How to Differentiate Between Epilepsy and Seizures

Understanding Seizures

When your brain undergoes a sudden spike in excessive electrical activity, a seizure occurs. Changes in behaviour, movements, emotions, or states of consciousness may result from it.

The severity and manifestation of seizures ranges widely, from short-term attentional lapses or muscular jerks to severe and prolonged convulsions. Although they are frequently linked to epilepsy, not all seizures indicate epilepsy.

There are two primary categories of seizures:

Generalised seizures that affect both sides of the brain.

Absence seizures or petit mal seizures often appear as staring spells. These seizures are characterised by abrupt and short lapses in attention.
Tonic-clonic seizures or grand mal seizures are the most recognisable type of seizures. They involve muscle stiffness (tonic phase) and followed by rhythmic muscle contractions (clonic phase). The individual may collapse to the ground, lose consciousness, and even experience convulsions.

Focal seizures that affect only one part of the brain.

The individual who experiences simple partial or focal seizures will remain conscious and awake, but they might have odd movements or sensations, such as a tingling sensation, getting an odd taste or smell, or having an involuntary jerking body part.
Despite appearing awake, the individual who experiences complex partial or focal seizures will be unresponsive or unaware of their surroundings. They may also engage in repeated motions. For example, they may walk in circles, rub their hands together, or smack their lips.

Causes of Seizures

There are three main categories of factors that cause seizures:

Provoked	Triggered by external factors, e.g., metabolic imbalances (low blood sugar), alcohol withdrawal, or certain drugs. These seizures usually do not happen again after the underlying problem is fixed. Those who have provoked seizures are not considered to have epilepsy.
Epileptic	Happen to those who have epilepsy, a disorder in which there is occasional abnormal electrical activity in the brain. Possible causes include brain damage from trauma, stroke, infections, or tumours. Epilepsy can sometimes be inherited. However, it is often unclear what specifically causes epileptic seizures.
Nonepileptic	Mainly caused by psychological issues, fainting spells, or muscle disorders. Despite having similarities with epileptic seizures, these seizures are not brought on by abnormal brain activity.

Understanding Epilepsy

Epilepsy is a neurological condition that affects people of all ages and is characterised by frequent, unprovoked seizures. It is among the most common neurological conditions.

Childhood epilepsy

Juvenile Myoclonic Epilepsy	Involves jerking and twitching of the muscles, particularly in the arms and shoulders, and appears during adolescence. Often happens in the morning after waking up and occasionally the knees may give way unexpectedly.
Absence Epilepsy	Characterised by short episodes of awareness loss that last for a few seconds. When these episodes occur, the child may turn pale, stare blankly, unresponsive to spoken words, twitching eyelids, and rolling back of the head or eyes. As many as 100 of these short absence seizures may occur in a single day.
Rolandic Epilepsy	The child’s face may twitch on one side, and occasionally an arm or leg may also twitch. The child may also experience tingling, numbness, speech and swallowing difficulties, and increased salivation or drooling. These seizures usually happen while they are falling asleep or waking up, and they are usually conscious.
Infantile Spasms (West Syndrome)	A severe type of epilepsy that usually starts in infancy. The infant may experience convulsive movements of the neck and torso muscles, bending and stretching of the body during seizures. Usually, these seizures occur during the process of falling asleep or soon after waking up. Even though a seizure lasts only a few seconds, there may be a hundred of them, with short breaks in between.

Causes of Epilepsy

The causes of epilepsy are commonly divided into five categories: immune, metabolic, infectious, genetic, structural, and unknown. These include brain damage from prenatal or perinatal factors, such as low birth weight, oxygen deprivation, or birth trauma; brain deformities caused by genetic conditions or congenital anomalies; genetic syndromes such as autism; brain infections, e.g., meningitis, human immunodeficiency virus (HIV), encephalitis or neurocysticercosis; brain tumours; and a stroke that limits the brain’s access to oxygen.

Seizures Vs Epilepsy

Seizures are isolated episodes of abnormal brain electrical activity. When seizures become a frequent issue, it is then called epilepsy. Usually, a diagnosis of epilepsy is made after at least 2 seizures that were not caused by a recognised medical condition.

Not every seizure is an indication of epilepsy. Epilepsy is not indicated by having one or a few seizures. It is only diagnosed when there is no apparent reason for two unprovoked seizures that happen at least 24 hours apart.

Diagnosis and Treatment

Diagnosis

The diagnosis process combines a comprehensive medical history review, physical examination, and multiple diagnostic tests.

Blood tests	Checks for genetic conditions, infections, electrolyte imbalances, or other metabolic problems that might be the cause of seizure.
Electroencephalogram (EEG)	Checks for abnormal brain electrical activity with electrodes placed on the scalp.
Imaging tests e.g., CT scan, MRI	Checks for damage, unusual growth, or scarring in the brain.
Lumbar puncture	Examines the cerebrospinal fluid that surrounds the brain and spinal cord in the event that an infection such as meningitis is suspected.

Treatment

Options for treating epilepsy and seizures include:

Avoid seizure triggers, e.g., flickering lights or sleep deprivation.
Eat a well-balanced diet.
Regular exercise.
Avoid smoking and excessive alcohol consumption, or other substance abuse.
Manage stress.
Anti-epileptic drugs such as sodium valproate, carbamazepine, lamotrigine that control seizures.
Through surgery, remove a tiny portion of the brain that is causing seizures.
Vagus nerve stimulation (VNS) where a tiny device is implanted beneath the chest's skin and device’s wires are connected to the vagus nerve in the neck.

Actions to Take when Someone is Experiencing a Seizure

To assist someone who is having a seizure of any kind, take the following general actions:

Immediately make an ambulance call.
If they are in danger—for example, close to sharp or heavy objects—move them.
Any tight clothing around their neck should be loosened to help with breathing.
When their convulsions stop, turn them onto their side.
Keep track of when the seizure begins and ends.
Tell them what happened as soon as they are conscious and able to communicate.
Be calm when speaking and provide comfort to the person.

Schedule an Appointment at Gleneagles Hospitals

Contact us to schedule an appointment if you have any questions or concerns about seizures and epilepsy. The team of expert neurologists at Gleneagles Hospitals is available for you to consult. We are committed to providing personalised care, tailored to your individual needs.

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