Epilepsy

A seizure occurs when part of the brain receives a burst of abnormal electrical signals that temporarily interrupts normal electrical brain function. There are a range of focal and generalized seizures.

Focal seizures happen when abnormal electrical brain function occurs in one or more areas of one side of the brain. They are also called partial seizures.  A person may experience an aura or a strange feeling consisting of visual changes, hearing abnormalities or changes in the sense of smell before the seizure occurs. There are two types of focal seizures: simple and complex.

• Simple focal seizures last less than one minute typically. A person may show different symptoms depending upon which area of the brain is involved. This type of seizure is limited to an isolated muscle group, such as the fingers, or to larger muscles in the arms and legs. The person does not lose consciousness, but may experience sweating, nausea or become pale.
• Complex focal seizures occur in the area of the brain that controls emotion and memory function. They last between one to two minutes and consciousness is usually lost. Behaviors such as gagging lip smacking, running, screaming, crying and laughing may occur. In the postictal period, or after the seizure, the person may complain of being tired or sleep after they regain consciousness.

Generalized seizures occur on both sides of the brain. There is a loss of consciousness and a postical state following the seizure. There are six types of generalized seizures:

• Absence seizures or Petit Mal Seizures are brief altered states of consciousness and starring episodes. The seizures last no longer than 30 seconds and the person may not recall that one occurred. They may occur several times a day and may be mistaken for a learning or behavioral problem, as they almost always start between ages 4 to 12 years.
• Atonic or drop attacks are when the person may fall from a standing position or suddenly drop their head. They remain limp and unresponsive during the seizure.
• Generalized tonic-clonic seizures (GTC), or Grand Mal Seizures, are characterized by five distinct phases that occur. The body, arms, and legs will flex, extend and tremor, followed by a contraction and relaxation of the muscles and then the postictal period. During this period following the seizure, the person may be sleepy, have problems with vision or speech, and may have a bad headache, fatigue or body aches.
• Myoclonic seizures refer to quick movements or sudden jerking of a group of muscles. They occur in clusters or several times a day for several days in a row.
• Infantile spasms are a rare type of seizure disorder that occurs in infants before six months of age when the child is awakening or when they are trying to go to sleep. The infant usually has brief periods of movement of the neck, trunk or legs that lasts for a few seconds. They may have hundreds of these a day, which can be a serious problem with long-term complications.
• Febrile seizures are associated with fever. There are more common in children between six months and five years of age and there may be a family history. These seizures tend to last less than 15 minutes and are called “simple” and do not have long-term neurological effects. However, seizures lasting more than 15 minutes are called complex and cause long-term neurological changes in a child.

What causes seizures?

The exact cause of a seizure may not be known, and a person may experience from one to many seizures. The following are some common causes:

In newborns and infants:

• Birth trauma
• Congenital problems (present at birth)
• Fever/infection
• Metabolic or chemical imbalances in the body

In children, adolescents and adults:

• Acohol or drugs
• Head trauma
• Infection
• Congenital conditions
• Genetic factors
• Progressive brain disease
• Alzheimer’s disease
• Stroke
• Unknown reasons

Other possible seizure causes may include:

• Brain tumor
• Neurological problems
• Drug withdrawal
• Medications

How do I know I’m having a seizure?

A person may have varying degrees of symptoms depending on the type of seizure. The following are common symptoms or warning signs:

• Staring
• Jerking movements of the arms and legs
• Stiffening of the body
• Loss of consciousness
• Breathing problems or breathing stops
• Loss of bowel or bladder control
• Falling suddenly for no apparent reason
• Not responding to noise or words for brief periods
• Appearing confused or in a haze
• Sleepiness and irritability upon waking in the morning
• Nodding the head
• Periods of rapid eye blinking and staring

During a seizure, a person’s lips may become bluish and breathing may not be normal, followed by a period of sleepiness or disorientation. Consult a doctor for a proper seizure diagnosis.

How are seizures treated?

Specific treatment for seizures will depend on a number of factors, such as age, overall health, medical history, extent of the condition, etc. The goal of treatment is to control, stop or decrease the frequency of the seizures without affecting normal activities of daily living. These are some common seizure management goals:

• Proper identification of the type of seizure
• Using medication specific to the type of seizure
• Using the least amount of medication to achieve adequate control
• Maintaining appropriate medication levels

Treatment may include:

• Medications
• Blood work
• Urine tests
• Electroencephalogram (EEG)
• Vagus nerve stimulation (VNS)
• Surgery