Seizure Disorder
What is it?
A seizure is a sudden disruption of the brain's normal electrical activity, which can cause a loss of consciousness and make the body twitch and jerk. Although many people who have a seizure never have another one, people who have seizures over and over again have a condition called
epilepsy.
Who gets it?
There are more than 20 different seizure disorders. One out of every ten Americans will have a seizure at some time. There are at least 200,000 people who have at least one seizure per month. Most cases develop before the age of
five.
What causes it?
There are clusters of nerve cells in the brain called neurons. A person's thoughts, feelings, and actions are produced by the electrochemical impulses that the neurons generate. Usually, the neurons send signals, or fire, around 80 times a second. Various conditions and stimuli can cause the neurons to fire abnormally, which causes a seizure. During a seizure, neurons may fire as many as 500 times a second.
Conditions that can cause seizures include high fever; brain infections, such as AIDS, malaria, meningitis, rabies, tetanus, and viral encephalitis; hypoparathyroidism; high levels of sugar or sodium in the blood; low levels of sugar, calcium, magnesium, or sodium in the blood; kidney or liver failure; phenylketonuria; insufficient oxygen to the brain; damage to brain tissue, such as from a brain tumor, head injury, intracranial hemorrhage, or stroke; and illnesses such as eclampsia, hypertensive encephalopathy, or lupus.
Seizures can also be caused by abuse of alcohol, amphetamines, tranquilizers, or cocaine; a reaction to a prescription drug; or exposure to toxic substances, such as lead or strychnine. Seizures can be triggered by flashing lights, video games, repetitive sounds, lack of sleep, stress, cigarette smoking, or hormonal changes during the menstrual
cycle.
What are the symptoms?
The symptoms of a seizure depend upon the area of the brain affected. For example, an electrical discharge that affects only a very small area of the brain might simply cause a person to experience an odd smell or taste. When large areas of the brain are involved, symptoms are more noticeable. The person will jerk and have muscle spasms, known as convulsions. Seizures may also cause a loss of consciousness or altered consciousness, a loss of bladder and bowel control, and confusion.
Many people experience an aura before having a seizure. Auras are odd sensations of smell or taste, or visual disturbances, and may be pleasant or unpleasant. Most seizures last for anywhere from two to five minutes, and leave the person feeling tired and confused. He or she may also have a headache and sore muscles. Most people can't recall what happened during the seizure. There are a few types of seizures that occur more commonly in children. The absence, or petit mal, seizure usually begins occurring around the age of four, and lasts from 15 to 20 seconds.
A child having an absence seizure will usually lose consciousness briefly. He or she will become very quiet and may blink, stare blankly, roll the eyes, or move the lips. The seizure ends as suddenly as it began, and the child resumes his or her activity, completely unaware of what had happened. These types of seizures usually stop by adolescence. However, if left untreated,petit mal seizures can occur up to 100 times a day. They can eventually lead to larger, longer lasting seizures, called grand mal or tonic-clonic seizures.
Another type of seizure seen only in children is infantile spasms, or salaam seizures. When these occur, the child suddenly raises from a prone position, bends the arms, neck, and upper body forward, and straightens the legs. These types of seizures last for only a few seconds, and occur in children who are under the age of three and have other types of neurodevelopmental delays, such as mental retardation. Children from three months to five years of age may also have febrile seizures, which are caused by high fever. These seizures usually last for less than 15 minutes, and occur only once. Akinetic seizures, also called drop attacks because they cause the patient to fall, also occur in young children. They are characterized by limp posture and a brief period of
unconsciousness.
How is it diagnosed?
Seizure disorders are diagnosed through a description of symptoms during the seizure, and a test called an electroencephalogram (EEG). Electrodes are placed on the scalp to measure the brain's electrical activity and check for any abnormalities in the brain waves. The patient may need to be hospitalized for longer term EEG monitoring, or a video EEG, which records what the patient was doing during the seizure. The doctor may order more tests to look for a possible cause. These may include blood tests to check sugar, calcium, and sodium levels, liver and kidney function, and white blood cell count; an electrocardiogram to check for an abnormal heart rhythm; and magnetic resonance imaging (MRI) or computed tomography (CT) scans to check for cancer, brain tumors, or signs of stroke or damage to the brain tissue. A spinal tap may be performed to check for brain infection. If there is no underlying cause, and the seizure occurs more than one time, then a diagnosis of seizure disorder is
made.
What is the treatment?
A person having a seizure is never restrained. Healthcare providers recommend loosening the person's clothing and removing any hard or sharp objects on which he or she could get hurt. Never put anything in the mouth of someone having a seizure. However, if the seizure causes the person to bite his or her tongue, you can place a soft, folded cloth between the person's teeth and tongue. Turning the his or her head to one side will help with breathing. Seizures caused by some underlying medical condition usually stop once the medical condition is treated. Seizures that have no underlying cause are treated with antiseizure drugs. However, only recurring seizures are treated with medication.
Some people have to take more than one drug to control seizures. The most commonly used drugs are those containing phenytoin, carbamazepine, phenobarbital, primidone, valproic acid and sodium valproate, clonazepam, and ethosuximide. Patients on antiseizure medications must see their doctor regularly for blood tests to check the levels of the drugs in the bloodstream and to monitor any side effects. Side effects that should be reported to the doctor include sluggishness, dizziness, hyperactivity, uncontrolled eye movements, speech or vision problems, nausea or vomiting, or problems sleeping. Brain surgery is only considered for patients with uncontrollable seizures and where doctors can pinpoint a defect in the brain that can be surgically removed without affecting normal brain
function.
Self-care tips
If you have a seizure disorder, you should wear a medical bracelet or necklace that identifies your disorder and lists any medications you take. You can help prevent seizures by following a healthy diet, getting plenty of sleep, and keeping your stress levels to a minimum. Since fevers can trigger seizures, take medication to lower fever at the first sign of illness. If your seizures begin with an aura, get to a safe place where you can lie down until the seizure passes. Also make sure those close to you know what to do when you have a seizure. You can protect yourself from injuries that cause seizures by wearing a helmet when riding a bicycle, skateboard, or motorcycle, or when playing sports, and wearing a seat belt when riding in a motor vehicle.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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