All You Need to Know About Seizures

When your brain undergoes a brief spike in excessive electrical activity, a seizure occurs. Changes in behaviour, movements, emotions, or states of consciousness may result from it. The severity and presentation of seizures range greatly, from short-term attentional lapses or muscle jerks to severe and prolonged convulsions. Although they are frequently linked to epilepsy, not all seizures indicate epilepsy.

Types of seizures

Generalised seizures

Affects both sides of the brain

Absence seizures (petit mal seizures): Often appear as staring spells, these are characterised by abrupt and brief attentional lapses.
Tonic-clonic seizures (grand mal seizures): Most recognisable type, involves muscle stiffness (tonic phase), and followed by rhythmic muscle contractions (clonic phase). Other symptoms are collapsing to the ground, having convulsions, and losing consciousness.

Focal seizures

Affects only one portion of the brain

Simple partial (focal) seizures: The individual stays conscious and aware throughout these seizures. They may exhibit odd movements or sensations, like a tingling feeling, a strange taste or smell, or an involuntary jerking body part.
Complex partial (focal) seizures: Even though they may seem awake, the person may not be able to respond or be aware of their surroundings. They may engage in repetitive motions like lip-smacking, hand rubbing, or walking in circles.

Differentiating between seizures and epilepsy

Isolated episodes of unusual brain electrical activity are called seizures. This condition is known as epilepsy when seizures start to occur frequently. Epilepsy is typically diagnosed after at least 2 seizures that were not caused by a recognised medical condition.

Risk factors of seizures

The following are risk factors for seizures:

Conditions involving intellectual and developmental disabilities
Has a family history of epilepsy or fever-related seizures
Autism spectrum disorder
Severe brain injury
Brain infections e.g., abscesses, meningitis, encephalitis
Brain tumours
Mild head injuries
Stroke
Cerebral palsy
Using illegal drugs (such as cocaine)
Babies born undersized for their age
Babies experiencing seizures within the first month of life
Babies born with abnormal brain areas

Warning signs before a seizure

The warning signs before a seizure, often referred to as auras or prodromal symptoms, can vary significantly from person to person and depending on the type of seizure. The warning signs may include:

Anxiety or fear
Nausea
Vertigo (the sensation of spinning or moving)
Visual symptoms (such as flashing bright lights)
Experiencing sudden fear, anxiety, panic, déjà vu (feeling like a situation is eerily familiar)
Headache
Sweating
Sudden mood swings

Effects and symptoms following a seizure episode

Before returning to their normal or usual state after a seizure episode, the person will experience a recovery phase, also known as the ‘post-ictal’ phase. The person may feel disoriented, worn out, sore, thirsty, weak, sick, nervous, lose control over their bladder or bowel, or have a headache during this phase. They might remember the seizure or they might not. Restoring their normal state could take hours or days.

Even though certain seizures are rarely problematic, common injuries like burns, cuts, bruises, and falls could happen. Patients who have generalised seizures with falls or those with prolonged or recurrent seizures are more likely to experience more severe complications, such as concussions, fractured bones, bleeding in the brain, or breathing issues.

Seizure diagnosis and treatment

Diagnosis

Seizure diagnosis includes a review of medical history, clinical evaluations, and diagnostic tests.

Electroencephalogram (EEG)	Looks for abnormal brain electrical activity using electrodes applied to the scalp.
Blood tests	Checks for any related seizure causes such as metabolic problems, infections, genetic disorders, or electrolyte imbalances.
Imaging tests	Checks for damage, scarring, or unusual growth in the brain. Examples include magnetic resonance imaging (MRI) and computerised tomography (CT) scan.
Lumbar puncture	Might be performed under certain circumstances such as if an infection like meningitis is suspected. It is done to examine the fluid that surrounds the brain and spinal cord, known as cerebrospinal fluid.

Treatment options

The following are the methods used to treat seizures:

Medications	Medications that alter the chemical levels in the brain can help control seizures. Anti-epileptic drugs like sodium valproate, lamotrigine, and carbamazepine are examples.
Surgery	Removes the tiny part of the brain responsible for the seizures.
Vagus Nerve Stimulation (VNS)	Stimulates the vagus nerve by connecting it in the neck with a small device similar to a pacemaker that is implanted beneath the chest’s skin using wires.

Seizure management

While there is no single set of method that can manage all kinds of seizures, to better control your seizures, you can put these self-management techniques into practice:

Avoid seizure triggers e.g., flickering lights or sleep deprivation.
Take your seizure medicines as prescribed.
Keep track of your seizures.
Maintain a healthy weight by eating a balanced diet.
Regular exercise.
Avoid smoking, excessive alcohol consumption, or other substance abuse.
Manage your stress.

Schedule an appointment at Gleneagles Hospitals

Contact us to schedule an appointment if you have any questions or concerns about seizures. 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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