you will have convulsions and jerking movements on both sides of your body. Myoclonic, like we talked about with the goats. And it's funny, I just was going through the archive today

and I saw one of the best titles we've ever had. That dangle goat fell over on the fainting goats. That was a good one. I think that was one of yours. Maybe. I'm pretty sure. But myoclonic seizures, the upper body is mainly involved and it might look like someone has been shocked,

like a jerking of the upper body. Right. The tonic seizures is when you stiffen up like you were talking about. Yeah, where you just suddenly, your muscles go fully tense and you just can't control them anymore. Atonic is the other one that you were talking about

when you lose muscle control. Yeah. And then there's the big daddy. This is the movie seizure. The tonic-clonic seizure. Yes. Just the name of it sounds menacing, you know? Tonic-clonic, it sounds like a Star Wars character

from the dark side or something. So it's grand mal. Tonic-clonic, the fallen. Yeah, grand mal does too. Well, I think because of the Darth Maul thing. And grand mafdarken, it's a combination. Oh, okay. I don't know who that last guy is.

Grand mafdarken? Yeah, which one is that? All right, we should just move past this. No, no, I need to know, especially if it's somebody from like the original three. I think grand mafdarken was the guy, wasn't that Peter Cushing? Yeah?

Oh, okay, sure. They digitally recreated. Why did you say Peter Cushing instead of Fran Tarkenton? What are you talking about? So the tonic-clonic movie style seizure is that that's the one that you've probably seen on TV and films and after school specials is when the body stiffens,

you sort of pass out on the floor and your body is convulsing and jerking on the ground, you're like eyes roll back in your head, that kind of thing. I couldn't tell if it kind of alternates back between the two or if it follows that discernible pattern where it goes tonic, like your muscles tense, you fall over, followed by clonic,

so you're convulsing after that. Sounds like it. Or if you kind of bounce back and forth, which would be pretty awful too. Yeah. But that's, yeah, that's the, like you said, the movie, that's the movie seizure that you see. I've never, it just occurred to me,

I've never seen someone have a seizure that I could recognize. I've not either. Yeah, you just knocked wood. I did. Or is that someone trying to come into the studio? No, this is like particle board, but I think it still counts.

Does that count? Seizures generally are pretty brief. A few seconds, maybe a few minutes at the most. In most cases, but they, like we said, they take a lot out of your brain and body. Yeah. A lot of stuff. Here's the thing.

It's like, so tense your, tense all the muscles in your body for a second. I don't even know how to do that. So it's like just doing it for a second. Sure. I'm like, oh man, I'm sore already. Yeah. I'm tired.

Imagine doing that for like three minutes. Yeah. That's a long seizure, I feel like. And like really like every muscle in your body's tense. Yeah. Or imagine like convulsing for a couple of minutes. Like heck yeah, you're gonna be physically tired. It's a violent reaction.

It is. So the normal processes of your body have just been totally thrown out of whack. And all they have to get back into whack. And one of your body's like main things for telling you something's wrong is to feel nauseated. So you're going to probably feel nauseated. You're going to feel maybe perturbed.

You're not gonna feel very good. And it's going to last for a while. Sometimes people will sleep. Yeah. And maybe they'll sleep for a minute. Yeah. Maybe they'll sleep for an hour. There's a lot of different things that can happen

in that post-ictal state. But the thing you want to look out for, so we've never seen anybody have a seizure before. Correct. But if you do see someone who is having a seizure, there are some very specific things that you should do. And not do. And not to.

Yeah. One of the things you should not do is stick your dirty wallet in their mouth. I haven't heard that one. Have your nasty credit card or a spoon. What are you carrying a spoon around with you for anyway? I don't know. To save somebody from swallowing their tongue,

leave it at home because you don't need it anymore. Yeah. The main thing you want to do is make sure that they will not further injure themselves. Like if you're in an apartment and they're on the couch, you may want to like move the coffee table out away from the couch or something like that. Right.

Turn them on their side if they have gone to the ground. Yes. So they won't choke. That is a real thing. But the tongue has nothing to do with it. Right. I think it's more like throwing up or something like that. Yeah.

