What You Should Know About Seizures

A seizure is a sudden change in movement or awareness due to a change in the electrical function of the brain. Sudden bursts of electrical energy may affect movement, sensation and consciousness.

Seizures are changes in the brain’s electrical activity. These changes can cause dramatic, noticeable symptoms, subtle or mild symptoms, or no symptoms at all.

The symptoms of a severe seizure include repetitive jerking and stiffening and a loss of control. Because some seizures can lead to injury or be a sign of an underlying medical condition, it’s important to seek treatment if you experience them.

The three major types are focal onset seizures, generalized onset seizures, and unknown onset seizures.

Focal onset seizures

Focal onset seizures begin in only one area of the brain. People may also refer to these as partial seizures.

Focal onset seizures start in small areas of the brain, such as a single lobe, but can affect large areas.

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Medical professionals typically split focal onset seizures into two types: focal aware seizures and focal awareness-impaired seizures.

Focal aware seizure

During a focal aware seizure, you’ll remain fully conscious and be aware that something is happening, even if you don’t recognize it as a seizure.

The symptoms of a focal aware seizure will depend on which part of the brain the seizure starts.

Focal aware seizures may be singular events but can also develop into other types of seizures. For this reason, people often refer to them as warnings or auras.

Focal impaired-awareness seizure

This type of seizure affects your consciousness. During a focal impaired-awareness seizure, you may not be able to move, talk, or hear as you did before. You may also not be able to remember the event.

Focal impaired-awareness seizures can last for up to 2 minutes . This type of seizure typically affects a larger portion of the brain than focal aware seizures.

Generalized onset seizures

These seizures start in both sides of the brain simultaneously. Among the more common types of generalized onset seizures are:

• Tonic: Tonic seizures will result in your muscles stiffening up.
• Clonic: The convulsions in clonic seizures may cause abnormal, jerky movements of your limbs. You will likely lose consciousness during these seizures that can last for a few minutes.
• Tonic-clonic:Tonic-clonic seizures include a combination of both tonic and clonic symptoms.
• Myoclonic: During a myoclonic seizure you may experience sudden muscle spasms. These are typically too short-lived to affect consciousness and pass quickly. Myoclonic seizures may be of generalized onset as well as focal onset.
• Absence: People may also refer to these as petit mal seizures. Absence seizures last for only a few seconds. They can cause you to blink repeatedly or stare into space. Other people may mistakenly think you’re daydreaming.
• Atonic: During atonic seizures your muscles suddenly go limp. Your head may nod, or your entire body could fall to the ground. Atonic seizures are brief, lasting about 15 seconds. People may refer to these seizures as drop attacks.

Unknown onset seizures

Sometimes no one witnesses the beginning of a seizure. For example, someone may wake up in the middle of the night and observe their partner having a seizure.

A person can have an epilepsy condition that causes both focal and generalized seizures at different times, but not simultaneously.

A focal seizure can progress to become a generalized seizure. Sometimes this happens slowly and sometimes it can happen rapidly.

Sometimes symptoms occur before the seizure takes place. These can include:

• a sudden feeling of fear or anxiousness
• a feeling of being sick to your stomach
• dizziness
• a change in vision
• a jerky movement of the arms and legs that may cause you to drop things
• an out-of-body sensation
• a headache
• déjà vu
• mood changes

Signs that indicate a seizure is in progress include:

• losing consciousness, followed by confusion
• having uncontrollable muscle spasms
• drooling or frothing at the mouth
• falling
• having a strange taste in your mouth
• clenching your teeth
• biting your tongue
• having sudden, rapid eye movements
• making unusual noises, such as grunting
• losing control of bladder or bowel function

Seizures can stem from several health conditions. Some examples include:

• alcohol withdrawal
• a brain infection, such as meningitis
• a brain injury during childbirth
• a brain irregularity present at birth
• choking
• substance use
• substance withdrawal
• an electrolyte imbalance
• electric shock
• epilepsy
• extremely high blood pressure
• fever
• head trauma
• kidney or liver failure
• low blood glucose levels
• a stroke
• a brain tumor
• vascular abnormality in the brain

Seizures can run in families. Tell your doctor if you or anyone in your family has a history of seizures. In some instances, especially with young children, the cause of the seizure may be unknown.

Living with epilepsy and experiencing repeated seizures can have both short- and long-term effects. These can range from a drop in quality of life to increased risks of mental health conditions.

Short-term effects

Some seizures can cause you to lose total control of your body. This can lead to falls and other movements that can result in injury.

People with epilepsy typically have more physical issues, such as bruising and fractures, than people without the condition.

Being prone to seizures may also affect your quality of life. For example, you may no longer be able to drive. You may want to avoid situations where a seizure could cause serious harm, such as swimming or traveling alone.

It’s important to wear a medical identification bracelet that tells emergency responders that you have epilepsy.

Long-term effects

If you don’t get treatment for seizures, their symptoms can become worse and progressively last longer. Prolonged seizures can lead to coma or death.

While death as a direct result of seizures is rare, the risk of premature death in people with epilepsy is up to three times higher than in the general population.

Living with epilepsy can have an impact on your mental health. People living with epilepsy may be depressed or anxious due to the worry of having a seizure. They may also feel isolated, be worried about getting hurt or experience stigma.

