Seizure: what it is, causes, symptoms and types (2023)

Overview

What is a seizure?

A seizure is a medical condition in which you have a temporary and uncontrollable increase in electrical activity in your brain. When this happens, the affected brain cells send uncontrolled signals to other people around them. This type of electrical activity overloads the affected areas of the brain.

This overload can cause a wide range of symptoms or effects. Possible symptoms include abnormal sensations, fainting, and uncontrolled muscle movements. Treatment options, depending on the type of seizure, include medication, surgery, and special dietary changes.

The term seizure comes from the ancient belief in various cultures that seizures were a sign of possession by an evil spirit or demon. However, modern medicine has discovered the truth: everyone can have seizures, and some people can have them more easily than others.

What is the difference between seizure and epilepsy?

Understanding the difference between seizures and epilepsy begins with knowing that seizures fall into two main categories, according tobecauseThey pass.

• provoked seizures: Occurs due to other conditions or circumstances (high fever, alcohol or drug withdrawal, low blood sugar). Provoked seizures account for 25% to 30% of all seizures.
• unprovoked seizures: These are not symptoms of an actual medical condition or circumstance and occur when a person's brain can more easily produce spontaneous seizures. This also includes seizures that occur more than seven days after a specific cause (such as a head injury or stroke).

Epilepsyis a brain condition that puts you at risk for spontaneous and unprovoked seizures. Health professionals diagnose you when you have at least two unprovoked seizures, or you have only one unprovoked seizure and are at high risk of having at least one more in the next 10 years. Having a single unprovoked seizure increases the chances of having another. Provoked seizures are not enough for a professional to diagnose epilepsy.

Who is affected?

Everyone can have seizures, but some people have medical conditions that make them easier. Seizures are also more likely at certain ages. Children are more prone to seizures and epilepsy, but many outgrow the condition. The risk of having a seizure or developing epilepsy also begins to increase at age 50 due to conditions such asAVC.

How common are seizures?

Seizures are rare but still well known to most people. Up to 11% of people in the US will have at least one seizure in their lifetime.

Epilepsy is much less common. Between 1% and 3% of people in the US will develop epilepsy at some point in their lives.

How do seizures affect my body?

Your brain contains billions of cells known as neurons. These cells transmit and transmit chemical and electrical signals to each other. A single neuron in your brain connects with thousands of others, forming communication networks. These networks are how different parts of your brain work together so you can do things like solve problems, store memories, and move around.

Seizures occur when a malfunction causes neurons to fire electrical signals out of control. This causes a domino effect, which means more and more neurons go crazy. The more neurons malfunction, the greater the effect of the seizure. If these glitches happen often enough, they can affect how brain cells work and make it easier for seizures to occur.

If they continue to occur or the seizures last too long, these electrical problems will damage and destroy the cells in your brain. When this happens to enough neurons in one part of the brain, the result can be permanent brain damage. Seizures can also cause severe changes in blood chemistry as the body tries to control the physical effects of the seizures. Chemical changes in the blood can cause permanent brain damage if they last too long (see the heading “Status epilepticus” below).

How the spread of a seizure affects your body

The types of seizures depend in part on where they occur in your brain. A healthcare professional can determine where they occurred based on your symptoms.

Seizure localization tends to occur in two main ways:

• generalized seizures. These are seizures that occur on both sides (hemispheres) of the side of the brain. These seizures tend to cause more severe effects and symptoms.
• focal seizures: Also known as partial seizures, they occur in only one hemisphere. This means that the symptoms only occur in a specific part or on one side of the body. But focal seizures can sometimes spread and become generalized seizures.

status epilepticus

Status epilepticus occurs when a seizure lasts longer than five minutes or you have more than one seizure without enough time to recover. Status epilepticus is a life-threatening medical emergency because it can cause brain damage or even death.

Other problems and effects

Seizures often involve fainting. When this happens, there is a risk of injury from falls or from what you are currently doing (such as driving or operating machinery).

