People trying to stop a man’s seizures cut the soles of his feet to let blood flow
A 42-year-old man in West Africa suffered serious injuries after people who had gathered around him made deep cuts on the soles of both his feet during seizures, believing that letting the blood flow would stop the convulsions.
His symptoms began with a sudden, severe headache that progressively worsened over approximately 24 hours. In the evening, he experienced a generalized tonic seizure lasting about two minutes, followed by three minutes of confusion. His mother placed a cloth in his mouth to prevent him from biting his tongue. She then sought medical assistance at a nearby health facility, where elevated blood pressure was noted. He was subsequently referred to a university hospital.
While his mother was looking for transportation, he experienced three additional generalized tonic seizures, each lasting approximately four minutes and separated by about five minutes.
In their report, “Bloodletting as a Harmful and Misguided First-Aid Response to Seizures in Sub-Saharan Africa: A Case-Based Review,” Gloire Chubaka Magala, Jamiilah Neve Nchare, Abel Christian Tanoh, Cedric Segla Achi Agbo-Panzo, Axel Toa Bi, Constance Yapo-Ehounoud, Mariam Doumbia-Ouattara, Évelyne Aka-Anghui Diarra and Berthe Assi describe a disturbing case of harmful bloodletting performed on a man during epileptic seizures.
“The belief that epilepsy is a “blood’s disease” has been previously documented in several African communities, where seizures are often perceived as manifestations of impure or deficient blood. However, to our knowledge, the use of bloodletting as an immediate response to seizures has not been previously reported in Sub-Saharan Africa. This case highlights the alarming evolution of misinformation and cultural misconceptions surrounding seizures and underscores their potentially devastating consequences. It also reinforces the urgent need to strengthen community-based awareness strategies, particularly through the use of digital communication channels and culturally adapted health education programs.” Magala et al.
Several people gathered around him and attempted inappropriate first-aid measures. They forcibly removed the cloth from his mouth and replaced it with a piece of wood taken from a nearby carpentry workshop. They then made deep, heated incisions on the soles of both feet using new razor blades, believing that letting the blood flow would calm the seizures.
His mother strongly opposed the bloodletting and eventually managed to pull her son away from the people who had gathered around him, who insisted that the procedure was necessary during a seizure.
At the hospital, a brain CT scan revealed a right temporoparietal intracerebral hematoma measuring 27.2 cm³, surrounded by 4.78 cm³ of edema. Examination also revealed multiple bleeding and ulcerative wounds on both soles, some of them necrotic and infected, as well as injuries to the palate, tonsils and upper and lower lips caused by the forced insertion of the wooden object.
The patient received treatment for high blood pressure and wound infections, including a 14-day course of antibiotics. The surgical team also provided local wound care. After 15 days in hospital, he was discharged. At that point, the injuries to his feet still prevented him from walking. At the one-month follow-up, he had experienced no further seizures, his blood pressure was 130/80 mmHg, and his plantar and oral wounds were healing. He was also able to walk independently for approximately 100 metres.
Bloodletting as an immediate response to seizures had not previously been reported in sub-Saharan Africa
The authors highlight persistent misconceptions about seizures in some African communities, where they may be attributed to supernatural forces, witchcraft or blood-related disorders. In some settings, blood is viewed as a possible cause of disease, a means of transmission or even a form of treatment. Previous studies in several African countries have documented beliefs linking seizures to blood-related disorders and the transmission of epilepsy through blood. However, the authors say that, to their knowledge, bloodletting as an immediate response to seizures had not previously been reported in sub-Saharan Africa.
“Although internet access and social media use have increased in Africa, the scientific community has not yet fully leveraged these tools, even though social media is already a cornerstone of scientific communication in high-income countries. To control the scientific narrative and counter media dominated by erroneous information that overshadows local achievements, African researchers, including neurologists, must use these platforms effectively, not only for communication but also for data collection, participant recruitment, and dissemination of research findings. Social media use significantly increases the visibility and citations of articles, thereby enhancing their impact on community practice and public health policy.” Magala et al.
Seizures are caused by abnormal electrical activity in the brain, not by an excess of blood. In this patient, they were acute symptomatic seizures associated with an intracerebral hemorrhage and should not automatically be taken as evidence of epilepsy.
The authors also warn that social media can contribute to the spread of health misinformation and disinformation. They call for culturally adapted public health education involving neurologists, healthcare institutions and trusted community members. They also recommend using social media and public awareness campaigns to share reliable information and help prevent dangerous responses to seizures.
Image: Epilepsy Society UK
