Conversational Analysis of Consciousness During Seizures
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2020
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Abstract
Objective
The objectives of the study were to 1) investigate how patients with epilepsy describe the subjective, conscious experience of having a seizure and 2) determine whether certain themes and descriptions correspond to specific types of epilepsy.Methods
We interviewed thirteen patients with electroencephalographically confirmed epilepsy about their subjective experience of having a seizure and used conversational analysis (CA) to analyze the language they used to describe this experience.Results
Seven patients had focal to bilateral tonic-clonic seizures (FBTCS), 7 had focal impaired awareness seizures (FIAS), 1 had focal aware seizures (FAS), and one had generalized onset tonic-clonic (GTC) seizures. Three had multiple types of seizures. Focal seizure origin was frontal in 2 patients, right hemisphere in 1, parieto-occipital in 1, and temporal in 8. Focal to bilateral tonic-clonic and GTC seizures were most frequently associated with descriptions of a total loss of consciousness (n = 8), whereas FIAS were most frequently associated with a perceived loss of consciousness but able to describe some aspects of being unconscious (n = 5). Temporal seizures most frequently accompanied reports of memory loss/impairment (n = 4). Ten patients provided specific descriptions of the transition between the interictal and ictal state or auras. Descriptions consciousness and unconsciousness ranged significantly, resembling a continuum rather than corresponding to distinct levels.Conclusion
The subjective experience of consciousness for patients with epilepsy may differ by seizure type and origin. These may reflect different involvement of brain regions involved in producing consciousness and arousal. Conversational analysis and narrative approaches can significantly aid clinicians in the diagnosis and management of epilepsy.Type
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Jenson, Deborah, Julie Uchitel, Aatif Husain and Sneha Mantri (2020). Conversational Analysis of Consciousness During Seizures. Epilepsy and Behavior, 112. p. 107486. 10.1016/j.yebeh.2020.107486 Retrieved from https://hdl.handle.net/10161/33893.
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Scholars@Duke
Deborah Jenson
My career began with graduate training under Hélène Cixous (Paris VIII) and Barbara E. Johnson (Harvard University), and segued to faculty roles at the University of New Mexico-Albuquerque (1995-2002), the University of Wisconsin-Madison (2002-2008), and Duke University (2008-2025; Emerita, 2026-). I am an interdisciplinary scholar of French and Caribbean Literature and Culture, with particular interest in the “long 19th century” in France and Haiti, cognitive literary studies, health humanities, and global south philosophy. Monographs, edited volumes, and translations include: Beyond the Slave Narrative: Politics, Sex, and Manuscripts in the Haitian Revolution (2011); Trauma and Its Representations: The Social Life of Mimesis in Post-Revolutionary France (2001); Poetry of Haitian Independence (2015, with D. Kadish and N. Shapiro); Unconscious Dominions: Psychoanalysis, Colonial Trauma, and Global Sovereignty (2011, with W. Anderson and R. Keller); Sarah, A Colonial Novella (2008, with D. Kadish); and "Coming to Writing" and Other Essays by Hélène Cixous (1991). Edited journal issues include The EcoBrain: Ecologies of Cognition and Cognitive Ecologies in Ecokritike (2025, with Cate Reilly, Miguel Rojas-Sotelo, and Hugh Roberts); Representation in Neusocience and Humanities in Frontiers Integrative Neuroscience and Psychology (2022, with Marco Iacoboni and Len White); States of Freedom, Freedom of States in The Global South (2012, with Michaeline Crichlow and Patricia Northover); The Haiti Issue: 1804 and Nineteenth-Century French Studies in Yale French Studies (2005). Duke University provided the opportunity for me not only to collaborate with others around humanities labs (the “Haiti Lab,” 2010-2013, and the “Health Humanities Lab”, 2016-2020), but to serve as a Research Professor of Global Health at the Duke Institute for Global Health, and an affiliate of the Duke Institute for Brain Sciences, where I co-directed the Neurohumanities Research Group, Duke Neurohumanities in Paris, and the Brain and Society theme of Bass Connections. In addition to my articles in humanities journals and edited volumes, I have published collaborative work in scientific venues including The American Psychologist (2023), Epilepsy and Behavior (2020), and Emerging Infectious Diseases (2011). My administrative roles at Duke included directing the Franklin Humanities Institute (2015-2017)and the Center for Latin American and Caribbean Studies (2012-2014). Teaching opportunities have built on the collaborative and interdisciplinary nature of my research, with courses including “Flaubert’s Brain: Neurohumanities,” “Haiti to New Orleans,” "Pandemic Humanities: Reimagining Health and Medicine in Romance Studies," “Storytelling in Medicine and Health,” “Trauma and Global Health," "Mimesis in Theory and Practice," and "Global Humanities in French.” Recent courses have built on my interests in philosophy, and include "Sylvia Wynter and Caribbean Philosophy," and co-taught courses with Felwine Sarr (“African Philosophy” and “Africana Philosophy in French”).
As I embark on the Emeritus phase of my Duke faculty career, I am preparing, with John Gartrell, Meg Brown, and two of our Romance Studies graduate students, an exhibit and symposium for the opening of the Sylvia Wynter archives at Duke in early March2026, and I am working on the translation of a novel by the award-winning Haitian author Yanick Lahens.
Aatif Mairaj Husain
Sneha Arun Mantri
I am a movement disorders specialist with a clinical practice focused on the care of people with Parkinson disease (PWP) and other movement disorders. I am interested in ways to improve the quality of care for patients with chronic neurodegenerative conditions, particularly translating clinically effective treatments and lifestyle modifications (e.g. exercise) into the “real world.” While a growing body of evidence demonstrates that physical activity, including high-intensity exercise, is feasible for PWP and leads to improved motor and non-motor outcomes, translating that knowledge into practice has been challenging. My research in this area focuses on the impact of patient/doctor communication and social determinants of health on promoting or preventing physical activity among PWP.
In addition to my clinical training, I hold a Master of Science in Narrative Medicine from Columbia University. This unique program, which grew out of the larger field of medical humanities, expands the conceptual framework of clinical medicine to incorporate patient perspective and social experience. I conduct mixed-methods research to design and implement interventions that are actually meaningful to the target population(s). As an example, in my study of Veterans with PD, I was able to conduct qualitative cluster analysis of Veterans’ self-reported barriers and motivators of adherence to exercise recommendations, reporting for the first time the unique barriers faced by this patient population. Additional funded projects using a narrative medicine approach have included (1) exploring the lexicon of burnout among clinical and non-clinical employees; (2) understanding the experience of fatigue and psychosis among PwP and their care-partners; (3) exploring the interactions between border-crossing in literature and border-crossing in medical education/practice.
In particular, narrative medicine offers guideposts toward a revitalized practice of medicine and medical education. In 2020, I was appointed Director of Medical Humanities at Duke, leading a team of clinician scholars in understanding moral injury and structural inequities in medicine. Under this umbrella, I co-direct the interprofessional course Moral Movements in Medicine; teach in the first-year Clinical Skills Immersion, the second-year Cultural Determinants of Health Disparities, and the fourth-year Medical Humanities courses; and mentor third-year students in the Medical Humanities study track.
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