"Don't believe everything you see on TV." You've heard that before and for the most part it's true. Medical dramas are under scrutiny now for misrepresenting and mishandling seizures. While Dr. House may make the medical profession look like a series of quips and one-off loose cannon antics, the cases they deal with are all too real for some people in real life.
Most TV medical drama fans understand that these programs aren't offering hands-on advice, a la "This Old House" or the like. There's no Bob Villa character explaining how he plans to crack open his neighbor's ribs and reroute the blood flow to the guy's right ventricle.
Still, you would hope there would be some element of reality and no blatant misinformation on these shows. Unfortunately, when it comes to seizures, medical dramas propagate misconceptions that put people with epilepsy in harm.
Researchers at Dalhousie University in Halifax, Nova Scotia, reviewed the most popular medical dramas — "Grey's Anatomy," "House, M.D.," and "Private Practice" and the last five seasons of "ER" — and found that in nearly half the incidences when a seizure was featured, the actors did precisely what you're not supposed to do.
Don't let these scrubs fool you
Seizures, being so visually dramatic, were featured 59 times in 327 episodes of these medical dramas. The researchers found inappropriate practices in 25 cases, almost always performed by a doctor or nurse who would otherwise know better.
Worse, the mistakes were the type that viewers might try to emulate should they encounter someone having a seizure: pinning the person down; trying to stop involuntary movements; or putting something in the person's mouth to prevent tongue swallowing.
For starters, you can't swallow your tongue. This is a persistent medical myth so engrained, apparently in the minds of writers of medical dramas as well as in the general public, that well-meaning passersby often try to stick something into the mouth of the person having a seizure to prevent tongue swallowing. All you are doing, though, is obstructing airflow, which is potentially life threatening. The person also may very well chomp through, swallow and choke on the object you stuck in there for protection.
You shouldn't pin a person down unless he's about to roll into traffic or other danger. Pinning a person won't calm him or shorten the length of a seizure. You run a risk of hurting yourself (people, even children, have remarkable muscle strength during seizures) or hurting the person you're trying to help by dislocating a joint or breaking a bone.
A tonic-clonic seizure, once called a grand-mal attack, is the most dramatic seizure and the type most often depicted on television. The "tonic" part lasts about 30 to 60 seconds and is characterized by a stiffening of the limbs and no breathing. The "clonic" part is the shaking that usually fades after a few more minutes.
There is much you can do to help a person having such a seizure. You can put something soft under his head so that he doesn't bang it. You can loosen clothing around his neck so he can breathe more easily. You can remove any eyeglasses or dangling jewelry.
Foaming at the mouth during a seizure is common; and mixed with blood from a bit lip or tongue, it can be dangerous, let alone quite frightening to see. So you can tilt the person's head to the side to prevent choking on any fluid.
You can stay near and be reassuring until the seizure passes. And you can time the seizure and note what happens, which will likely be useful information for the person who had the seizure.
Treatment for epilepsy has advanced greatly in recent years. But seizures are not uncommon. I myself have encountered and helped likely a half dozen strangers having seizures in my lifetime. If you stay calm and keep the person having the seizure safe, things will work out — despite your lack of medical training or familiarity with "Grey's Anatomy."
The lead researcher on this seizure study was Andrew Moeller, a third-year medical student, who somehow managed to find 280 hours in medical school to watch these dramas. He will present the findings in April at the American Academy of Neurology's 62nd Annual Meeting in Toronto.