Seizures are not a disease in themselves. Instead, they are symptoms of many different disorders that can affect the brain. Some seizures may hardly be noticed, while others are disabling. They occur due to abnormal electrical activity in the brain. If a person has two or more unprovoked seizures, they are said to have epilepsy.
The manifestations of seizures vary, because of different parts of the brain control movements, sensations, behaviours and experiences. A person may or may not lose consciousness when having seizures.
Seizures are categorized as generalized and focal seizures.
Generalized seizures affect both sides of the brain. They can be further categorized as:
Absence seizures: Also known as petit mal seizures. They cause frequent blinking or staring into space for a few seconds. They are more common in children.
Tonic seizures: They are characterized by muscle stiffness and may cause sudden fall
Atonic seizures: They cause loss of muscle control and sudden collapse
Clonic seizures: They cause repeated jerking muscle movements affecting the face, neck and arms.
Myoclonic seizures: They cause sudden brief jerky movements affecting a part of the body or the whole body
Tonic-clonic seizures: Also known as grand mal seizures where a person can lose consciousness, have muscle spasms, bite their tongue, and experience loss of bladder control. A person may feel tired for several hours after experiencing tonic-clonic seizures.
Focal seizures, earlier also known as partial seizures, arise from one small area of the brain. Focal seizures can be further classified into 3 types:
Simple focal seizures: Affect a small area of the brain and do not cause loss of consciousness. It can lead to a change in sensation and emotions. It can also cause involuntary jerky movements.
Complex focal seizures: In this type of epilepsy, a person can be left confused and unable to reply to any questions for a few minutes.
Secondarily generalized seizures: It arises in one area of the brain and then spreads to both sides of the brain. In this type of situation, a person will have a focal seizure first which is then followed by a generalized seizure.
The symptoms vary according to the type of seizure.
Twitching of part of the body
Numbness in a limb
Smacking of lips
Involuntary chewing or swallowing
Fiddling with objects
There are two stages in this type of seizure.
Tonic stage: loss consciousness, stiffening of the body, and fall to the ground
Clonic stage: Jerking of limbs, tongue bite, loss of bladder or bowel control, breathing difficulty
Muscles become stiff
Momentary loss of contact with the environment
Fluttering of eyelids
Sudden twitching of some part of the body or the whole body
Muscles suddenly relax and the person abruptly falls
An emergency condition in which a person experiences seizure for more than 5 minutes or multiple episodes within 5 minutes without regaining consciousness between them. It can lead to death or permanent brain damage if not treated promptly.
The causes vary according to the age group.
Lack of oxygen during birth, brain abnormalities, maternal drug use, bleeding in the brain, low blood sugar level, and inborn errors of metabolism
Infants and Children
Seizures during episodes of fever, infections, and brain tumors
Children and Adults
Inherited, head trauma, and congenital conditions
Head Injury, stroke, liver and kidney failure, low sodium, dementia
There are various risk factors of epilepsy such as:
Trauma or lack of oxygen supply to the brain during birth
Premature birth or low birth weight
Brain defects, injuries, tumors and infections
Alcohol or drug abuse, alcohol withdrawal
Lack of sleep
Injury from falls during a seizure
Permanent brain damage
Aspiration pneumonia due to swallowing of food and saliva into the lungs
It is important to reach out for medical help immediately if a person is having a seizure for the first time or if a person is having repeated seizures.
Your doctor will carry out tests and prescribe medications to keep prevent recurrence of seizures.
You must wear helmets to decrease the risk of getting a head injury. Keep away from illegal drugs and alcohol. Have adequate sleep and maintain a regular sleep pattern. Taking medicines as prescribed and reporting regularly for review is crucial.
The prognosis varies from person to person. Some people are at life-long risk of having recurrent seizures and will need to keep taking medications. Some people with epilepsy may be advised to decrease the dose gradually and stop taking drugs if they do not experience any seizures for a length of time.
After obtaining your medical history and performing a physical examination, your doctor will recommend some tests. An electroencephalogram (EEG) is done to look for abnormal electrical activity in the brain. Other tests may include blood tests and lumbar puncture. A CT scan of the head or MRI may be recommended.
The treatment includes lifestyle changes, anticonvulsant medications, and in some selected cases, surgery. Surgery is needed if the epilepsy is due to tumour, bleeding in the brain, abnormal blood vessels and for some kinds of congenital abnormalities of the brain
No, if you had one episode of seizure, it does not mean you have epilepsy. Seizures can happen for other reasons as well. Some reasons include low blood sugar, high fever, and withdrawal from alcohol or drug.
Most people with epilepsy do not die from it. But the risk is higher in some cases such as brain tumour or stroke, falls or injuries, and seizures that last more than 5 minutes (status epilepticus). Very rarely, there are cases of sudden unexpected death in epilepsy (SUDEP).
HOD And Consultant - Department Of Neurology
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