It might seem strange that anyone would wish to pretend to have an epileptic seizure, but in consultant practice this is one of the more common differential diagnoses to be considered. The great majority of such patients have some knowledge of epilepsy—either they have seen a relative with seizures, or more commonly they have had some true seizures themselves. Unless the true and suspect attacks are both seen by an expert, it may be impossible to sort out exactly what is happening. A doctor may be trapped into giving more and more anti-epileptic drugs for seizures which he believes to be out of control. Conversely if he sees one fit which he is quite sure is feigned, he may well wrongly believe all are feigned.

The points which distinguish a true and simulated seizure are the character of the convulsions, which are often not imitated very well. A colleague (David Marsden) has rightly remarked that they are ‘intensified by restraint and mollified by inattention’. Incontinence does not distinguish between true and simulated seizures as this can be, and often is, simulated. A normal EEG recorded during a generalized ‘seizure’ is virtually incontrovertible evidence of simulation. However, the records may be so technically marred by the patient’s thrashing around that interpretation is difficult. Combined video and EEG recording is often more helpful.

Psychiatrists, rightly or wrongly, draw a distinction between simulation of disease due to conscious malingering, for example, a man pretending to be sick to avoid conscription to the army, and unconscious hysteria, in which it is alleged that the simulation is the product of the unconscious mind. In each case some potential gain to the patient from the pretence is apparent. The gain in simulating seizures usually is to seek more attention. Rather than lay blame, doctors should regard these events as an indication that patients cannot cope with their life problems, and they should do their best to help and not to blame.

Finally, seizures may occur in a number of other, systemic illnesses or disorders such as hypoglycaemia (low blood sugar) (which may occur in treated diabetes mellitus if too much insulin is given); renal (kidney) failure; hepatic (liver) failure; respiratory (lung) failure; alcohol abuse and its withdrawal; and inborn errors of body metabolism. Finally, the potential effects of prescription or illicit drugs in precipitating seizures must always be considered.

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No, the San Diego Clinic (SDC) does not sell CMO. But we know who does. SDC is a research and treatment facility. We are not involved in the sale of any products. We do, of course, dispense CMO to subjects enrolled in our studies, and to clinic patients who may be part of one of our diagnosis and treatment programs for arthritis or other chronic ailments that have autoimmune components.

Since it was SDC that conducted the human clinical studies on CMO, most health care professionals, retail sales outlets, and distributors communicate with us frequently to ask for advice about unusual cases or to report the results of their experiences with CMO. Consequently we know just about all the sources providing authentic CMO and can readily confirm the legitimacy of yours.

Considering how many new CMO counterfeiters seem to crop up every week and how quickly some of them disappear, it is not practical for us to try to compile a list of those counterfeiters to publish here. The list would be out of date by the time this book is off the press.

There are so many impostors, it can be quite a chore trying to decide if the product you’ve found or are being offered is real CMO or some ineffective imitation. The best you can do on your own is use the information provided in the previous chapter on CMO impostors. Anything that deviates in the slightest from our description of the authentic product should be suspect.

For example, you know that CMO is derived from certain fatty tissue of beef, so that means anything claiming to be derived from a vegetable source couldn’t possibly be the authentic product.

You should also be suspicious of products that seem to be priced unusually low. The process for extracting CMO is costly. We’ve seen many counterfeit products offered at prices lower than it actually takes to produce the authentic CMO. That bargain priced counterfeit CMO is most likely to be nothing more than a waste of your money.

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Symptoms: nausea, paleness or “green” tinge to skin, excessive perspiration, vomiting, and anxiety.

Home care

Give the child an anti-nausea remedy recommended by the doctor. Give this medication an hour before a trip and then every four hours during the journey.

Keep the child cool.

Restrict the diet.

Have the child look out the window while traveling. Distract the child with a game during the trip.

Precautions

Some children are more susceptible than others to motion sickness.

Motion sickness is not brought on by the child, and the child can’t control it.

Prolonged motion sickness can lead to severe vomiting and finally to dehydration, which is an emergency situation and requires hospital care.

A child who is susceptible to motion sickness will have repeated attacks every time he or she travels.

Car, air, and sea sickness are all forms of motion sickness. Prolonged rhythmic motion up and down or from side to side will make most children nauseated, presumably because the movement affects the balance mechanism of the inner ears. Some children are more susceptible to motion sickness than others; young infants are apparently immune. Motion sickness is not deliberately brought on by the child, nor can the child control it. Susceptible children will have attacks over and over.

Signs and symptoms

Motion sickness is fairly easy to recognize. A motion-sick child becomes nauseated, pale or “green,” and anxious; the child may perspire and vomit.

Home care

If your child suffers from motion sickness, ask your doctor to recommend an anti-nausea medication. Give your child an anti-nauseate by mouth one hour before the start of each trip, and then every four hours during the trip. Dimenhydrinate anti-nauseate tablets or liquid are highly effective and safe. It also helps to keep the child cool and on a light diet before and during the trip. Having the child look out the car window will often eliminate motion sickness. Distracting the child with a game can also be useful.

Precaution

Prolonged motion sickness (over hours) can eventually result in excessive vomiting and dehydration.

Medical treatment

Your doctor’s treatment will be the same as your home treatment unless the child has become dehydrated. Dehydration requires hospital care during which the child is given fluids intravenously.

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