An Overview of Seizures

Symptoms, causes, diagnosis, treatment, and coping

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When people hear the word seizure, they usually imagine someone who has collapsed and is in the throes of painful convulsions. While it's true that some having a seizure will experience these symptoms, that's not always the case. It's also a common misconception that having a seizure means someone has epilepsy. While seizures may indicate an epilepsy disorder, they can also be caused by myriad other things.

If you (or someone you know) suddenly has a seizure but has never had one before, it's important to get medical help right away. Your doctor will need to figure out what caused the seizure and whether you're likely to have more, and then begin exploring what treatment, if any, is necessary.

Categories of Seizure

Broadly speaking, there are three categories of seizures:

  • Generalized onset seizures: These affect both sides of the brain at once and can include tonic-clonic, absence, and atonic seizures.
  • Focal onset awareness seizures: This type typically affects one side of the brain; the person remains fully awake and aware.
  • Focal onset impaired awareness seizures: These also affect one side of the brain, but can causes gaps in consciousness.

Each of these categories includes several types of seizures. While someone with epilepsy may experience only one type of seizure, others may be affected by several. In those cases, the person may require different forms of treatment to control the different types of seizures.

Symptoms

Symptoms of seizures vary greatly depending on their type. Some forms are very apparent, while others may occur without you even knowing what's going on.

  • A classic tonic-clonic seizure is the type most people recognize. Formerly called a grand mal seizure, the person's entire body goes stiff and does a lot of jerking.
  • By contrast, an absence seizure may cause a person to suddenly "blank out" for a moment, then return to full consciousness. (These used to be referred to as petit mal seizures.)
  • With atonic seizure, a body part suddenly goes limp or the head drops for several seconds.
  • In the case of focal onset seizures, patients can experience changes in smell, taste, vision, or dizziness, or tingling or jerking of a body part. These symptoms may or may not be associated with an impaired level of consciousness, staring into space, and repetitive movements such as chewing, hand rubbing, or walking in circles.

Often, symptoms persist for a few hours or even days after a seizure. The longer and more intense the seizure, the longer recovery tends to take.

Causes

Seizures and epilepsy often are mistaken as being the same, but this is not the case.

A seizure is a transient event caused by excessive or non-synchronous brain activity that can be provoked or unprovoked. By contrast, epilepsy is a medical condition that's characterized by two or more seizures and has many potential causes, from traumatic brain injury to cerebral palsy.

Common conditions that provoke seizures include acute head trauma, low blood sugar, low blood sodium, alcohol and/or drug abuse. In addition, a high fever can provoke seizures in some predisposed children.

There also are nonepileptic seizures or pseudoseizures. These clinically resemble seizures but are not caused by abnormal electrical activity in the brain. Rather, they're secondary to stress or psychological issues in certain individuals.

Diagnosis

If you have a seizure, your doctor will likely order a variety of tests and scans to figure out why. These may include:

You should also expect a physical and neurological exam. Try to be prepared to give a detailed medical and family history as well. Be as detailed as you can when it comes to sharing any details about your seizure(s).

Treatment

More than 25 anti-seizure drugs are approved by the U.S. Food and Drug Administration (FDA). Research suggests that 70 percent of people with epilepsy can have their seizures completely controlled by using one or more of these medications. Other epilepsy treatment options involve surgeries, implants, and a strict ketogenic diet.

However, if you have a seizure that's caused by something other than epilepsy, you likely won't need an anti-seizure drug or other seizure-related treatment. Instead, your doctor will focus on the underlying cause, whether it be a fever, an electrolyte imbalance, abnormal blood sugar, or a drug-related event.

An exception is brain cancer. The disease itself and brain surgery to remove tumors can lead to recurrent seizures, which may require anti-seizure drugs to control.

Coping

If your doctor believes your seizure was an isolated event, you may still worry about having another one. If you need help dealing with that fear, you may benefit from mental health counseling. Otherwise, you shouldn't need to make changes to your life based on having a single seizure.

If you're diagnosed with epilepsy or something else that may cause recurrent seizures, you may need to make some lifestyle changes and learn to cope with your diagnosis. Taking measures to ensure your safety when you have a seizure is also beneficial.

A Word From Verywell

The important thing to remember in case you or someone you know has a seizure is that it's a serious medical event that requires emergency care. However, seizures are common and doctors and nurses know how to deal with them, both in an emergency setting and if you require short-term or long-term treatment.

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