Symptoms and Causes

Are there warning signs before a seizure?

Many people go through a period where they can feel a seizure coming on. This preparation time, known as the prodrome (rhymes with "peak"), can sometimes include what is known as the "aura." An aura is actually a symptom of a focal seizure, which only affects one side of the brain.

When focal seizures do not spread, the only seizure effect is an aura. When focal seizures spread throughout the brain, an aura is more of a warning sign that a more serious seizure is about to occur.

Auras can also take many different forms. These include:

• sensory symptoms. If an aura affects areas of your brain connected to your senses, those neurons can mistakenly act as if they are receiving real information. This can cause symptoms such as seeing bright lights or distortions in the appearance of objects, hearing unexpected sounds, sudden and unexpected tastes of smells, and strange sensations on the skin.
• emotional changes. Auras cause some people to feel negative emotions like fear or anxiety, or positive emotions like joy or excitement. Other people may experience déjá vu ("day-zha flight," the French term for when a new experience feels familiar) or never vu ("zha-may flight," the French term for when a familiar experience feels familiar). looks new).
• autonomic symptoms. Auras can affect the body systems that your brain runs automatically. Some examples include sweating, drooling or drooling, and your skin turning pale or red. A common aura is "gastric rise," a bloated feeling in the belly.

What are the symptoms of a seizure?

Different types of seizures have different types of symptoms, and describing your symptoms to a health professional can help diagnose and treat the type of seizure you have. The two main types of seizures are focal and generalized.

generalized seizures

The main types of generalized seizures are:

• Tonic-clonic seizures.
• absence crisis.

tonic-clonic seizures

Previously known as "grand mal" (French for "big sickness") seizures, tonic-clonic seizures are often the most recognizable. They occur in the following phases:

• Tonic (usually 10 - 30 seconds): During this phase, he passes out when all his muscles tense up. Falls and injuries are common.
• Clonic (usually 30-60 seconds, but sometimes longer): This phase involves uncontrollable seizures (muscle movements).
• Post-seizure recovery (up to 30 minutes): During this phase, you wake up and go back to the way you were before the seizure. Confusion and muscle pain are common.

absence crisis

Previously known as "petit mal" (French for "little sickness") seizures, they are more common in children. Absence seizures often feel like daydreaming, "spaces," or looking into the distance (a "thousand-yard stare"). These seizures end quickly, with no need for a recovery period.

Absence seizures are short-lived, but you can have them dozens or even hundreds of times in a day. They are easily confused by distraction or a sign of a learning disability.

Other types of generalized seizures

Generalized seizures can occur in other ways similar to those described above:

• tonic seizures. Like a tonic-clonic seizure, but there's no clonic phase. People pass out during this and tense up, but do not have seizures.
• clonic seizures. Also like a tonic-clonic seizure, but there is no tonic phase. During these, people pass out and have seizures without their muscles tensing up.
• atonic seizures. These are also known as "drop attacks." During an atonic seizure, people lose control of their body muscles and suddenly fall to the ground. There is a high risk of injury from falls during them. This type of seizure is more common in Lennox-Gastaut syndrome, a severe form of childhood epilepsy.
• myoclonic seizures. These involve a jerk or rapid contraction that affects a muscle or a group of connected muscles. When it affects your standing leg, it can cause you to fall over.(NOTE: Although they are similar to a myoclonic jerk, which is a sudden muscle contraction when you fall asleep, they are not the same thing. Myoclonic jerks that occur when you fall asleep are normal and are not a sign of seizures or epilepsy.)

focal seizures

Focal seizures affect a smaller area of ​​the brain and stay in one hemisphere. These are also known as partial seizures, and auras, when they occur, come before them. Symptoms, such as uncontrolled muscle movements, can spread to different places on one side of the body, such as from one side of the face to the hand or foot on the same side.

