A seizure is a sudden, uncontrolled electrical disturbance in the brain. It can cause changes in your behavior, movements or feelings, and in levels of consciousness. If you have two or more seizures or a tendency to have recurrent seizures, you have epilepsy. There are many types of seizures and Seizure Symptoms which range in severity. Seizure types vary by where and how they begin in the brain. Most seizures last from 30 seconds to two minutes. A seizure that lasts longer than five minutes is a medical emergency.
Seizures are more common than you might think. Seizures can happen after a stroke, a closed head injury, an infection such as meningitis or another illness. Many times, though, the cause of a seizure is unknown. Most seizure disorders can be controlled with medication, but management of seizures can still have a significant impact on your daily life. The good news is you can work with your health care professional to balance seizure control and medication side effects.
With a seizure, signs and Seizure Symptoms can range from mild to severe and vary depending on the type of seizure. Seizure signs and symptoms may include:
- Temporary confusion
- A staring spell
- Uncontrollable jerking movements of the arms and legs
- Loss of consciousness or awareness
- Cognitive or emotional symptoms, such as fear, anxiety
Doctors generally classify seizures as either focal or generalized, based on how and where abnormal brain activity begins. Seizures may also be classified as unknown onset, if how the seizure began isn’t known.
Focal seizures result from abnormal electrical activity in one area of your brain. Focal seizures can occur with or without loss of consciousness:
- Focal seizures with impaired awareness. These seizures involve a change or loss of consciousness or awareness. You may stare into space and not respond normally to your environment or perform repetitive movements, such as hand rubbing, chewing, swallowing or walking in circles.
- Focal seizures without loss of consciousness. These seizures may alter emotions or change the way things look, smell, feel, taste or sound, but you don’t lose consciousness. These seizures may also result in the involuntary jerking of a body part, such as an arm or leg, and spontaneous sensory symptoms such as tingling, dizziness and flashing lights.
Symptoms of focal seizures may be confused with other neurological disorders, such as migraine, narcolepsy or mental illness.
Types of Seizures
Seizures that appear to involve all areas of the brain are called generalized seizures. Different types of generalized seizures include:
- Absence seizures. Absence seizures, previously known as petit mal seizures, often occur in children and are characterized by staring into space or by subtle body movements, such as eye blinking or lip smacking. These seizures may occur in clusters and cause a brief loss of awareness.
- Tonic seizures. Tonic seizures cause stiffening of your muscles. These seizures usually affect muscles in your back, arms and legs and may cause you to fall to the ground.
- Atonic seizures. Atonic seizures, also known as drop seizures, cause a loss of muscle control, which may cause you to suddenly collapse or fall down.
- Clonic seizures. Clonic seizures are associated with repeated or rhythmic, jerking muscle movements. These seizures usually affect the neck, face and arms.
- Myoclonic seizures. Myoclonic seizures usually appear as sudden brief jerks or twitches of your arms and legs.
- Tonic-clonic seizures. Tonic-clonic seizures, previously known as grand mal seizures, are the most dramatic type of epileptic seizure and can cause an abrupt loss of consciousness, body stiffening and shaking, and sometimes loss of bladder control or biting your tongue.
Causes of seizures
Nerve cells (neurons) in the brain create, send and receive electrical impulses, which allow the brain’s nerve cells to communicate. Anything that disrupts these communication pathways can lead to a seizure.
The most common cause of seizures is epilepsy. But not every person who has a seizure has epilepsy. Sometimes seizures happen because of:
- High fever, which can be associated with an infection such as meningitis
- Lack of sleep
- Low blood sodium (hyponatremia), which can happen with diuretic therapy
- Medications, such as certain pain relievers, antidepressants or smoking cessation therapies, that lower the
- seizure threshold
- Head trauma that causes an area of bleeding in the brain
- Brain tumor
- Illegal or recreational drugs, such as amphetamines or cocaine
- Alcohol abuse, during times of withdrawal or extreme intoxication
Not everyone who has one seizure will have another one, and because a seizure can be an isolated incident, your doctor may not decide to start treatment until you’ve had more than one. The optimal goal in seizure treatment is to find the best possible therapy to stop seizures, with the fewest side effects.
Treatment for seizures often involves the use of anti-seizure medications like Dicorate ER, Topiramate, Carbamazepine, Gabapentin, Phenytoin, and Oxcarbazepine Several options exist for anti-seizure medications. The goal is to find the medicine that works best for you and that causes the fewest side effects. In some cases, your doctor might recommend more than one medication.
Finding the right medication and dosage can be complex. Your doctor will consider your condition, your frequency of seizures, your age and other factors when choosing which medication to prescribe. Your doctor will also review any other medications you may be taking, to ensure the anti-epileptic medications won’t interact with them.
Surgery and other therapies
If anti-seizure medications aren’t effective, other treatments may be an option:
- Surgery. The goal of surgery is to stop seizures from happening. Surgeons locate and remove the area of your brain where seizures begin. Surgery works best for people who have seizures that always originate in the same place in their brains.
- Vagus nerve stimulation. A device implanted underneath the skin of your chest stimulates the vagus nerve in your neck, sending signals to your brain that inhibit seizures. With vagus nerve stimulation, you may still need to take medication, but you may be able to lower the dose.
- Responsive neurostimulation. During responsive neurostimulation, a device implanted on the surface of your brain or within brain tissue can detect seizure activity and deliver an electrical stimulation to the detected area to stop the seizure.
- Deep brain stimulation. Doctors implant electrodes within certain areas of your brain to produce electrical impulses that regulate abnormal brain activity. The electrodes attach to a pacemaker-like device placed under the skin of your chest, which controls the amount of stimulation produced.
- Dietary therapy. Following a diet that’s high in fat and low in carbohydrates, known as a ketogenic diet, can improve seizure control. Variations on a high-fat, low-carbohydrate diet, such as the low glycemic index and modified Atkins diets, though less effective, aren’t as restrictive as the ketogenic diet and may provide benefit.
Some Basic Questions to ask your Doctor
- What do you think caused my seizure?
- Do I need to have any tests done?
- What treatment approach do you recommend?
- What are the alternatives to the primary approach that you’re suggesting?
- How likely is it that I might have another seizure?
- How can I make sure that I don’t hurt myself if I have another seizure?
- I have these other health conditions. How can I best manage them together?
- Are there any restrictions that I need to follow?
- Should I see a specialist? What will that cost, and will my insurance cover it?
- Is there a generic alternative to the medicine you’re prescribing?
- Are there any brochures or other printed material that I can take home with me?
- What websites do you recommend?
What to expect from your doctor
Your doctor is likely to ask you a number of questions:
- Can you describe your Seizure Symptoms?
- Where were you and what happened right before it started?
- Was anyone there to witness what happened?
- What do you remember feeling just before the seizure? What about right after the seizure?
- What symptoms did you experience?
- How long did the seizure last?
- Have you ever had a seizure or other neurological problem in the past?
- Do you have any family members who have been diagnosed with a seizure disorder or epilepsy?
- Have you recently traveled outside the country?