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05/11/2018

Epilepsy Society neurologist on BBC Radio 4 to discuss brain seizures

Live on BBC Radio 4 every Thursday, The Life Scientific features Professor Jim Al-Khalili talking to leading scientists about their life and work, finding out what inspires and motivates them and asking what their discoveries might do for mankind.

The most recent programme is titled 'Detective of the Mind' with Epilepsy Society neurologist Dr Suzanne O'Sullivan, who discusses brain seizures.

Dr Suzanne O'Sullivan

Suzanne has written books about some of her most memorable and interesting cases. Her first, book 'It's All in your Head' won the Wellcome Book Prize in 2016. The book describes many of her case studies involving patients whose illnesses are psychosomatic.

Suzanne argues that this is an area of medicine that has not been studied deeply enough yet. For the patients themselves, these debilitating symptoms are all too real and "there is a huge variety of symptoms that can happen in the context of epilepsy"

Very often, Suzanne's job is challenging because she is dealing with symptoms that are transient. She has to "piece together very difficult symptoms" from things that have happened in the past and not the present.

Neurology beginnings

Suzanne was first attracted to neurology by being inspired by the people who trained her. She first studied in Dublin and worked for some "inspirational" neurologists who made the subject interesting and she wanted to follow in their footsteps.

Growing up in Ireland, she was fortunate to go to university as she was the first generation in her family to go. Suzanne first trained as a clinical neurophysiologist who interrogates the nervous system using electrical tests, but it removes people away from the patient.

Currently, there are so many ways to interrogate the brain and you can test the integrity of the nervous system quite easily so you can confirm where in the body a specific "deficit" lies.

Epilepsy - breaking the stigma and time for change

Suzanne believes that people have a "fixed idea" of what epilepsy is. Her definition of epilepsy occurs when there is an unwanted burst of electrical discharge in the brain that shouldn't be there. If we get a sudden synchronous autonomous burst, that can produce an epileptic seizure. Whilst most people understand an epileptic seizure to be a convulsion or a blank spell, that is only a small part of a "much stranger truth". The electrical discharge that causes a seizure could pick off on a small part of the brain and the part of the brain "matters a great deal".

Suzanne has a particular range of techniques that she uses to see what's occurring in the brain during epileptic seizures. Her job is to confirm whether or not people are having seizures and where in the brain they're arising. She runs a facility called a 'Video Telemetry Unit' where they admit people to hospital and measure numerous physiological parameters, for example brain waves, heart rate, blood pressure, breathing.

Also they video them and wait for the patient to display whatever strange symptom they have been complaining about. If the patient displays the symptom, they will look at their brain and heart activity, they can hopefully deliver a diagnosis.

Epilepsy is not a single disease, as it has lots of different causes. It can have a range of effects on our behaviour. One patient of hers reported that they saw the cartoon figures of the seven dwarves running from one side of the room to the other. Suzanne found that their seizures were arising in the temporal lobe, which is important for memory and imagination.

Suzanne wants to change the way doctors are trained so that they bring a diagnosis to the patient at the beginning, so people consider it from the outset. Suzanne explains that people are not good with dealing with psychosomatic disorders and they don't have treatment facilities for them.

Writing career

Suzanne considered being a writer when she was a child. After she won the Wellcome Book Prize in 2016, she treated herself to a creative writing course and a year's sabbatical.

In her most recent book, Brainstorm, she looks at how different cultures have specific diseases. She found that there are a lot of culture bound syndromes, which are idioms of distress that exist only within specific cultures or societies. A recent incident happened in Yorkshire where a child collapsed in school, which caused an outbreak of children collapsing in the same school.

Suzanne feels that various areas of science need to work together closely and to have practical interdisciplinary work. Also, she believes that doctors and neurologists should start placing people in a cultural context in order to get a better diagnosis and treatment plan for patients.

You can listen to the full programme here.

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