Seizures

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KEY POINTS

• Seizures happen when the signals in the brain do not pass back and forth as they should. A seizure is a symptom, not a disease.
• Your healthcare provider will treat you depending on the cause of the seizure. You may need anti-seizure medicines.
• Follow the treatment prescribed by your healthcare provider. Take medicine exactly as prescribed. Do not increase how much you take or stop taking your medicine without first checking with your provider.

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What is a seizure?

The brain has millions of nerve cells that pass signals back and forth to help the brain and body work normally. Seizures happen when the signals in the brain do not pass back and forth like they should. A seizure is a symptom, not a disease. There are different types of seizures, depending on the cause and the area of the brain that is affected. The types of seizures look and feel very different, such as:

• A seizure that starts with a loss of consciousness and falling down, followed by body stiffening, shaking, or jerking. The seizure may last a few minutes. Then you go into a deep sleep for a few minutes. When you wake up, you will probably not remember the seizure. You may be drowsy for hours after the seizure. This is called a grand mal or tonic-clonic seizure.
• A seizure that involves a short loss of consciousness, of staring, fluttering eyelids, or twitching in your face. You are awake but not aware of what is going on around you. You will probably not remember the seizure. Each seizure may last only 10 to 30 seconds, but hundreds may happen each day. This is called an absence or petit mal seizure.
• A seizure that causes numbness or jerking of the limbs. You may be awake and remember what happened, or you may lose consciousness for a short time. This is called a focal or partial seizure.

Having one seizure right after another or one very long seizure is a medical emergency because it can keep your brain and other organs from getting enough oxygen.

If you have had several seizures and no cause can be found, your healthcare provider may diagnose a seizure disorder, which is also called epilepsy. People with epilepsy may have a seizure every day, but most have them less often and some people only have a seizure once every few years. If you have epilepsy, there are many medicines to help prevent seizures and allow you to work, drive a car, and be active.

Epilepsy is not a mental illness, is not an illness that you can give to other people (contagious), and is not a sign of low intelligence.

What is the cause?

A seizure happens when nerve cells in the brain don’t work right and there is a sudden abnormal electrical signal in the brain. The exact cause of this is often not known. Seizures can be a symptom of many diseases and conditions, including:

• Brain injury or tumor
• Infection or high fever
• Stroke
• Withdrawal from or abuse of alcohol or drugs, such as narcotics, cocaine, amphetamines, tranquilizers, and sleeping pills
• Very low blood glucose (sugar) or low blood sodium
• Brain disease such as Alzheimer’s disease
• Birth defects of the brain
• Toxemia in pregnancy
• Kidney or liver failure
• Very high blood pressure

What are the symptoms?

Symptoms may include:

• Aura, a sense that may give you warning that a seizure is about to happen. You may have changes in your vision such as seeing flashing lights, hear sounds, be aware of strange smells or feel anxious or fearful.
• Rapid eye blinking or staring
• Twitching of your face, smacking of your lips, or nodding of your head
• Shaking or jerking of your arms and legs
• Stiffening of your body
• Dizziness or loss of consciousness
• Loss of bladder or bowel control
• Not responding to noise or words for a short time
• Seeming confused or in a daze
• Nausea or vomiting

You may be drowsy for several minutes or even an hour or longer after the seizure.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

• Blood and urine tests
• EEG, which measures and records the electrical activity in the brain
• MRI, which uses a strong magnetic field and radio waves to show detailed pictures of your brain
• CT scan, which uses X-rays and a computer to show detailed pictures of your brain and skull
• Lumbar puncture, also called a spinal tap, which uses a needle to get a sample of fluid from the area around your spinal cord

How is it treated?

The treatment for seizures depends on the cause. If you have a medical problem that is causing the seizures, you will be treated for that problem.

Your healthcare provider may prescribe medicine to help prevent seizures. Medicine is the main treatment, but other possible treatments include:

• Surgery on the part of the brain that is causing seizures
• Putting a small device under the skin in your neck that sends bursts of electricity to your brain to reduce the number of seizures

It’s not possible to know how long seizures will be a problem for any one person. Absence seizures often stop by adulthood. Other types of seizures may be a lifelong problem.

How can I take care of myself?

Your friends and family should know about your seizure disorder and what to do if you have a seizure. This includes:

• Loosening clothing around your neck and removing eyeglasses
• Moving things away from you that could hurt you
• Not moving you unless you are in a place where you could get hurt
• Not trying to hold you down, but if possible, they should roll you onto your side and gently keep you on your side. This position will help keep you from choking on vomit if you start vomiting.
• Checking to make sure you are breathing
• Not putting anything in your mouth, because the risk of biting your tongue is less than the danger of inhaling or being injured by anything put in your mouth. You will not swallow your tongue.
• Staying with you until you are recovered or until medical help has arrived

Call 911 for a seizure as an emergency if:

• This is the person’s first seizure
• The person is pregnant, has diabetes, or is injured
• The person does not awaken after the seizure
• The person has stopped breathing or is choking
• The seizure lasts 5 minutes or longer
• The person has a seizure while in the water
• Another seizure starts soon after the first one stopped

Ways to care for yourself include:

• Follow the treatment prescribed by your healthcare provider. Take medicine exactly as prescribed. Do not increase how much you take or how often you take it. Never stop taking your medicine without first checking with your provider.
• If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink.
• Avoid high-risk jobs that involve heavy or fast-moving equipment, heights, bodies of water, or other situations where you or others might be injured if you have a seizure.
• Ask your healthcare provider which sports are safe for you. If you drive, ask if and when it is safe for you to drive.
• Wear a medical alert bracelet or necklace so others will know about your condition.

Ask your provider:

• How and when you will get your test results
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

If you are having problems coping with your seizures, reach out for support. Talk with your healthcare provider about your feelings. Find and join an epilepsy support group. Counseling services can help you and your family cope with your seizures. You can get more information from:

• Epilepsy Foundation of America
  1-800-332-1000
  http://epilepsy.org

How can I help prevent seizures?

To help prevent further seizures:

• Take your medicine as directed. Never skip a dose or stop taking your medicine without first checking with your provider.
• Make sure you get enough sleep every night. Getting too little sleep can be a major cause of seizures if you have a seizure disorder.
• Avoid alcohol and mood-altering drugs.