Sure. And just sort of try and ensure their safety. Like don't try and hold them down. Don't try and get them to stop what they're doing. Like you can't. I'm going to lay on you till the demons get out. Yeah. It's not a good idea.

No. So basically just try and make things as safe as possible. Like if they're around them. If their clothing is right. Yeah. Keep sharp stuff away from. Yeah. And yeah.

If they're sitting up or standing up or whatever. Yeah. Try to get them on to the lowest point as comfortably. Put a pillow under their head maybe. Yeah. If their clothes are like bunching up around their neck. Like try to loosen the clothing. Yeah. Yeah. Make it safe and comfortable for them.

Stay with them. Yeah. Don't be like, all right. Well, I'm going to go get my eyes checked. Or go call the police or not the police but 9-1-1. Right. That was a really surprising thing that this article said was don't leave, just hang out with them. That is more important than calling 9-1-1.

Yeah. There is a point where you should call 9-1-1 though. There's a type of seizure or there's a mode that seizures can go into called status epilectis which is like a really bad situation. That's when it continues. Unabated. Yeah.

For like five minutes. It used to be I think 20 or 30 minutes. And then they said, that's way too long. If someone is having a seizure of any type for five minutes or longer, you want to call 9-1-1. Yeah. Because what you're seeing is a medical emergency. Under almost every single case of a seizure,

the brain can kind of reset itself and come out of the seizure within a five minute period. If it doesn't, it strongly suggests that it's not going to happen. And they may actually have to medically induce a coma to just stop the electrical activity in the brain and let it reset itself. So you've got a bonafide medical emergency on your hands.

Or the other way it can happen is they can be having a seizure and then have another seizure and not regain consciousness in between. That actually qualifies as a status epilectis seizure as well. And you want to call 9-1-1 for those. Yeah, or if it's a pregnant woman, then you want to call 9-1-1 because there can be further complications there, for sure.

All right, so it looks like there's six different types of epilepsy, if I'm reading this right. We'll say at least six. Starting with benign, rolandic epilepsy. This is the one that you would have in childhood and that you would probably outgrow. Hence the benign thing. It's just kind of like, yeah, I don't even worry about it.

It's just a phase the kid's going through, you know? Juvenile myoclonic epilepsy is actually one, you wouldn't have it in early childhood, but it actually would come on around the same time as puberty as if puberty is not tough enough. Right, now with seizures. Yeah, I mean, I feel so bad for anyone that has this condition, but especially like

if it comes on at puberty, you don't know what's going on. Well, plus also it's like the severe type of seizures, tonic-clonic seizures usually characterize it, or myoclonic, and you don't outgrow it. No, you keep this. It comes on in childhood, but yeah, you have it for life. Lennox guest star syndrome. I feel like I'd heard of this one before.

I had not. This one's very severe, and there are many kinds of seizures that you can have, and I believe this one sticks around for life too. It does, and usually it comes after it's become apparent that there are cognitive impairments. There can be delayed motor skill development. It's kind of like comorbid with like a type

of cognitive impairment as well, but it's characterized by drop attacks too, where you can really injure yourself because you just fall over. Because there's an impairment in the muscle, or the motor cortex. Right, look at you. I got it eventually.

Reflex epilepsy is the one that you might, if you have ever gotten a strobe light warning. Or heard of that Pokemon thing, which that legend is actually true. Yeah, I mean, this is one that is triggered by something in the environment. In fact, remember I told you I was going to that David Byrne concert?

We got a, Ticket Holders got emails the day before the show that said, trigger warning, we use strobe lights in the show. Oh wow. So I think they, for stuff like this, they kind of are sending that stuff out now. That's good of them, yeah. Because I mean, you can have a seizure,

even if you don't have epilepsy, you can have a seizure brought on by flashing lights that are fast enough to just basically get your brain going, and it's off, and you have a seizure. Not a seizure, but an intense strobe light situation, I think makes everyone feel a little off. Yeah, it makes me dance. The, so yeah, where are the bubbles?

Give me my glow stick. Temporal, oh wait, hold on, let me give you one more about that. So the reflex epilepsy, it doesn't have to just be from like flickering lights. Oh no. Like the strobe lights. It can be sound.