Focal seizures include the following subtypes:

• simple focal seizures. Sometimes known as simple partial seizures, you are aware of them when they occur. With these types of seizures, the aura is the seizure itself and not just a warning sign.
• complex focal seizures. They are sometimes known as complex partial seizures. It interrupts your awareness of what is happening to you or around you.

Auras as warning signs

When a focal seizure spreads to the other side of the brain, it can become a generalized tonic-clonic seizure. If you have had a seizure in the past or know you have epilepsy, you should treat an aura as a warning sign. To protect yourself, you can do the following:

• Feel as safe as possible.Sit or lie down so you don't fall and hurt yourself. You should also stop whatever you are doing if it is something like driving or using heavy machinery or tools.
• Contact someone you trust to help you.Tell them where you are and how to find you.
• If you can't get through to someone you know, tell someone close to you. that you are in a position of responsibility or authority that you believe you are about to be attacked.An example of this is telling a police officer or security guard, a teacher, or a store clerk.

What causes seizures?

Seizures can occur for many different reasons. These include:

• aneurysms.
• Brain tumors (including cancer).
• hipoxia cerebral(lack of oxygen).
• Forteconcussionand traumatic brain injury.
• degenerative brain diseases such asAlzheimer diseaseofrontotemporal dementia.
• Drugs and alcohol (this includes prescription drugs, recreational drugs, and even caffeine).
• Drug or alcohol withdrawal.
• Eclampsia (a condition in which high blood pressure can cause seizures in pregnant women).
• electrolyteproblems, especiallylow sodium (hyponatremia), calcium or magnesium.
• Fever, especially high ones (read more aboutFeverish convulsions, including what to do for a loved one or a child who has one; are very common in children and having them slightly increases the risk of future seizures or epilepsy).
• Sensitivity to intermittent or flickering light.
• Genetic disorders (conditions you have at birth that you inherited from one or both parents).
• Hormone-related changes. For example, catamenial epilepsy can affect people with a menstrual cycle, causing seizures to occur more frequently at certain points in the cycle.
• infections (especiallyencephalitisomeningitis). Infections can occur due to viruses, bacteria, parasites, or fungi.
• Inflammation from autoimmune conditions (where your immune system attacks your brain).
• metabolic problems, especiallyhigh blood sugar (hyperglycemia)olow blood sugar (hypoglycemia).
• Mental health problems (known as psychogenic seizures) such asconversion disorder.
• Problems with the structure of your brain (especially those you have had since birth).
• WHY.
• caresses youtransient ischemic attacks (TIAs).
• Toxins and poisons (such ascarbon monoxide poisoningor heavy metal poisoning).

What types of seizures affect children?

Children can have seizures for any of the above reasons. Fever is one of the most common causes of childhood seizures. Other causes include:

• juvenile myoclonic epilepsy. This condition usually begins in the mid-teens. The main symptom of this type of epilepsy is having one or more myoclonic seizures on both sides. These usually occur after waking up in the morning and are more likely with lack of sleep. Tonic-clonic and absence seizures are also possible.
• Lennox-Gastaut syndrome. This severe form of childhood epilepsy causes various types of seizures and brain damage. Developmental delays are also common. It is at high risk of injury because it commonly causes atonic seizures ("drop seizures").

Are seizures contagious?

No, seizures are not contagious. While you can spread conditions like infections that cause them, none of them will definitely cause a seizure. Also, some conditions that cause seizures are genetic (you can inherit them or pass them on to your children).

Diagnosis and Tests

How is a seizure diagnosed?

A health professional, usually a neurologist, can diagnose a seizure based on the symptoms you've had and certain diagnostic tests. These tests can help confirm whether or not you had a seizure and, if you did, what may have caused it. Genetic testing can also help find inherited disorders that cause seizures (and sometimes even the most likely type of seizure you may have).

A key part of diagnosing seizures is finding out if there is a focal point, a specific area where the seizures begin. Locating a focal point for seizures can make a big difference in treatment.

What tests will be done to diagnose this condition?

