The comprehensive guide to seizures

7 min


A seizure is a sudden, uncontrolled and abnormal electrical impulses in the brain. Seizures results in changes in movements, sensation, perception, and consciousness. There are many types of seizures.

Types Of Seizures

They are majorly classified into Focal and generalized .

Focal Seizures

They result from abnormal electrical activity in the specific area of the brain. It might occur either with or without loss of awareness. They are further classified into focal seizures with impaired awareness and focal seizures without loss of consciousness.

1. Focal seizure with impaired awareness

In this type, people do not have consciousness or awareness. Usually, people don’t respond well and stare into space. In addition, they perform repetitive movements. They include hand rubbing, chewing, swallowing, or walking in circles.

2. Focal seizures without loss of consciousness

These seizures involve altering emotions. In this type, people don’t lose consciousness. They result in involuntary jerking Focal seizures without loss of consciousness. Sensory perceptions or emotions are altered to some extent. They include vision, smell, touch, taste, or sound. Indeed, you don’t lose consciousness. These seizures may also result in the involuntary jerking of higher or lower limbs. Other symptoms include tingling, dizziness, and flashing lights. Unexpectedly, the symptoms of neurological disorders are confused with focal seizures.

Generalized Seizures

Generalized seizures involve an entire part of the brain. There are different types of generalized seizures. They include:

1. Absence seizures

Formerly known as petit mal seizures. It is widespread in children. The most highlighted symptom is subtle body movements. Other symptoms include eyelid fluttering or lip-smacking. The anti-seizure medications control such types of seizures. The people do not have consciousness.

2. Tonic seizures

They bring about stiffening of the muscles. They usually affect muscles in the arms, legs, and back. This type might cause a person to fall to the ground.

3. Atonic seizures

They are also known as drop seizures. It causes a loss of muscle control that leads the person to collapse or fall, all of a sudden.

4. Clonic seizures

These seizures have rhythmic or repeated, jerking muscle movements. Usually, they affect the arms, neck, and face.

5. Myoclonic seizures

Generally, they appear as sudden twitches or brief jerks of the arms and legs.

6. Tonic-clonic seizures

Previously, known as grand mal seizures. These seizures are the most dramatic type of epileptic seizure. These seizures have an abrupt loss of consciousness, body stiffening and shaking. Also, results in loss of bladder control or biting your tongue.

Why Seizures Occur?

Generally, a number of factors cause seizures. An individual might experience any type of seizure. Yet, the typical reason behind them is still a question. Causes of commonly occurring seizures include:

  1. Genetic factors.
  2. Congenital problems.
  3. Birth trauma.
  4. Fever or infection.
  5. Chemical imbalances in the body.
  6. Alcohol or illicit drug abuse.
  7. Neurological problems.
  8. Progressive brain disease.
  9. Stroke.
  10. Brain tumor.
  11. Alzheimer’s disease.

What Happens During A Seizure?

During a seizure, a lot of violent electrical activity takes place in your brain. These activities results in the appearance of different seizures. Eventually, symptom starts to show up. It depends on the type of seizure and the region of the brain involved. Seizure affects different individuals in different ways. It can take on several different forms.

During a seizure, your brain does action as same as normal. For instance, you can see, feel, move and do other things. Similarly, in some seizures, you could do the same either with your will or not. In some seizures, the parts of the brain can still work normally.

Mostly, seizures have a beginning, middle, and end. However, it is difficult to identify them. You cannot find each and every stage or symptom as described in the book picture. Usually, seizures are episodic. They are unpredictable. If you have more than one seizure, it is stereotypic.

How Seizure Is Diagnosed?

Generally, it starts with the history collection. Secondly, neurological examination adds to the list. Blood tests and lumbar puncture are used for diagnostic purposes. The most used diagnostic tool for seizure is EEG (Electroencephalogram). This tool helps in locating the focus of abnormal electrical discharges. Also, helps to identify the specific seizure. However, it only reads the electrical activity of the cerebral cortex at the time it is taken. With that, it does not exclude the diagnosis of epilepsy. During a seizure, it involves all the parts of the cortex. Even epilepsy shows EEG abnormalities but not characteristics of seizures. Long-term video EEG monitoring helps to distinguish the seizures. It helps to rule out the pseudoseizures.

Probably, computed tomography (CT), and magnetic resonance imaging helps in diagnostic purposes. It helps to rule out brain lesions that could trigger seizures. Positron emission tomography (PET) and single-photon emission computed tomography (SPECT) helps to measure the cerebral blood flow in people undergoing surgery for epilepsy.

Which Seizure Is The Worst?