It can be touch, yeah. They're like different, basically where you have reflex epilepsy, there's a part of your brain that receives sensory stimuli that is hypersensitive. So whether it's your eyes, whether it's your ears, whether it's your skin, and it'll be like a very small region on your skin,

and it can be activated by tapping, scratching, rubbing, and tooth brushing. Oh, interesting. Which if you think about it, that is interesting, but also if you are going to trigger a seizure from brushing your own teeth, that would suck. Yeah. You know?

But there are some ways around that. Oh, surely there are. Like an electric toothbrush might have a different sensation or something. Oh, maybe, I hope so. Although I bet an electric toothbrush would set it off more than anything. I guess it depends, I don't know. Temporal lobe epilepsy,

the most common kinds of seizure here are complex vocal, and although there are other seizures that can occur too. And this is the one where I think it's like, well, it takes place in the temporal lobe, which controls the motion and memory, but I think these are the ones that can be really interesting and hard to describe by someone that's had one.

Yeah, like you'll have a bunch of memories come back all of a sudden at once. Which, that's another thing, another common device you'll see in movies, not necessarily with seizures, but when somebody's like, like their brain's being taken over or something like that, like just a bunch of different like visualizations will flash or whatever.

Of their life. Yeah, I think that that's basically what happens with temporal lobe epilepsy. Interesting. Yeah, or you can also have just be overwhelmed by a bunch of weird emotions, good, bad, neutral, that are not being brought on by anything, but the seizure. Yeah, at that David Burn show,

I had a moment where I was so overwhelmed with the sound, the lights. And the acid. The emotion of the moment in the art that I felt like I was on ecstasy at one point. What song was it? That specific moment was during once in a lifetime. Nice.

So that was coming together with nostalgia to just like suck me in the face. But you know, it had to do with other things as well. So I mean, while, again, did not have a seizure, I have no idea what that's like. It's interesting to feel the brain sort of get rocked a little bit to where you can feel it. But with positive feelings.

Sure. See, that's what epilepsy should be. It should be like a sudden jolt of ecstasy in your brain. Yeah. And then frontal lobe epilepsy is the final kind. And this is the one where you're more likely to have like your body herking and jerking or really stiff on one side.

Right. Yeah. So you got me with the herking and jerking. It always reminds me of the Mr. Show herky jerky dancer. Should we take a break? I think so. Mr. Show made an appearance. So yeah.

All right. We'll be right back. If you want to know, then you're in luck. Just listen up to Josh and Chuck's stuff you should know. On the podcast, Hey Dude, the 90s called David Lasher and Christine Taylor, stars of the cult classic show, Hey Dude, bring you back to the days of slip dresses

and choker necklaces. We're going to use Hey Dude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s. We lived it. And now we're calling on all of our friends to come back and relive it. It's a podcast packed with interviews,

co-stars, friends, and non-stop references to the best decade ever. Do you remember going to Blockbuster? Do you remember Nintendo 64? Do you remember getting Frosted Tips? Was that a cereal? No, it was hair. Do you remember AOL Instant Messenger

and the dial-up sound like poltergeist? So leave a code on your best friend's vapor because you'll want to be there when the nostalgia starts flowing. Each episode will rival the feeling of taking out the cartridge from your Game Boy, blowing on it and popping it back in as we take you back to the 90s.

Listen to Hey Dude, the 90s called on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. Hey, I'm Lance Bass, host of the new iHeart podcast, Frosted Tips with Lance Bass. The hardest thing can be knowing who to turn to when questions arise or times get tough or you're at the end of the road.

Ah, okay, I see what you're doing. Do you ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help. This, I promise you. Oh, God.

Seriously, I swear. And you won't have to send an SOS because I'll be there for you. Oh, man. And so, my husband, Michael. Um, hey, that's me. Yep, we know that, Michael. And a different hot, sexy teen crush boy bander

each week to guide you through life step by step. Oh, not another one. Kids, relationships, life in general can get messy. You may be thinking, this is the story of my life. Just stop now. If so, tell everybody, yeah, everybody about my new podcast and make sure to listen so we'll never, ever have to say bye, bye, bye.

Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple podcast or wherever you listen to podcasts. Stuff you should know, stuff you should know. One of the things I saw, I wanna say that's not really apropos of what we're gonna talk about next, but when someone is having a seizure during the middle seizure part,

they may start doing like involuntary movements. Yeah. Everything from lip smacking to like playing with their buttons to actually undressing and dressing. I thought that was really interesting. Yeah, that is interesting, especially when you remember alien hand syndrome. And that was the corpus callosum.

And I mean, parts of the corpus callosum are involved sometimes with epilepsy too. One of the other things epilepsy bears a strong resemblance to, especially in the fact that it has an aura and an actual middle phase and then a recovery phase are migraines. Oh yeah. Very much related to migraines.

And actually you can get migraines as a symptom of the recovery phase, the post-ictal phase, which that would really suck to have a huge seizure and then come out of it and have a migraine. Yes. That would not be good. It would not. The causes of epilepsy are, it sort of depends.

Sometimes you can have a brain injury. Sometimes like if you get hit in the head, sometimes you could have a tumor that's putting pressure on the brain. If you can determine the cause as a doctor, then it's called symptomatic epilepsy. If you're not quite sure what's going on. That's a HUD scratcher.

Yeah, or idiopathic epilepsy. It's so funny they have a name for it rather than. I know. I don't know. Sure. I mean, I guess that makes sense, but I don't know is really what that means. And then there's even another category,

cryptogenic epilepsy, and that's when the doctor is like, well, I kind of have some information, but I'm not quite sure if it's symptomatic or idiopathic. Right. It's really specific. It is. Unless it's idiopathic, then it's totally non-specific. That's right.

So I found this really interesting. The way that epilepsy is diagnosed, because just because you have one seizure, it doesn't mean you have epilepsy. Yeah. If you have a seizure, you want to go to the doctor to find out if actually, no, you actually do have epilepsy.

Right. But there's a number of ways you can get, you can have a seizure. If you're an infant or a kid and your temperature gets to 100.4 degrees Fahrenheit or higher, I think 38 degrees Celsius, that's called a febrile seizure, feverish seizure. Yeah.

Doesn't mean you have epilepsy. You may never have another seizure again. Supposedly, if you are withdrawing from alcohol or some types of drugs. Yeah, I saw that. You can suffer seizures, but I saw another research of the literature that said this is not true.

Oh, really? It's just a legend, but like a medical legend. Supposedly hypoglycemia, abnormal heart rhythm, panic attacks. All of those can bring on seizures or mimic seizures. And then there's something called a pseudo seizure, which to anybody's witnessing it would be like, that's a seizure, that person must have epilepsy. But if you had that person undergoing

an electroencephalogram at the time of brain scan, you would see that their brainwaves were not doing what somebody who has epilepsy's brain would be doing. And that's actually brought on by psychological distress. Yeah, or like past abuse in your life or something like that. Which is bad enough. I mean, that's, yeah.

Yeah, so you mentioned the EEG, the electrocephalograph. At this point, if you're being hooked up to one of those machines, you've probably already gone to the doctor, had some blood tests done. It's interesting that the doctor is sort of like bringing your car in. You're like, well, it's not making that noise now.

And the mechanic's like, well, I don't know what to do then. Right, normally the mechanic's like, well, just let me take your car home for a week, right? And you gotta let them. The same thing with your doctor. You have to move into your doctor's house until you have a seizure in front of you. That's not true, but they can

and will try and induce a seizure sometimes so they can really see what's going on. No, it's not. So during an EEG, they will try and induce a seizure. They may put the strobe light in front of your face. Yeah, it'll take you to a David Burns show. Exactly, which would be a great way to get treated. Or they'll tell you to come in and not having slept.

Yeah, fatigue is one thing, lack of sleep that can bring them on. Yeah, it's a common trigger. Yeah, so they will try and induce a seizure. A lot of times after an EEG, they will go whole hog with a CT scan or an MRI. Right. And what is that funny?