Possible tests to help diagnose seizures include:

• Electroencephalogram (EEG).
• Blood tests (these look for things like metabolic and chemical imbalances in the blood, immune system problems, toxins, and poisons).
• Computed Tomography (CT).
• Magnetic Resonance Imaging (MRI).
• Lumbar puncture (lumbar puncture).

Providers may also recommend testing if they suspect injuries, side effects, or complications of a seizure. Your doctor is the best person to tell you (or someone you choose to make medical decisions for you) what kinds of tests they recommend and why.

Management and Treatment

How is a seizure treated? Is there a cure?

In the case of provoked seizures, treating or curing the condition causing the seizures will usually stop them. In cases where the underlying condition is not curable or treatable, healthcare professionals may recommend medications to try to reduce the severity of seizures and the frequency with which they occur.

Providers generally recommend against treating unprovoked seizures for the first time. That is because there is no certainty that another will happen. An exception to this is if the person is at increased risk of having another seizure or when he has status epilepticus. Stopping status epilepticus is critical because it can lead to permanent brain damage or death. Health professionals may use your medical history and tests such as an EEG, CT scan, or MRI to determine if you are at increased risk of having another seizure.

What medications or treatments are used?

Treatments for seizures vary widely. That's because the treatment of a provoked seizure depends almost entirely on the cause. Treatment for epilepsy-related seizures also depends on the types of seizures you have, why they occur, and which treatments work best.

Possible treatments for seizures due to epilepsy include one or more of the following:

• Medicines. These are the first line of treatment for people with epilepsy. Different types of medicines can stop seizures right when they happen, and other types can prevent seizures or make them happen less often. Intravenous (IV) medications can treat a seizure while it is occurring. You can also take daily medicine to help prevent seizures or decrease their frequency.
• epilepsy surgery. When medications don't work, surgery can sometimes stop seizures by removing or disconnecting the problem area from the rest of the brain. Health professionals often recommend evaluation for epilepsy surgery if seizures continue, despite trying two anti-seizure medications at recommended doses.
• Diet changes.Low-carb or no-carb (ketogenic) dietssometimes it can stop seizures altogether or reduce how often they occur. These diets can help when medicines don't work. If surgery is not possible, these diets may be an alternative for some people.
• Brain stimulation.This treatment uses a device implanted in your brain that delivers a mild electrical current. This current interferes and tries to stop the electrical activity of a seizure. Two forms of brain stimulation,deep brain stimulationand receptive neurostimulation, are currently available.
• vagus nerve stimulation. The tenth cranial nerve, the vagus nerve, connects directly to your brain. Electrical stimulation on the left side of this nerve can help reduce the frequency of seizures.

Treatment complications/side effects

Complications from seizure treatments vary widely depending on the cause, the type of seizure, the type of treatment, and more. Your doctor is the best person to tell you which side effects or complications are most likely for you. This is because they can provide you with specific information about your specific case.

How can I take care of myself or control the symptoms of a first seizure?

You should not try to self-diagnose or treat a seizure. This is because seizures are often a sign of very serious medical conditions that affect the brain. If you or a loved one is experiencing a seizure for the first time, see a health professional. Your doctor can tell you what symptoms or effects to watch for that could mean you need medical attention after a seizure.

What should I do if someone I'm with has a seizure?

If you are with someone who is having a seizure, there are several things you can do as part of first aid. Some do's and don'ts include:

Of the

• Make sure they can breathe.Loosen clothing around the person's neck to make sure they are breathing.
• Move dangerous objects away from them.This includes breakable items that could fall and injure you. If they wear glasses, carefully remove them and place them out of their reach.
• Place them in the rescue position.Turn the person on their side. This position helps protect a person's ability to breathe and prevents them from inhaling liquids such as saliva or vomit.
• Try to time the seizure as best you can.Telling a healthcare professional how long the seizure lasted can be critical information. It can also help you know if you need to call for emergency medical help.
• Stay with them as they come out of the seizure and recover.People who have a seizure often feel confused or scared when they wake up and return to normal. Help soothe and comfort them.
• Make sure they're okay when they wake up.If you have any injuries after the seizure, make sure they need medical attention. If the person hits their head or there is a risk of head, neck or back injury, it is safest to seek medical attention and make sure there are no serious injuries that you cannot see.
• Call for help if the person has status epilepticus.Call 911 (or your local emergency number) if the seizure lasts longer than five minutes or if the person has another seizure before recovering from the first. Status epilepticus is a life-threatening medical emergency. You should also call for emergency help if they do not start to recover or are unresponsive for more than 10 to 15 minutes after the seizures stop. This could be a sign of an ongoing seizure in his brain, even though his body is no longer shaking.

