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First Aid Management of Seizures in TV Medical Dramas
Fusing Fact With Fiction

ARTICLE IN BRIEF

A new study, which will be described in greater detail next month at the AAN annual meeting in Toronto, found that among 59 seizures depicted in 327 episodes of leading TV medical dramas, first-aid management of the seizure was deemed inappropriate in 45.8 percent of the episodes.

In a recent episode of “House, M.D.,” the American TV medical drama that has aired on Fox since November 2004, a child who has a seizure is held down by two doctors who eventually take the child to the operating room and drill burr holes into the child's head to relieve increased intracranial pressure.

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ANDREW MOELLER: “The depiction of seizure first-aid on television is inappropriate in nearly half of all seizures on popular television dramas today. If seizure first-aid is based on a persons understanding from popular television dramas, he or she could be causing harm to someone that they are actually trying to help.”

This was one of the worst first-aid depictions of seizures in TV drama, according to investigators who reviewed the portrayal of seizures in all episodes of the four highest-rated US medical dramas —House, M.D.,” “Grey's Anatomy,” “Private Practice,” and the last five seasons of “ER.”

The study, which will be described in greater detail next month at the AAN annual meeting in Toronto, found that among 59 seizures depicted in 327 episodes, first-aid management of the seizure was deemed inappropriate in 45.8 percent of the episodes. Among the inaccurate interventions depicted, 27.1 percent showed a person with seizure being held down; 15.2 percent depicted staff trying to stop the involuntary movements in the person having a seizure, and in 18.6 percent, something was put in the mouth of the person having a seizure.

“The depiction of seizure first-aid on television is inappropriate in nearly half of all seizures on popular television dramas today,” said Andrew Moeller, a study author and medical student at Dalhousie University in Halifax, Nova Scotia.

“If seizure first-aid is based on a person's understanding from popular television dramas, he or she could be causing harm to someone that they are actually trying to help.”

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DR. JACQUELINE A. FRENCH: “The number one thing I perceive as a result of what people know about epilepsy from TV is that they think that all seizures are convulsions.”

TV: PUBLIC HEALTH TOOL

Sallie Baxendale, PhD, a consultant neuropsychologist in the Department of Clinical & Experimental Epilepsy at the Institute of Neurology in London, who has also studied and written about how seizures are portrayed on television and film, said the inaccurate information also feeds myths about seizures that can be dangerous.

“One of the most dangerous myths is that you should put a spoon in patients' mouths to stop them from swallowing their tongue,” said Dr. Baxendale, who was not involved with the study. “In reality patients can bite down hard on any object in their mouth and spoons in particular can cause extensive dental trauma.”

Dr. Baxendale noted that seizures are usually portrayed in medical dramas as highly dramatic events — life or death issues that need intensive medical input to rescue the patient. And she suggested that this perpetuates incorrect stereotypes that bear no resemblance to the everyday experience of most people with epilepsy.

Said Jacqueline A. French, MD, professor of neurology at New York University (NYU) and director of the Clinical Trials Consortium at the NYU Comprehensive Epilepsy Center: “The number one thing I perceive as a result of what people know about epilepsy from TV is that they think that all seizures are convulsions.”

Moeller's study bears this out. Of the 59 seizures portrayed, 46 (78 percent) were primarily or secondarily generalized tonic-clonic convulsions.

Another myth, Dr. French said, is that some horrible disease underlies every seizure. This myth, she said, was highlighted in an episode of “Grey's Anatomy.” In the show, a young woman has a seizure out of the blue and is cared for by a neurosurgery team. The team does diagnostic scans after which the neurosurgeon tells the medical student that the woman has epilepsy and he doesn't know why but if they can't figure it out she will die.

“That episode was particularly scary,” said Dr. French, adding that she wondered how many calls she would get the next day from patients asking if they were going to die since no one knew why they had epilepsy.

“The bottom line is that it is not hard to get it [first-aid management of seizures] right,” Dr. French said. When a person is having a seizure, turn the person on his or her left side with the head down so that the person doesn't aspirate any saliva.

Story lines for epilepsy could be mined in any number of creative ways, added Dr. Baxendale. “It's just disappointing to see the same tired, inaccurate clichés churned out year after year.”

RESOURCES TO PROMOTE MEDIA HEALTH CARE ACCURACY

Hollywood, Health & Society — an organization in the Norman Lear Center at the University of Southern California Annenberg School of Communications — was established eight years ago as a project through the Centers for Disease Control and Prevention to help writers and producers of TV medical dramas to more accurately depict health situations such as seizures. The organization, which is now funded through both private and government enterprises, provides writers and producers of scripted TV shows with experts on a wide range of medical issues: http://bit.ly/pUO4W.