Seizures 

Overview  

A seizure is characterized as an abrupt and uncontrollable surge of electrical activity occurring within the brain. It can lead to various alterations in behavior, movements, emotions, and consciousness levels. If an individual experiences two or more seizures, separated by at least 24 hours and without a known cause, this condition is classified as epilepsy.

There are numerous types of seizures, each with its own set of symptoms and severity. The symptoms can vary based on where the seizure originates in the brain and how far it spreads. Most seizures last from 30 seconds to two minutes, but if a seizure continues for more than five minutes, it requires immediate medical attention as it becomes a medical emergency. Common signs of seizures include convulsions, loss of consciousness, muscle spasms, altered sensations, and changes in behavior.

In many cases, seizure disorders can be managed with the use of medications. The prescribed drugs are effective in controlling seizures, but they may also have side effects that need to be taken into consideration. It is essential for individuals with epilepsy to work closely with their healthcare provider to strike a balance between seizure control and managing any medication–related side effects. Regular communication and follow–up appointments with the healthcare provider are crucial to monitor the effectiveness of the treatment and make any necessary adjustments to improve the individual’s quality of life. 

Symptoms  

Seizure symptoms can vary in severity and type, but they often include temporary confusion, staring spells, uncontrolled jerking movements of the arms and legs, loss of consciousness or awareness, and changes in cognitive or emotional states like fear, anxiety, or a feeling of deja vu. Healthcare providers classify seizures as focal or generalized based on where and how the abnormal brain activity originates, but if the exact onset is unknown, they are categorized as having an “unknown onset.” 

Focal seizures

Focal seizures arise from abnormal electrical activity in a specific area of the brain. These seizures can occur with or without a loss of consciousness: 

• Focal seizures with impaired awareness: During these seizures, individuals experience a change or loss of consciousness, similar to being in a dream. They may appear awake but are unresponsive to their surroundings. Repetitive actions like hand rubbing, mouth movements, or walking in circles may occur. Afterward, they may have no memory of the seizure or even be unaware that it happened. 
• Focal seizures without impaired awareness: These seizures can affect emotions and sensory perceptions. Things may appear, smell, feel, taste, or sound different during the seizure, but consciousness remains intact. Sudden emotional changes, like feeling angry, joyful, or sad, can also occur. Some individuals may experience vague sensations that are difficult to explain, along with trouble speaking and involuntary jerking of body parts such as arms or legs. Additionally, sensory symptoms like tingling, dizziness, or seeing flashing lights might be present. It’s crucial to differentiate focal seizures from other brain or nervous system disorders, such as migraines, narcolepsy, or mental illnesses, as their symptoms can sometimes overlap.

Generalized seizures

Generalized seizures are characterized by involving all areas of the brain from the start. There are several types of generalized seizures: 

• Absence seizures: Also known as petit mal seizures, mostly affect children. During these seizures, a person may seem like they are daydreaming or staring into space without any response. The seizures are short and end quickly, so there is no recovery time needed. However, they can happen many times a day, which might be confusing, as it could be mistaken for being distracted or having a learning problem. 
• Tonic seizures: Tonic seizures lead to muscle stiffening, typically affecting the back, arms, and legs. Individuals experiencing tonic seizures may lose consciousness and fall to the ground. 
• Atonic seizures: Known as drop seizures, atonic seizures result in a sudden loss of muscle control, causing the person to suddenly fall down or drop their head. 
• Clonic seizures: Clonic seizures are similar to tonic–clonic seizures, but they lack the initial stiffening of muscles (tonic phase). Instead, during clonic seizures, people lose consciousness and immediately experience convulsions with rapid jerking movements of their muscles. 
• Myoclonic seizures: These seizures involve a sudden, brief jerk or twitch that affects either a single muscle or a group of connected muscles. If it affects the leg while standing, it can lead to a fall. 
• Tonic–clonic seizures: Formerly referred to as grand mal seizures, are highly dramatic epileptic episodes. They are characterized by sudden loss of consciousness, body stiffening, and shaking. In some cases, individuals may experience loss of bladder control or accidentally bite their tongue during the seizure. These seizures can persist for several minutes and may initially begin as focal seizures before spreading to affect a large portion or the entire brain. 

If you or someone else experiences a seizure and any of the following conditions are present, it is crucial to seek immediate medical assistance: 

• The seizure lasts longer than five minutes. 
• The person stops breathing after the seizure ends. 
• A second seizure occurs immediately. 
• The seizure happens alongside a high fever or heat exhaustion. 
• The individual is pregnant or has diabetes. 
• The seizure results in an injury. 

Even if you experience a seizure for the first time, seeking medical advice promptly is essential. 

Causes  

Seizures can occur due to a multitude of factors, including genetic abnormalities that can contribute to various seizure disorders. While it’s important to note that not every individual who experiences a seizure has epilepsy, this condition is recognized as the most common underlying cause of seizures. 

Neurons in the brain generate, transmit, and receive electrical impulses. This allows the cells to communicate with one another. Anything that interferes with the communication routes can cause a seizure. Other known cause of triggers of seizures include: 

• Aneurysms 
• Brain tumors, including cancer 
• Cerebral hypoxia or lack of oxygen 
• Severe concussion and traumatic brain injury  
• Degenerative brain diseases like Alzheimer’s disease or frontotemporal dementia  
• High fevers, particularly febrile seizures which are common in children 
• Brain infection, such as meningitis or encephalitis which can occur due to viruses, bacteria, parasites, or fungi 
• Severe general sickness, including of COVID–19 infection  
• Sleep deprivation  
• Issues with electrolytes, particularly low sodium, calcium, or magnesium  
• Certain medications used to treat pain, depression, or to assist individuals quit smoking  
• Amphetamines, cocaine, and other narcotics  
• Abuse of alcohol, including during withdrawal or excessive intoxication 
• Hormone-related changes, especially catamenial epilepsy can affect people with a menstrual cycle