No

• Don't restrict them.You can hurt the person or hurt yourself.
• Don't put anything in his mouth.There are manymyths about seizures and epilepsy. One myth is that putting something in a person's mouth, such as a belt or a spoon, can prevent them from swallowing or from biting their tongue. ++Do not do that.++ You should not put anything in the mouth of someone who is having a seizure. You can hurt them or get hurt.
• Do not panic.Keep calm. If other people around you are panicking, reassure them as best you can. Almost 98% of seizures do not last more than five minutes.

How long after treatment will I feel better?

Recovery time from treatment depends on the types of seizures you have and the treatments you receive. Your doctor can tell you what to expect, including how long it will take to recover and when you should start to feel better.

Prevention

How can I reduce my risk?

Everyone is at risk of seizures, and they also occur unpredictably, so it's not possible to completely prevent them. The best thing you can do is avoid possible causes to reduce your chances of having a seizure.

The best things you can do to reduce your risk of having a seizure include:

• Eat a balanced diet and maintain a healthy weight for you.Many conditions related to circulatory and heart health, especially stroke, can damage areas of the brain. This is one of the main causes of seizures in people over 65 years of age. This can also help avoid electrolyte problems (too much or too little sodium, for example).
• Don't ignore infections. Eye and ear infections are especially important to treat. If these infections spread to the brain, they can cause seizures. Infections can also cause a high fever, which can lead to seizures.
• Use safety equipment.Head injuries are one of the leading causes of seizures. Using safety equipment (helmets, seat belts and restraint systems, etc.) whenever necessary can help prevent injuries that lead to a seizure.
• Do not abuse alcohol, prescription or recreational drugs.Misuse of these substances can cause seizures, and withdrawal from these substances can also cause seizures if you are dependent on them.
• Manage your health conditions.Managing chronic conditions can help you avoid seizures, especially those that occur due to low blood sugar, either withDiabetes type 1oType 2 diabetes.
• Avoid potential seizure triggers.People with a history of seizures caused by flashing lights should be careful to avoid similar triggers whenever possible.

Outlook / Forecast

What can I expect if I have seizures?

Less than half of the people who have a single unprovoked seizure will have another. If a second seizure occurs, healthcare professionals often recommend starting anti-seizure medications.

Medicines can help prevent seizures or reduce their frequency. However, sometimes it is necessary to try several drugs (or combinations of them) to find the one that works best.

In some cases, people have "refractory epilepsy," which is resistant to drugs. For people with refractory epilepsy, surgery, a ketogenic diet, or an implantable device are the next options to consider.

How long will I have this condition?

For provoked seizures, the risk of having another one depends on what caused the first seizure and whether that cause was treatable or curable. If it is treatable or curable, your risk of having another seizure is low (unless you have a repeat of the circumstances that caused the first seizure).

Many people who have an unprovoked seizure will never have another for the rest of their lives. For those who have a second seizure, epilepsy is a lifelong condition because it is not curable. However, it is possible for this condition to go into remission and the seizures to stop occurring.

What is the prognosis for this condition?

For people who have had one or more seizures, the prognosis and outlook depends on several factors. These include:

• Did they find a cause for your seizure and was it provoked or not?
• If they found a cause, was it treatable or curable?
• What type of seizure did you have?
• How severe was the seizure and how long did it last?
• Was that your first seizure?
• If this is not your first seizure, has a health professional diagnosed you with epilepsy?
• Did you receive treatment and, if so, what did you receive?

