There’s nothing quite like the moment you get called to the ward because “the patient was unresponsive, then shook a bit, and now they’re sleepy but fine.” 😵💫 Classic post-ictal confusion. But was it really a seizure? Or syncope? Or just an afternoon nap rudely interrupted by a junior doctor’s torchlight?
When you’re trying to clinically catch a seizure, this handy mnemonic will help. Let’s break it down.
🧠 Mnemonic: “CATCH A Seizure”
| Letter | Feature | Explanation |
|---|---|---|
| C | Confusion (post-ictal) | The hallmark post-ictal state: confused, disoriented, staring into the void 🌀 |
| A | Amnesia (post-ictal) | “I don’t remember anything” — often reported by both patient & confused interns |
| T | Tongue-biting | Especially lateral — highly suggestive of tonic-clonic seizure |
| C | Cyanosis | Apneic episodes during seizure lead to bluish discoloration |
| H | Headache (post-ictal) | Common complaint once they regain consciousness 🧠💥 |
| A | Aura | A sensory warning before seizure — olfactory (“burning rubber”), visual, etc. |
A Clinical Encounter from Quetta
I once reviewed a 65-year-old lady from Kharan brought in by her daughter: “Doctor sahib, she just collapsed, and then she was chewing something with no food in her mouth.”
Tongue-biting? Check. Post-ictal confusion? Check.
EEG later confirmed temporal lobe epilepsy.
In the elderly, seizures are frequently underdiagnosed — especially when they’re subtle, or misattributed to “just aging” or a TIA. Trust me, even Dr. Basit Khan once chased a full stroke workup before realizing it was a complex partial seizure.
Happy learning! 🙂
