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Q. I have severe tonic-clonic seizures and get sudden cardiac arrest. Is it anoxic brain injury?

Answered by
Dr. Sadaf Mustafa
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Mar 13, 2020 and last reviewed on: Mar 19, 2020

Hi doctor,

Does the length of time in critical care always reflect the severity? Is the length of time on a ventilator depend more on the cause i.e. longer if lung infection rather than neurological, etc? Can you have severe illness complications and still be in ICU for a short while?

When I was 21, I had severe uncontrolled tonic-clonic seizures (constant on and off for a day then last over an hour and a half) apparently I had every medication could have if the last drug did not work then there was nothing else I could have. Apparently, I then had a cardiac arrest where the doctor had said it was very difficult to get me back tried for a long time my heart was struggling and was not breathing.

I was anesthetised and on a ventilator. I had blood gases showing acidosis, high lactate, also ECG showed ST changes and right axis deviation. Echo showed dilated cardiomyopathy and right ventricular dilatation (this was not there just weeks before), no urine output apparent renal insufficiency, blood glucose in the 30's mmol. EEG showed non-reactive background alpha. Cat scan showed low attenuation temporal lobe. MRI showed matter changes. My family were told to come in immediately in the middle of the night as doctors felt I might not make it and if I had another seizure would not be able to stop it. I had a do not resuscitate order put on. Why did they put do not resuscitate order on me at 21?

I hear of people who were in critical care for much longer. I have memory flashbacks and cannot figure out why the length of stay does not relate to severity. I was on a ventilator for 12 hours and sedation coma reduced over two days. I was in for three to four days. I feel it was rushed and if it had not been then I may have not got the lasting problems I have now.

The word anoxic brain injury has been mentioned. After in ICU I have had many problems seizures, ataxia, very brisk hyper reflex is reflexes more in legs than arms, Babinski reflex, tremor, myoclonus, altered sensation, numbness of arms down to feet especially back of hands. I have memory problems and a different personality, I find it hard to learn new things, etc. Are these common symptoms of anoxic brain injury?

Dr. Sadaf Mustafa

General Medicine Internal Medicine
#

Hi,

Welcome to icliniq.com.

I am so sorry that you went through so much and I am glad to know that you have made it. You are extremely lucky to have survived all this. It seems like after persistent seizure you developed acidosis that pushed you in cardiogenic shock. Very few people come out of it. You are the second case in my 12 years of experience that I have seen communicating.

Ventilators has its own complications and they can lead to mortality and morbidity which are more difficult to battle than the real problem, therefore it is always recommended to wean as soon as possible.

Anoxic brain injury occurs right there an then when the event occurs. Ventilators could only prevent part of it and not the entire process. I was curious to know what brought it on in the first place? Why did you had the seizures like did you had the seizure disorder or an infection process?

Anoxic brain injury can have various consequences and yes it can cause different psychological, motor, and cognitive deficits depending upon which part of the brain was involved.

I hope this helps.


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