December 7, 2022

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Patient History - He survived an avalanche, then the 25-year-old developed very special symptoms

Patient History – He survived an avalanche, then the 25-year-old developed very special symptoms

It all started with an avalanche in the Alps. A 25-year-old man who was on a ski vacation was buried under an avalanche, resulting in about 15 minutes as the brain received less oxygen than usual. Oxygen is absolutely essential to the brain, and a lack of oxygen for just a few minutes can cause irreversible brain damage.

Fortunately, the man was rescued and taken to hospital. During rehab, he experienced small spasms in his mouth and legs when he tried to talk and walk, respectively. Moreover, he was gradually getting better and better.

unique symptoms

The most amazing complication occurred several weeks later when he was solving Sudoku. At the same time as he used his right hand to write the numbers, his left arm began to move uncontrollably in large convulsions, called tonic fits. The contractions stopped as soon as he stopped solving the Sudoku game, and started again once he resumed the brain exercise.

The doctors were astonished. They had never heard of Sudoku as a seizure trigger. They tried to give him other problems with reading and arithmetic, but here the man’s left arm was still quite on the table.

Explained photography phenomenon

Functional doctors perform MRI scan from a man’s brain. This is a kind of examination where you can see which parts of the brain are activated when solving different tasks. In this case, the man had to solve a sudoku during a brain scan.

In this way, one could see the hyperactivity in the right island of the brain when the man solved his sudoku. The lamina is a region of the brain responsible for, among other things, processing spatial information. This fits perfectly with the fact that the Sudoku man’s strategy was to visualize the square grid in three dimensions.

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Doctors can also report that some special brain fibers that regulate other neurons by limiting nerve signals from them, called subcortical U fibers, were destroyed by the lack of oxygen that occurred during the avalanche.

So doctors can explain a man’s contractions in the following way:

When the man solved his sudoku, some very specific brain cells in the ice cap were activated. Normally, these brain cells are inhibited by U fibers so that they do not become very active, but when the U fibers are destroyed in man, the brain cells in the ice sheet become hyperactive instead. Overactivity in the right hemisphere causes uncontrolled contractions of the left arm because the right hemisphere controls the left part of the body.

focal seizures

The convulsions in the man occurred due to damage to the cellular network in the ice sheet. This causes electrical signals in the brain to spread in an uncontrolled manner within this area of ​​the brain.

However, the rest of the brain was operating as usual, and thus the man was fully conscious at all times. This is called focal seizures, and is the most common form of epilepsy in adults.

reflex epilepsy

The unique case of the 25-year-old skater is an example of reflexive epilepsy. Reflexive epilepsy is a term for epileptic seizures Caused by external impulses, such as touch, air, taste, sound, or light. The most well-known reflex epilepsy is photosensitive epilepsy, in which convulsions are triggered by flashing lights.

In a 25-year-old German man, seizures were caused by sudoku, something that had not previously been reported in the scientific literature. Since the avalanche, the man has put Sudoku on the shelf for good, and he hasn’t had a cramp since.

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sources

1) JAMA Neurology: spells of solving Sudoku puzzles