<p class = "canvas-atom canvas-text Mb (1.0em) Mb (0) – sm Mt (0.8em) – sm" type = "text" content = "Boyce's parents explained on Tuesday that he had epilepsy and died of a seizureBut, as New York City neurosurgeon Nitin Mariwalla tells PEOPLE, his family may never know exactly how the crisis caused his death. "Boyce's parents explained Tuesday that he was epileptic and deceased as a result of a Nitin Mariwalla, neurosurgeon from New York City, tells PEOPLE that his family could never know exactly how this crisis caused his death.
<p class = "canvas-atom-text-canvas Mb (1.0em) Mb (0) – sm Mt (0.8em) – sm" type = "text" content = "Mariwalla says that it does not work There was no witness in the seizure – and information on Boyce's death indicated that he had been "found unanswered at his home" on Saturday afternoon – it's difficult to determine that a crisis has actually occurred. "data-reactid =" 18 "> Mariwalla claims that, except in the presence of a witness of the seizure – and information on the death of Boyce – he would have been" found insensitive to his home "Saturday afternoon – it is difficult to determine that it is a seizure actually occurred.
"It's hard to say," says Mariwalla. "I think it's probably in the category of sudden and unexpected death in epilepsy. This is an acronym called SUDEP. It's basically a pocket diagnosis. This means that a person with epilepsy has died unexpectedly and that there is no toxicological or anatomical cause of death during the autopsy. It's a kind of unanswered answer. We simply say what it is, it is a sudden death in a patient with epilepsy. This does not describe the cause of death.
The problem, says Mariwalla, is that a crisis can lead to death in different ways, and it can be difficult to solve the post mortem problem.
One option is that Boyce had a swelling of the brain as a result of the seizure.
"When you have a seizure, you can move to a condition called status epilepticus," says Mariwalla. "Epileptic status is where you have continual seizures. In other words, the input does not break. When this happens, you accumulate in the brain very toxic metabolites that can swell the brain. Your brain needs huge amounts of oxygen and glucose to keep working like that, and you can somehow burn your brain. "
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Swelling of the brain may also occur when the patient's airway is obstructed and breathing is difficult, a common side effect of a seizure.
Mariwalla says that it is also possible for people to die from a cardiac event related to the crisis, or if they lose consciousness and beat their heads – although it is rare. He says that in some cases, epileptic patients treat themselves with over-the-counter medications, which can interfere with the drugs against seizures and their ability to prevent them.
Mariwalla says that it is difficult to live with and manage epilepsy and that it varies greatly from one patient to the next. People with epilepsy are diagnosed if they have had two or more unprovoked seizures, that is, people who have had other seizures, such as a blood sugar level low, overheating or alcohol withdrawal, are not eligible.
This disorder means that a person's brain cells are not functioning properly.
"In general, we think that epilepsy is a dysfunction of the nervous system, brain cells," Mariwalla said. "Most brain cells are supposed to do is trigger electrical signals significantly. Even though we develop memories, these are formed from repeated discharges of neurons. With regard to epilepsy, you basically get a misfire or a spread of that electricity that then triggers all the surrounding neurons. "
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People with epilepsy can have a wide range of seizure frequencies. Some have one or two a year, others have more than 20 a day. And all do not look like the "classic Hollywood crisis" in which the patient falls and his body begins to weld, Mariwalla says.
"Epilepsy can sometimes be very, very focused and cause no motor movement," he says. "There is a type of epilepsy called absence seizures or petit mal seizures, which are considered generalized seizures, but it's only a whim of a blank look that the kids are going to have. They come in all forms. "
For those with more than 20 seizures a day, they often opt for an extremely difficult but life-saving brain operation that removes the part of the brain responsible for seizures. But for others, they can handle it with drugs.
"The majority of these drugs are aimed at calming neurons and preventing electrical activity from spreading abnormally," Mariwalla said. "The problem with some of these drugs is that they can be toxic to the body. Sometimes they can literally slow you down in general. But we have developed very good drugs that are well tolerated, that we can start with young people and young people, and that can be very effective and, of course, save lives. "