I just imagine you having to ride a hog while you have the EEG thing on your head. A CT or an MRI. Have you ever been to one of those parties where they have the whole hog cooked? Just like laying there? Yes. Looking like a hog?

Yes, and I shouldn't go into any more detail because our vegetarian and vegan listeners would not be happy, but yes, I have. All right. I have not. It's something else. I bet. I can't imagine just sticking a fork

in something that looks like an animal. Yeah, it says stick a fork in me. I'm done. All right. Yeah, we'll just move on. Okay. Yes, the CT or MRI, what they're trying to do there

is just get an inside peek at exactly what's going on in the brain like you were talking about. There could be a lesion or something that they don't see and this will show all. Yeah, so again, you come in, they say, so you had a seizure, huh?

Put this colander on your head and look into this light while I start flashing it and make sure you haven't slept in a day. And they try to trigger a seizure and then they look at the EEG readout of what your brain's doing. Yeah, they look at the spikes. Yeah, this is an epileptic seizure.

This isn't just some other type of seizure. This is like epilepsy and then yeah, they'll put you through the Wonder Machine or something like that and look for lesions, weird oxygen concentrations, whatever, to try to pinpoint where the problem's coming from. Because again, it can just be one specific region of your brain or it could be a generalized type of seizure

in your whole brain and then based on these clues, they start deducing what type of epilepsy you might have. Right, and then what you can do about it. Obviously, you're not gonna eat a pigeon these days or drink dog bile, but... Well, you could eat pigeon. Don't drink the dog bile. No, there is medication that you can take,

but from what I read, it can be pretty rough on you and a lot of bad side effects. So what you try to do, I think with a lot of, like with a lot of hardcore medications like this, is find that balance of what do I need to try and control these seizures and still kind of be able to operate and have a good quality of life.

Yeah, and I think a lot like if you've been diagnosed with say bipolar or depressive disorder, something like that, where there's a lot of different medications out there that do different things and you're probably gonna have to try different combinations until you find the one that works best for you.

So as this article put it, to balance quality of life and control of your seizures. Right. That's what you're looking for in a medication or combination of medications. Same thing with epilepsy. Yeah, I mean, you may not want the full dose and you may just want to limit your seizures

and have an acceptable amount of seizures because the medication's so rough on you. Sure, yeah, that's the worst part. And they've actually come up with a device called the Vegas Nerve Stimulator. Remember the Vegas Nerve? I don't remember. Was it the female orgasm episode

that it played such a role in? I think it's been in a couple of them. We said God was either a woman or clearly favors women because women's orgasms are triggered by vagus nerves and even if you become paralyzed, the Vegas Nerve is still intact. That's right.

Only for women. Well, there's a device that's basically like a pacemaker for your brain is what they call it. And it stimulates that vagus nerve and it just sends a little electrical pulse on like a regular rhythm to your brain. And they're like, this really works. It doesn't necessarily get rid of all of your seizures,

but it brings the frequency of them down so much that you could just get by with a low dosage of medication, but they have no idea how it works. They think maybe it keeps the brain juiced on a normal basis. It's almost like a pacemaker. It is.

Well, like I said, they call it the pacemaker of the brain. No, okay. I said that. And then there's the, well, I mean, it sounds crazy, but if it is isolated in one part of your brain, they can actually go in and just remove that part of your brain in many cases

and solve the problem. And no, not only no side effects, and they're not taking a stab in the dark. Like they know what parts of the brain they can remove. They're not like, well, let's try this. But sometimes you actually show intellectual improvements after the surgery. Like when they remove the crayon from Homer's brain.

Remember that one? Yeah. That was one of the best ones ever. Yeah, that was a good one. There's also a corpus callostomy. Yeah, I'm saying it right. Yeah, that's right. So remember, you know,

there's a type of generalized seizures or the whole brain seizures. Well, the corpus callosum is the white matter that connects the two hemispheres of the brain. So they just go in there and go, and no more generalized brain seizures, right? The thing is, I'm very curious what the side effects are of that,

because we developed a corpus callosum over time. And there's this really interesting thing. We got to do this someday on a guy named Julie and Jane came up with the bicameral mind. And he had this theory that before we had a corpus callosum and the two hemispheres talk to one another, that was back when we used to think the gods were talking to us.

