Seizures following the Great East Japan Earthquake

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In the January 7, 2013 early online access in the journal Epilepsia, Doctors Shibahara and colleagues from the Department of Neurosurgery and Epilepsy and Epileptology at the Kesennuma City Hospital in Kesennuma, Japan, and the Tohoku University in Sendai, Japan present a fascinating analysis at the glimpse at what happens to seizures after a significant national disaster. As the authors reminded the readers, on the afternoon of March 11, 2011 Kesennuma City was hit by the great Japan earthquake and subsequent devastating tsunami. The purpose of their study was to document changes in the number of patients with distinct neurological diseases seeking treatment following the disaster. This particular city was isolated by the disaster, allowing for study with a limited selection bias.

Patients who were admitted for neurological emergencies from January 14 to May 1, 2011, 117, were compared with patients in the corresponding 16-week period in years 2008, 2010, or 323 patients, when there was no major disaster.

The investigators found that the number of patients with unprovoked seizures was significantly higher during the eight-week period after the earthquake than during the same periods in 2006 through 2010. In contrast, the number of patients treated for other neurological conditions, such as stroke, trauma, and tumors remained unchanged. As the authors point out, to their knowledge this was the first report in the increase in the number of patients with seizures following a life threatening natural disaster. They posited that stress associated with life threatening situations can enhance seizure generation.

This is a fascinating study because it reminds us that the circumstances that can enshroud a natural disaster can very much lead to neurological problems in addition to life threatening traumatic injuries. The study also reminds us that after a significant disaster, whether it be a great earthquake, a major hurricane or storm or other natural disaster that special care must be given to our neurological patients as they are also at risk for exacerbation of their ongoing neurological condition. This study is important and helpful because it helps to remind us that we need include care of neurological conditions in disaster preparedness plans.

by Joseph I. Sirven, MD
Editor-in-Chief, epilepsy.com
Last Reviewed: 2/19/2013