Seizure: What It Is, Causes, Symptoms, Treatment & Types

Introduction

Seizures are sudden and uncontrolled electrical disturbances in the brain. They can cause changes in behaviour, movements, feelings, and consciousness. While often associated with epilepsy, seizures can occur for various reasons & affect people of all ages. Uncertainty and anxiety about potential seizures can affect mental and emotional health, limiting social interactions. Let’s explore what seizures are, their causes, symptoms, different types, and available treatments.

What is a Seizure?

A seizure happens when there is a surge of abnormal electrical activity in your brain. It happens quickly and disrupts the normal flow of electrical signals between neurons, leading to temporary changes in brain function. Seizures can range from barely noticeable to severe episodes involving loss of consciousness and uncontrollable body movements.

Key points about seizures:

• They can affect anyone at any age
• A single seizure doesn’t necessarily mean a person has epilepsy
• Seizures vary in duration, typically lasting from 30 seconds to 2 minutes
• A seizure lasting more than 5 minutes is considered a medical emergency

What are the Causes of Seizures?

Seizures can stem from various factors, including:

• Epilepsy: A neurological disorder characterised by recurrent, unprovoked seizures.
• Head Trauma: Brain injuries can cause seizures, either immediately or years later.
• Brain Infections: Conditions like meningitis or encephalitis can cause seizures.
• Stroke: Brain damage from a stroke can trigger seizures.
• Brain Tumours: Both cancerous and non-cancerous tumours can cause seizures.
• High Fever: Especially in young children (febrile seizures).
• Drug or Alcohol Withdrawal: Sudden cessation of certain substances can lead to seizures.
• Illicit Drug Abuse: Certain illegal drugs (amphetamines or cocaine) can stimulate seizures.
• Low Blood Sugar: Particularly in people with diabetes.
• Electrolyte Imbalances: Abnormal levels of sodium or other electrolytes in the blood can trigger seizures in susceptible people.
• Sleep Deprivation: Lack of sleep can lower the seizure threshold in some people.
• Flashing Lights or Patterns: In people with photosensitive epilepsy.
• Certain Medications: Some drugs can lower the seizure threshold as a side effect.

What are the Symptoms of Seizures?

Seizure symptoms can vary widely and depend on the type of seizure and the area of the brain affected. Common seizure symptoms include:

• Temporary confusion
• Staring spell
• Uncontrollable jerking movements of arms and legs
• Loss of consciousness or awareness
• Cognitive or emotional changes (fear, anxiety, déjà vu)
• Altered senses (strange tastes or smells)
• Muscle stiffness
• Convulsions
• Sudden falls
• Rapid eye movements
• Drooling or frothing at the mouth
• Loss of bladder or bowel control

It’s important to note that some people may experience warning signs, known as auras, before a seizure. These can include feelings of fear, dizziness, or visual disturbances.

Different Types of Seizures

Seizures are broadly classified into two main categories: focal seizures and generalised seizures.

Focal Seizures (Partial Seizures): 

Focal seizures originate in one area of the brain. They are further divided into:

a) Focal Aware Seizures (Simple Partial Seizures):

• The person remains conscious & aware during the seizure
• May experience alterations in emotions, senses, or small muscle movements
• Usually brief, lasting less than 2 minutes

b) Focal Impaired Awareness Seizures (Complex Partial Seizures):

• Consciousness is affected, and the person may appear confused or dazed
• May perform repetitive movements like hand rubbing, walking in circles, or lip-smacking
• It can last for 1-2 minutes

Generalised Seizures: 

These seizures involve both sides of the brain from the onset. Types include:

a) Absence Seizures (Petit Mal):

• Brief episodes of staring into space
• It may involve subtle body movements like eye blinking
• Common in children, typically lasting 5-10 seconds

b) Tonic Seizures:

• Cause stiffening of muscles
• This may lead to falls if the person is standing

c) Atonic Seizures (Drop Seizures):

• Sudden loss of muscle tone, causing the fall
• Usually very brief, lasting about 15 seconds

d) Clonic Seizures:

• Characterised by repeated, jerking muscle movements
• Often affect the neck, face, and arms

e) Myoclonic Seizures:

• Sudden, brief jerks or twitches of arms & legs
• It may occur in clusters

f) Tonic-clonic Seizures (Grand Mal):

• The most dramatic type of epileptic seizure
• It involves loss of consciousness, muscle stiffening, and violent shaking
• It can last several minutes

Seizure Diagnosis  

Initial Evaluation:

• The doctor will gather detailed information about your seizure experiences.
• A neurological examination will be performed. It focuses on your emotional status and testing your motor and cognitive functions.

Diagnostic Procedures:

• Blood Tests or Spinal Tap: These are used to identify potential infections.
• Electroencephalography (EEG): This involves placing electrodes on the scalp to track the brain’s electrical activity.
• Imaging Techniques: MRI, CT, or PET scans can identify any brain issues.
• Single-Photon Emission Computed Tomography (SPECT): A small amount of radioactive material is injected to observe blood flow in the brain during a seizure.

What are the Treatments Available for Seizures?

Treatment for seizures depends on the root cause and the frequency & severity of the episodes. Common seizure treatments include:

• Anti-epileptic Drugs (AEDs): Medications that help control seizures by altering brain chemistry.
• Dietary Therapies: Some people, especially children, may benefit from specific diets like the ketogenic diet.
• Vagus Nerve Stimulation (VNS): The doctor may implant a clinical device under the skin that sends electrical impulses to the brain through the vagus nerve.
• Responsive Neurostimulation (RNS): RNS is an implanted device that monitors brain waves and delivers electrical stimulation to prevent seizures.
• Deep Brain Stimulation (DBS): Involves implanting electrodes in specific brain areas to regulate electrical signals.
• Surgery: In some cases, removing the part of the brain causing seizures may be recommended.
• Lifestyle Changes: Managing stress, getting adequate sleep, and avoiding known triggers can help reduce seizure frequency.
• Emergency Medications: Doctors may prescribe emergency medications like diazepam for prolonged or cluster seizures.

Conclusion

Seizures are complex neurological events that can significantly impact a person’s life. While they can be frightening, most seizures do not cause long-term harm. With proper diagnosis and treatment, many people with seizure disorders can effectively manage their condition and lead fulfilling lives. If you or someone you know experiences seizures, it’s crucial to consult with a doctor for proper evaluation and personalised treatment.

FAQs

Can seizures go away on their own?

Some seizures, particularly those caused by temporary factors like high fever or drug withdrawal, may get resolved on their own once the underlying cause is addressed. However, for people with epilepsy or recurrent seizures, treatment is necessary to manage the condition. In some cases, especially in children, seizures may decrease in frequency or stop entirely as the person grows older. However, working closely with a doctor to monitor the condition & adjust treatment as needed is essential. 

How to prevent seizures? 

Dietary Changes:

Consult your doctor about adopting a ketogenic diet, which is rich in fats and proteins but low in carbohydrates. This diet has been shown to help reduce seizure frequency.

Sleep Hygiene:

Ensure you get adequate rest, as sleep deprivation can trigger seizures.

Medication Adherence:

Take your medicines exactly as prescribed by your doctor.

Emergency Medications:

Use rescue medications only in emergencies to quickly halt a seizure. These do not replace daily medications.

Options include:

• Diazepam: Can be administered orally if the person is conscious, or as a nasal spray.
• Lorazepam: Taken orally.
• Midazolam: Can be given orally if the person is conscious, or as a nasal spray.

What should I do if I witness someone having a seizure?

If you witness someone having a seizure:

• Stay calm and time the seizure if possible
• Clear the area of any hazards to prevent injury
• Do not try to restrain the person or put anything in their mouth
• Gently turn the person on their side if possible to help prevent choking
• Stay with the person until the seizure ends & they are fully alert
• Call emergency services if the seizure lasts longer than 5 minutes if the person has trouble breathing, or if it’s their first seizure.