One part of our brain was talking to us. And it seemed like it was coming from outside of our brain. It was like the angel and the devil on your shoulder? Basically, or literally the gods having like a role in your daily life and guiding you through life. It was actually one side of your brain, but since it wasn't connected to the other side,

it didn't seem like it was coming from you. And so to cut the corpus callosum, I wonder if it would have similar effects like that. Yeah, and I think that also was for alien hand syndrome. The corpus callosum had a lot to do with it because one side, like a malfunction of it, because one side isn't talking to the other. Interesting.

There was also some types of epilepsy called intractable epilepsy where, and this is like, this is really high. 25 to 30% of people who have epilepsy have intractable epilepsy. Like it's not going away. Yeah, and it's really tough to control even when you're being treated.

And you can actually die too. I get the feeling this is pretty rare, but sudden unexplained death and epilepsy or SUDEP is something that can happen. Yeah, they, again, they don't know how it works, but they think that maybe it has to do with a regular heartbeat that can result, a regular breathing, or that someone gets trapped face down

in something like bedding and suffocating during a seizure. Wow. Because a lot of seizures, a lot of types of seizures, especially tonic ones, the tonic that, yeah, that your muscles seize up happen while you're sleeping. And if you're sleeping on your stomach,

you could conceivably choke or suffocate. They think maybe that has something to do with it, but they're just not sure. I saw an obituary the other day for someone that died in their sleep, and that really struck me for the first time as like, that's a really nice way to say someone died in bed. Like, I don't think it ever happens

where someone's just asleep and doesn't wake up, right? Like, I think you're just asleep in bed. You wake up and you're like, I'm dying, and then you die. And this just sounds like a really nice way to say they died in their sleep. We've talked about that before. About somebody who- Can you really die while you're asleep

and not wake up and be like, I'm dying? We were talking about someone who woke up to die in pain. I think that's probably how it always happens, right? Rather than just dying in their sleep. No, I think people might pass away asleep. I think you could. That's sweet. Especially if you're on the dope.

Like they got you doped up, like in hospice or something like that. You could very easily just die in your sleep while you're kind of out of it. But I don't know. I hope you're wrong. And me too. Living with epilepsy, you know, it can be very tough.

It's, you have to think about everything from driving to going swimming by yourself. Raising an infant if you're a woman. Or a man. Or a man. Yeah. But yeah, this one specifically said like, epilepsy can be a challenge to women,

you know, when they're deciding whether to have kids or not. Sure. That's just, I hadn't even thought about that. But you can't have a seizure while you're breastfeeding or something. What happens after that? Yeah, or I mean, if you're just a,

the lone caregiver to a child at home. Sure. To a 18 month old and all of a sudden you need treatment yourself. That's the scary thing. All the states and the United States have different rules as far as driving. Like, you know, sometimes it's,

you can't have had a seizure for the past 12 months or something. Yeah, you mediated a guy who had a couple of seizures and like, he like, he lost his license because of it. Really? Yeah. Like, I think it was 12 months in Virginia or something. What else?

Yeah, I think that's it. Oh, well, I did look up celebrities with epilepsy, of course, because that's all anyone cares about, right? Yes. Prince had epilepsy. I didn't know that. Adam Horowitz. I didn't know that.

From the BC boys. Yeah. Mr. Danny Glover. I didn't know that. Lil Wayne, Big Wayne. Is there a Big Wayne? Medium Wayne. You mean the rock?