In general, provoked seizures tend to have the best prognosis if the underlying condition is treatable or curable. Seizures caused by severe or recurring conditions are difficult to treat. It is also often difficult to treat seizures and epilepsy that occur with congenital or hereditary conditions.

The outlook for unprovoked seizures depends on the types of seizures, how often they occur, whether medications help them, and more. In general, two-thirds of people with epilepsy can expect their seizures to be controlled for a year or more after trying one or two well-chosen and well-dosed anti-seizure medications. Your doctor is the best person to tell you about your prognosis and what he can do to help himself. They can tailor this information to your specific case and refer you to other providers and resources for additional help.

sudden unexpected death in epilepsy

There is a small risk of sudden unexpected death in epilepsy (SUDEP) for people with this condition. SUDEP occurs for unknown reasons. Experts suspect that it is heart rhythm or breathing problems.

For people with controlled (treated) epilepsy, the death rate each year is about 1 person in 1,000. For people with uncontrolled (untreated) epilepsy, the death rate each year is about 1 in 150.

living with

How do I take care of myself?

If you've had a seizure in the past, it's important to watch for signs of another. If you have a second seizure, it is very important to see a doctor as soon as possible. Seizures cause changes in the brain that make it easier for more seizures to occur; therefore, early diagnosis and treatment are essential.

If a health professional diagnoses you with epilepsy, you can help yourself by doing the following.

• Take your medication as prescribed.Taking your antiepileptic drugs can make a big difference in the frequency and severity of your seizures. It is important that you continue to take your medicines even if you feel better. You should never stop taking your medications without talking to your doctor.
• Talk to your provider about alternatives.If you want to reduce or change your medications, your doctor will determine if this is possible and will guide you on how to do it safely.
• Consult your provider as recommended.Your doctor will set up a time for you to see them. These visits are especially important to help manage your conditions and find the right medications or treatments.
• Do not ignore or avoid symptoms.Seizures and epilepsy are more likely to respond and have a good outcome with early diagnosis and treatment.
• Avoid seizure triggers.If there are situations that increase the risk of seizures, such as flashing lights orsleep deprivation, it is important to avoid these triggers. This can help you better manage your seizures.

When should I go to the emergency room?

You should go to the emergency room if you have a blackout event and you don't know what caused it. If you are alone and having what you think is a seizure for the first time, call or see your doctor right away.

It is usually not necessary to call an ambulance after a seizure if the person has epilepsy. However, even if they know why they had a seizure, they may have injuries that require medical attention.

When should I ask for help?

If you are with someone who is having a seizure, remember the following:

• Get help if this is your first seizure.A healthcare professional should examine anyone after a suspected or confirmed seizure for the first time. Seizures are often a sign of serious health problems.
• Call for help if the person has status epilepticus.Call 911 (or your local emergency number) if the seizure lasts longer than five minutes or if the person has another seizure before recovering from the first. Status epilepticus is a life-threatening medical emergency. You should also call for emergency help if they do not start to recover or are unresponsive for more than 10 to 15 minutes after the seizures stop. This could be a sign of an ongoing seizure in his brain, even though his body is no longer shaking.

Is it safe to get pregnant if I have epilepsy and take medication?

People with epilepsy can have children. Although many antiepileptic drugs are not considered safe during pregnancy, most people with epilepsy can still have healthy children if they work with a health professional. Your doctor is the best person to discuss this or refer you to a specialist.

A note from the Cleveland Clinic

Seizures are not an uncommon neurological condition. About 11% of people will have a seizure at some point in their lives, but most will only have one, and usually for a specific reason. This means that a seizure will never be a problem again. People who have more than one seizure for no specific underlying reason have epilepsy. Although epilepsy is often a scary condition, there are ways to treat it. With treatment, many people with epilepsy can live happy, fulfilling lives.