The changes in the brain that can cause epilepsy may be associated with the different brain changes that can cause psychiatric comorbidities. Up to 30% of people with epilepsy also have a serious mental health condition like bipolar disorder, schizophrenia and severe depression.

Your doctor may recommend specific tests to accurately diagnose a seizure and help ensure that the treatments they recommend will be effective.

Your doctor will consider your complete medical history and the events leading up to the seizure. For example, migraine, headaches, sleep disorders, and extreme psychological stress can cause seizure-like symptoms.

Lab tests may help your doctor rule out other conditions that can cause seizure-like activity. The tests may include:

• blood testing to check for electrolyte imbalances
• a spinal tap to rule out infection
• a toxicology screening to test for drugs, poisons, or toxins

An electroencephalogram (EEG) can help your doctor diagnose a seizure. This test measures your brain waves. Viewing brain waves during a seizure can help your doctor diagnose the type of seizure. An EEG can show evidence of seizure activity even when a person isn’t having a seizure. But an EEG can also be completely normal when a person is not having a seizure.

Imaging scans, such as a CT scan or MRI scan, can also help by providing a clear picture of the brain. These scans allow your doctor to see abnormalities like brain damage or a tumor.

Treatments for seizures depend on the cause. By treating the cause of the seizures, you may be able to prevent future seizures from occurring. The treatment for seizures due to epilepsy include:

Medications

Antiepileptic drugs are often the first treatment option for people experiencing multiple seizures. They target the signaling activities in specific brain cells and can effectively control seizures in approximately 70% of cases.

There are several types of antiepileptic drugs. You and your doctor may have to work to find out which is the best medication for treating your condition.

Brain surgery

Doctors may recommend surgical options for treating epilepsy and seizures if medications don’t work.

Surgical procedures to treat epilepsy include:

• resective surgery
• multiple subpial transection
• hemispherectomy
• corpus callosotomy

Brain surgery for epilepsy can improve quality of life but does carry a risk of complications. Consult with your doctor to discuss whether surgery is the right option for you.

Nerve stimulation

In addition to brain surgery, surgeons can insert nerve stimulation devices in the body to treat epilepsy.

Vagus nerve stimulation involves placing electrodes around the vagus nerve in your neck and a generator for these electrodes in the upper chest. These devices then stimulate the nerve with electrical signals, which can help manage seizures.

Responsive neurostimulation systems also work by stimulating the brain to manage seizures. Doctors can program these devices to assess and respond to nerve activity associated with seizures, often stopping them.

These less invasive surgical options can help safely reduce seizure frequency and severity.

Doctors may also suggest deep brain stimulation therapy. This is where a surgeon places electrodes onto the thalamus.

The thalamus is a part of the brain that processes signals from almost every sensory system. It regulates consciousness, alertness, and sleep cycles.

Electrical signals from these electrodes help regulate the excitability of certain parts of the brain. This can help reduce the frequency of seizures.

Diet changes

Dietary changes may help people manage epilepsy and reduce seizure frequency long term.

If antiepileptic drugs don’t work, following a ketogenic diet can be an alternative to surgery for some people living with epilepsy.

Multiple studies have linked the diet to positive outcomes in symptom management. However, the exact reasons why it helps people with epilepsy are not known.

However, the ketogenic diet and its variants can feel restrictive. Following the diet long term may be challenging for some.

Be sure to check in with your doctor before starting a new diet, especially as a mode of treatment.

It can be challenging to live with epilepsy. But if you have the right support, it’s possible to live a full and healthy life.

Take prescribed medications

It’s important to continue taking antiepileptic drugs if your doctor prescribes them.

It’s important to regularly check in with your doctor and tell them whether you’re experiencing any side effects of your medications. If you have your seizures under control for long periods, your doctor may recommend a gradual reduction in dosage.

Avoid triggers

Some people may be able to identify specific triggers for their seizures. These can include:

• stress
• drinking alcohol
• lack of sleep

Avoiding these triggers may help you manage your condition.

Educate friends and family

Teach your friends and family more about epilepsy and how to care for you while a seizure occurs.

This includes taking steps to reduce the risk of injury like cushioning your head, loosening tight clothing, and turning you on your side if vomiting occurs.

Find ways to maintain your current lifestyle

Continue your usual activities if possible, and find ways to work around your epilepsy so you can maintain your lifestyle.

For instance, if you’re no longer allowed to drive because you have seizures, you may decide to move to an area that’s walkable or has good public transportation, or use ride-share services so you can still get around.

Making safety modifications to your place of residence can reduce the risk of injury. This can include covering the corners of low objects, not locking the bathroom door when using it, and using guards on radiators and heaters.

Other tips

• Find a good doctor who makes you feel comfortable.
• Try relaxation techniques, such as yoga, meditation, tai chi, or deep breathing.
• Find an epilepsy support group. You can find a local one by looking online or asking your doctor for recommendations.

In many instances, a seizure isn’t preventable. But maintaining a healthy lifestyle can give you the best chance at reducing your risk. You can do the following:

• Get plenty of sleep.
• Eat a balanced diet and drink plenty of fluids.
• Exercise regularly.
• Engage in stress-reducing techniques.
• Don’t take illegal substances.

If you’re on medication for epilepsy or other medical conditions, take them as your doctor recommends.