No, Lil Wayne, Neil Young. Really? Uh-huh. The great Harriet Tubman. I think we knew that. Did we? We covered that, yeah. And then the NFL former NFL twins,

Tiki and Ronde Barber, and there were twins who both had it. So that's... Oh yeah, they think there might be a genetic basis to it. Yeah, I don't think we've even mentioned that. They've identified something like 200 different gene deficiencies that could possibly lead to epilepsy. And interestingly, if you were a child

and you were diagnosed with epilepsy, your doctor may say, put that kid on Atkins. Oh yeah, ketonic diets might have something that helps. Yeah, they think when you have kind of gone through your fat stores, you go to ketones in your brain, and it's gotta have something to do with that. Start burning ketones in your brain,

that's gotta have an impact on your electrical activity. Why it only works on kids rather than adults is it's a mystery to me. Yeah. You got anything else? I got nothing else. Well, that's epilepsy, everybody. If you ever see somebody who's having a seizure,

remember everything we told you and keep that spoon out of their mouth. And since I said that, it's time for Listener Mail. I'm gonna call this, boy, marathoners. We heard from them. We probably should have thought that through before we did a marathon episode. Asking for people to email?

Yeah, I think we would have gotten the same amount of emails from marathons. I was like, I love marathon. People who marathon love to talk about marathons. So we were asking for it, even without asking for it. Well, and we also asked about the marathon high versus a marijuana high. Yeah.

And turns out a lot of marathoners smoke weed. I bet I will, I can imagine which one you selected. Well, actually I did not select one of those. Because they were kind of all the same. They were like, it's not the same. One guy said he would get high and run. Oh, I saw that guy. Until the runners had kicked in and he said,

so I would be high the entire marathon. Yeah, yeah. Like, you're insane. His friends thought he was. How would you even start? You know, he was probably, should I eat combos today or run a marathon today? I had a friend who used to get super high

and go to work out and lift weights. Yeah, like Kevin Spacey. Oh, that's right in American beauty. That's always seemed so bizarre to me. And look what happened to him. Yeah. You want to stay away from the weed and the weightlifting combo.

All right, here we go. I've been listening for almost two years, guys. Never missed an episode. I'm a former ultra marathoner, typically in the 50K distance. So definitely on the shorter end. 5,000 mile. Can you believe that?

A 50K is a short one. Yeah. 50, 5-0. Sure. And I can speak to experience in both the runners high and hitting the wall in the same race. Wow. In 2013, I was competing in my last 50K.

And while I was toward the back of the pack in these events, always, I was feeling great when I reached the four hour mark, laughing and joking with aid station volunteers and having a great time. I felt like I was on top of the world at mile 20. And then it happened. I hit the wall.

Boo. Hard. I had been able to cover 20 miles of pretty rugged trail in four hours. Suddenly my legs went from feeling amazing in light to feeling like sex of wet cement. That happens to me at like mile 0.75. Yeah.

It took me another four hours in the final 12 miles of the race. Oh my God. Maybe it's time I start training for my next one, guys. You're invited to join me. Maybe Chuck hates running because he hasn't found the right distance yet. Perhaps it's 32.5 miles.

Nope. Nope. That is from Sean Riley in Columbia, South Carolina. Sean Riley, who is crazy. But thanks for riding in. 50K short ones. Yeah, but we should say there is quite a difference, apparently, between pot high and a runner's high.

Yes. No one said that there were anything alike. No. Most people said they were pretty different. Yeah. Okay, cool. So we're done with marathoning. No need to email us more about marathons.

We're good. We got it. Okay? Yeah. If you do have epilepsy or you know someone who does though, I would love to hear from you and let us know what it's like to live with that. Sure.

If you want to get in touch with us, you can go to our website. It's called stuffyshouldknow.com. And there you will find links to all of our social media accounts, or you can send us a plain old, faster than email to stuffpodcastandhowstuffworks.com. For more on this and thousands of other topics, visit howstuffworks.com.

On the podcast, Hey Dude, the 90s called David Lacher and Christine Taylor, stars of the cult classic show, Hey Dude, bring you back to the days of slip dresses and choker necklaces. We're gonna use Hey Dude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s.

We lived it, and now we're calling on all of our friends to come back and relive it. Listen to Hey Dude, the 90s called on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. Hey, I'm Lance Bass, host of the new iHeart podcast, Frosted Tips with Lance Bass. Do you ever think to yourself, what advice would Lance Bass

and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help. And a different hot, sexy, teen crush boy bander each week to guide you through life. Tell everybody, ya everybody, about my new podcast and make sure to listen so we'll never, ever have to say. Bye, bye, bye.

Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple Podcasts, or wherever you listen to podcasts.