Underlying cause of seizure needs to be further investigated

I have been a registered nurse for 55 years. I’m writing in about my 42-yearold son who recently suffered a focal seizure while driving. He has a history of neck pain, possibly caused by his history of skateboarding on pipes during his early teen years and drumming in a band.

My daughter (also a registered nurse) read an article stating that neck nerve compression could cause a seizure. Do you have any knowledge regarding this?

My son has no history of seizures, and a scan in the ER came out negative for any brain abnormalities.

DEAR READER >>

Seizures have many different causes. Anyone can have a seizure under the right conditions of stress, but epilepsy is a condition of recurrent and unprovoked seizures.

I found quite a few articles in both the lay and medical literature stating that nerve compression in the neck can cause seizures, but I am unconvinced that this is a likely cause. The peer-reviewed papers I read included case reports of people who developed focal seizures after an injury, but the injury didn’t have to be in the neck; the seizures were reported even with burn injuries to the hand.

Most of the reported cases had other risks for seizures, including having a family history of epilepsy. Many cases of epilepsy are from an unknown cause. I suspect that a person often attributes epilepsy to something that is actually unrelated, but it’s possible that there is a connection between peripheral nerve injuries and seizures, which hasn’t been wellelucidated.

It is abundantly clear that brain and spinal cord injury, whether from trauma, stroke or cancer, can be a seizure focus and lead to epilepsy. In the ER, a CT scan is often done, but most experts in epilepsy want to see a high-resolution MRI scan to look for any brain lesions that might lead to seizures.