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Seizure - Causes, Types, Symptoms, and Management

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A seizure is a sudden and unpredictable disturbance in the electrical activity of the brain, causing involuntary jerking, altered behavior, and consciousness.

Written by

Dr. Jayasree S

Medically reviewed by

Dr. Abhishek Juneja

Published At August 26, 2022
Reviewed AtOctober 6, 2022

What Is a Seizure?

It is an unexpected episode of electrical disturbance in the brain that can cause uncontrollable reactions in the body, such as loss of consciousness, jerky movements, rigidity, unusual sensations, and altered behavior. Seizures are associated with several medical conditions involving the brain. Sometimes having a seizure attack may cause more damage to brain function. There are several identified types of seizures, depending on the symptoms, intensity, and clinical manifestations. Some seizures are mild with minimal symptoms, whereas some other types involve whole-body fits. Understanding the underlying cause and expert management can bring seizure attacks under control.

What Is the Main Cause of Seizures?

Under normal conditions, the nerve cells in the brain send out chemical substances and electrical impulses to the rest of the body to control and regulate its activities. When there is a functional impairment in any area of the brain, the electrical activity might lose its rhythm and tend to malfunction. In some situations, many nerve cells send electrical impulses at once without warning, which causes a burst of electrical activity throughout the body. This is presented as a seizure attack. The abnormal electrical activity can be due to known or unknown reasons.

When the seizure attacks keep coming back in a repeated pattern due to an imbalance in the brain's electrical rhythm, the condition is called epilepsy. Leaving seizures untreated might lead to increased recurrence and worsening of symptoms. Each episode tends to get prolonged and damage the brain, ending up in a state of coma or death. Seizures form as a result of the following conditions as well:

  • Illnesses like stroke, infections in the brain, head injury, and brain tumors.

  • When there are structural abnormalities and damaged areas inside the brain.

  • Intense stress.

  • Extremely low blood sugar levels may be due to poor food intake.

  • Electrolytic imbalances in the body.

  • Excessive use of alcohol and abusive drugs. Withdrawal from these can also develop seizures.

  • Long periods of sleep deprivation.

  • Flashing lights.

  • Prolonged high fevers.

  • Certain neurological conditions involve mental disabilities acquired by birth.

What Are the Different Types of Seizures?

Depending on the area of the brain involved in the abnormal electrical activity, Seizures can be:

  1. Generalized Seizure - When both sides of the brain are involved, including myoclonic seizures, tonic-clonic seizures or grand mal seizures, atonic seizures, tonic seizures, and absence seizures.

  2. Focal Seizures - When a single area in one side of the brain is involved, including simple focal seizures, complex focal seizures, and secondarily generalized seizures.

What Is an Aura Associated With a Seizure?

For some individuals, the seizure attack follows a phase called an aura. It is a group of symptoms one experiences before the attack, including:

  • Feeling dizzy.

  • The blurring of vision and headache.

  • Unknown fears, anxiety, and deja vu.

  • Strange ringing noises in the ears.

  • Nausea, along with a bitter taste in the mouth.

  • Out-of-body feeling.

  • Numbness and tingling in the body.

  • Tremors in arms and legs, one might drop the things they are holding.

What Are the Symptoms of Seizures?

The degree of symptoms depends on the type of seizure attack. It can be as minimal as a moment of stillness, blinking of the eyes, or a confused look on the face. Or it can happen with violent shaking of the entire body, falling onto the ground, and losing consciousness. An actual seizure attack may have all or some of the following problems going on:

  1. Went unconscious for a while, staying confused afterward.

  2. Involuntary jerking of the body, uncontrollable muscle spasms, and stiffness. A violent fit can cause fractures and bruises in the body too.

  3. Rapid, uncontrollable eye movements.

  4. Frothing saliva drooling from the mouth.

  5. A strange taste in the mouth.

  6. Clenching teeth might accidentally bite into the tongue, harming it.

  7. One might cry out loud or make strange grunting noises.

  8. Lose bowel and bladder control.

  9. Mood alterations.

  10. After the seizure attack, one might feel drowsy, tired, confused, and anxious for several hours or the coming few days.

How to Diagnose a Seizure Attack?

Seizures are diagnosed based on clinical symptoms and physical examination of the patient. Based on the presentation of symptoms at the time of the attack, the doctor can know which area of the brain is possibly affected. To understand more about abnormal brain function, one can also perform a neurological assessment. To confirm the diagnosis, one orders additional tests like an electroencephalogram (EEG), where electrodes are attached to the head to note down the pattern of electrical activity in the brain. Additionally, one can perform computed tomography (CT) scan and magnetic resonance imaging (MRI) to understand the underlying cause of seizure attacks.

What to Do When Someone Is Having a Seizure?

The family members and caretakers must be aware of what to do immediately at the time of a seizure attack when you see one. Following are the steps to follow:

  1. Make the affected lie down on the floor on one side to avoid choking on saliva and help with easy breathing.

  2. Make sure the area is clear of sharp and hard objects that might hurt the affected while having a fit.

  3. Place something soft under the head as a cushioning so that the head does not hit the floor.

  4. Remove eyeglasses, tight clothing, or accessories that can harm or suffocate the individual.

  5. If the seizure does not stop even after five minutes from the start, get emergency medical help.

What Is the Treatment for Seizures?

People who suffer a single seizure episode may not even require further treatment if the tests do not show any abnormal findings. Those who suffer multiple seizure attacks can be labeled epileptic and require treatment. Treatment involves:

  • Antiepileptic drugs for controlling the tendency of the brain cells to burst out electrical signals. The majority of the patients get good results with the drugs. Commonly prescribed antiepileptic drugs are Sodium valproate, Carbamazepine, Lamotrigine, Levetiracetam, and Topiramate.

  • Diet alterations - Eating a balanced diet and taking plenty of fluids helps. Doctors suggest special diets like the keto diet and Atkins diet as well. One can also maintain adequate sleep and do regular exercise to reduce the risk of seizures. Avoiding stress and substance abuse is recommended as well.

  • Surgical corrections are performed to remove the underlying cause of seizure attacks, such as tumors or a part of the brain that is malfunctioning.

  • Procedures like vagus nerve stimulation help reduce the frequency of seizure attacks, where a stimulator device is implanted under the skin to send electrical impulses.

Conclusion:

A seizure attack can temporarily alter a person’s behavior, time-place-person awareness, movement, and feelings, which can be pretty upsetting for the affected and the onlookers. Some types of seizures can be life-threatening if they persist for more than 30 minutes and cause permanent injury to the brain or even death. The perplexing factor about a seizure attack is its unpredictability in occurrence. It is a relief that seizures can be brought under control to a great extent by suitable medications. Seeking the help of a qualified medical professional to identify the underlying problem is the first step toward a cure.

Dr. Abhishek Juneja
Dr. Abhishek Juneja

Neurology

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