The answer is Tonic-Clonic seizure. It is a generalized seizure. Also, known as “grand mal” seizure. The characteristics of such seizure are as follows:

  1. Aura may or may not be present.
  2. Sudden loss of consciousness.
  3. During the tonic phase, the entire body becomes rigid. The person falls all of a sudden. It affects respiration for a while. They become cyanotic. They open their eyes widely with dilated pupils. Their hands are clenched and their jaw is fixed. At the end of this phase, they start to breathe deeply.
  4. During the clonic phase, they have rhythmic, jerky contractions and relaxations of all body muscles. They are especially seen in extremities. In this case, the patient bites the tongue, lips, and inside of the mouth. Drooling occurs which creates frothing at the lips.
  5. The entire tonic-clonic seizure lasts from 2 to 5 minutes. Then the patient enters into the postictal phase. During that phase, the patient remains totally unresponsive for a while. The client may rouse and goes for postictal sleep. It lasts for about 30 minutes to several hours. After this sleep, the patient tends to have the following symptoms and they resolve. They include general fatigue, depression, confusion, or headaches. The patient feels complete amnesia during the seizure episode followed by nausea, stiffness, and soreness.

Can Seizures Be Cured?

The treatment used for seizures involves anti-seizure medications. There are lots of options. Yet, finding the apt medications for you is the crucial part. Eventually, the selected medicines have to have fewer side effects. Sometimes, doctors prescribe more than one medicine.

Appropriate medicine depends on their age, health conditions and frequency of seizures. In addition, doctors will review the other medications as it interacts with anti-seizure medications.

Sometimes the medicines don’t work. Ultimately, the next option is surgery. They include:

1. Surgery

It is an invasive procedure. The aim of such surgery is to cease the seizure from happening. Surgery works excellent with people having seizures that is originating in the same place in the brain.

2. Vagus Nerve Stimulation

A device is implanted underneath the skin of the chest. It triggers the vagus nerve in the neck. Also, delivers signals to the brain. Henceforth, inhibits the seizures. Even with such stimulation, a person has to take medications.

3. Responsive neuro stimulation

A device is implanted on the surface of the brain or within the brain tissue. It detects seizure activities. Eventually, it sends the electrical stimulation to the detected area and stops the seizure.

4. Deep Brain Stimulation

In this case, an electrode is implanted within the selected areas of the brain. It generates an electrical impulse that helps to regulate abnormal brain activity. The amount of stimulation is controlled by a device placed under the skin of the chest. The electrode over the brain is connected to this device.

Can Seizure Cause Brain Damage?

Surprisingly, severe seizures can cause brain damage. Most seizures do not have a detrimental effect on your brain. However, certain studies are stating that a recurrent seizure brings about nerve injury in your brain. Besides, they result in poor cognitive function and may affect the quality of life. Another study claims that generalized seizures cause progressive brain dysfunction in patients with temporal lobe epilepsy.

What Happens Before A Seizure?

Probably, some people have a warning. This is the first symptom of the so-called seizure. It is said to be a part of seizure as the electrical activities are already been fluctuated in the brain. During this phase, you are still conscious and oriented.

Meanwhile, some people don’t even have a warning shot. They lose consciousness straight away. Typically, an aura happens before the big event (seizure).

The aura seems to be a feeling that is quite hard to describe. It is a change in feeling, thought, sensation, feeling, or behavior. Most interestingly, when an individual has more than one seizure, they experience a similar aura each time. Auras are different for everyone. The auras last from seconds to 2 minutes.

Tips To Help Someone Having A Seizure?

Firstly, clear the area to prevent possible injury or trauma. Try to place them laterally and provide a pillow to prevent head injury. Stay with the person who is having a seizure and call the emergency unit (call for 108) as soon as possible. As soon as you witness the symptoms, keep a track of time. Mostly, seizures won’t last longer than 1 or 2 minutes. If lasts longer more than 3 minutes, call for the emergency care unit.

If a person having a seizure is standing, make them lie on the floor. It prevents falling. If the person having a seizure on the floor, make them lie laterally, so that the saliva doesn’t block their windpipe. Do not try to put anything into their mouth.

Once a seizure is over, follow a standard protocol. Check for any injuries in them. Clear their mouth using your finger. Remove or loosen the tight clothing around their neck. Stay with them till they are completely awake. Provide them a safe area to rest. Do not offer them anything to drink or eat until they are completely awake and alert. Ask questions and allow them to orient themselves with the surroundings. It would take some time to become completely awake and alert.

What Are The Complications?

Seizure might bring you the circumstances that are dangerous. They include:

  1. Falling: it results in head injury or trauma. Sometimes, it breaks your bone.
  2. Drowning: if you develop a seizure while swimming, it possibly could lead to accidental drowning.
  3. Accidents: it is highly dangerous when you have a seizure while driving or operating equipment. It might cost your life.
  4. Pregnant women who take anti-epileptic drugs bring trouble to both mothers as well as the baby. Seemingly, it causes birth defects.
  5. People with seizures are prone to have psychological problems. They include depression and anxiety. They are most prevalent in nature.

Pregnancy And Seizures

Women who have a past history of seizures will able to have healthy pregnancies. However, birth defects can occur off certain medications. For instance, valproic acid is well known for treating generalized seizures. Yet, seizures bring cognitive defects and neural tube defects in babies. Therefore, it is mandatory to have preconception planning for those who have past history of seizures. Rarely, doses are changed before or during pregnancy.

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Harikrishnan B
Pursuing Bachelor of Science in Nursing. Keen on exploring mysteries and inspired by the beauty of Science.