An overview of Seizure Disorders

A seizure is a sudden, uncontrolled electrical disturbance in the brain. The brain cells malfunction and send electrical signals uncontrollably It can cause changes in your behavior, movements or feelings, and in levels of consciousness. Having two or more seizures at least 24 hours apart that aren't brought on by an identifiable cause is generally considered to be epilepsy.

The three Trusted Source major types are focal onset seizures, generalized onset seizures, and unknown onset seizures.

Focal onset seizures

Focal onset seizures occur in only one areaTrusted Source of the brain. People may also refer to these as partial seizures.

Focal onset seizures can start in small areas of the brain, such as a single lobe, but can affect large areas.

Medical professionals typically split focal onset seizures into two types: focal aware seizures and focal awareness-impaired seizures.

Focal aware seizure

During a focal aware seizure, you’ll remain fully conscious and be aware that something is happening, even if you do not recognize it as a seizure.

The symptoms of a focal aware seizure will depend on which part of the brain the seizure starts.

Focal aware seizures may be singular events but can also develop into other types of seizures. For this reason, people often refer to them as warnings or auras.

Focal impaired-awareness seizure

This type of seizure affects your consciousness. During a focal impaired-awareness seizure, you may not be able to move, talk, or hear as you did before. You may also not be able to remember the event.

Focal impaired-awareness seizures can last for up to 2 minutesTrusted Source. This type of seizure typically affects a larger portion of the brain than focal aware seizures.

Generalized onset seizures

Generalized seizures can happen in other ways that have similarities to those above:

Tonic seizures : Like a tonic-clonic seizure, but there’s no clonic phase. People pass out during these and tighten up but don't have convulsions.

Clonic seizures : Also like a tonic-clonic seizure, but there’s no tonic phase. During these, people pass out and go straight to convulsions without their muscles tensing up.

Atonic seizures : These are also known as “drop attacks.” During an atonic seizure, people lose control of muscles in their body, causing them to drop to the ground suddenly. There’s a high risk of injury from falling during these. This kind of seizure is most common with Lennox-Gastaut syndrome, a severe form of childhood epilepsy.

Myoclonic seizures : These involve a quick jerk or twitch that affects one muscle or a group of connected muscles. When it affects your leg while standings, it can cause you to fall. (NOTE: While these are similar to a myoclonic jerk, which is a sudden muscle twitch as you’re falling asleep, they aren’t the same thing. Myoclonic jerks that happen as you fall asleep are normal and aren't a sign of seizures or epilepsy.)

Unknown onset seizures

Sometimes no one witnesses the beginning of a seizure. For example, someone may wake up in the middle of the night and observe their partner having a seizure.

This often means there’s insufficient evidenceTrusted Source for medical professionals to diagnose the root cause of a seizure. In these instances, they will define the seizure as an unknown onset seizure.

Nerve cells (neurons) in the brain create, send and receive electrical impulses, which allow the brain's nerve cells to communicate. Anything that disrupts these communication pathways can lead to a seizure. Some types of seizure disorders may be caused by genetic mutations.

The most common cause of seizures is epilepsy. But not every person who has a seizure has epilepsy. Sometimes seizures may be caused or triggered by:

1. High fever, which can be associated with an infection such as meningitis

2. Brain tumor

3. Stroke

4. Autoimmune disorders, including systemic lupus erythematosus and multiple sclerosis

5. Abnormalities of the blood vessels in the brain

6. Head trauma that causes an area of bleeding in the brain

7. Medications, such as certain pain relievers, antidepressants or smoking cessation therapies, that lower the seizure threshold

8. Low blood sodium (hyponatremia), which can happen with diuretic therapy

9. Flashing lights, moving patterns or other visual stimulants

10. Use of illegal or recreational drugs, such as amphetamines or cocaine

11. Alcohol misuse, during times of withdrawal or extreme intoxication

12. Lack of sleep

You can experience both focal and generalized seizures simultaneously, or one can happen before the other. The symptoms can last anywhere from a few seconds to several minutesTrusted Source per episode.

1. Uncontrollable jerking movements of the arms and legs

2. Loss of consciousness or awareness

3. Cognitive or emotional symptoms, such as fear, anxiety or deja vu

4. Temporary confusion

5. A staring spell

6. Dizziness

7. An out-of-body sensation

8. A headache

Signs that indicate a seizure is in progress include:

1. losing control of bladder or bowel function

2. having sudden mood changes

3. losing consciousness, followed by confusion

4. having uncontrollable muscle spasms

5. drooling or frothing at the mouth

6. falling

7. having a strange taste in your mouth

8. having sudden, rapid eye movements

9. making unusual noises, such as grunting

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

Juvenile myoclonic epilepsy : This condition usually starts in the mid-teenage years. The main symptom of this type of epilepsy is having one or more myoclonic seizures on both sides. These usually happen 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 multiple types of seizures, and brain damage. Developmental delays are also common. It has a high injury risk because it commonly causes atonic seizures ("drop attacks").

A healthcare provider, usually a neurologist, can diagnose a seizure based on symptoms you had and certain diagnostic tests. These tests may help confirm whether or not you had a seizure and — if you did — what might have caused it. Genetic tests can also help find inherited conditions that cause seizures (and sometimes even the most likely type of seizures you could have).

A key part of diagnosing seizures is finding if there’s a focal point — a specific area where your seizures start. Locating a focal point for the seizures can make a huge difference in treatment.

What tests will be done to diagnose this condition?

Computerized tomography (CT) scan.

Blood tests (these look for things like metabolic and blood chemistry imbalances, immune system problems, toxins and poisons).

Electroencephalogram (EEG).

Spinal tap (lumbar puncture).

Magnetic resonance imaging (MRI).

Treatments for seizures depend on the cause. By treating the cause of the seizures, you may be able to prevent future seizures from occurring. The treatment for seizures due to epilepsy include:

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

Medications :These are the first line of treatment for people with epilepsy. Different kinds of medications can stop seizures as they happen, and other kinds can prevent seizures or make them happen less frequently. Intravenous (IV) medications can treat a seizure while it's happening. You can also take daily medications to help prevent seizures or decrease how often they happen.

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. Healthcare providers will usually recommend an evaluation for epilepsy surgery if your seizures continue despite trying two anti-seizure medications at recommended doses.

Brain stimulation :This treatment uses a device implanted into your brain that delivers a mild electrical current. That current interferes with and tries to stop the electrical activity of a seizure. Two forms of brain stimulation, deep brain stimulation and responsive neurostimulation, are currently available.

Vagal nerve stimulation :The 10th cranial nerve, the vagal nerve, connects directly to your brain. Electrical stimulation on the left side of this nerve can help reduce how often your seizures happen.

Diet changes : Low- or no-carb (ketogenic) diets can sometimes stop epileptic seizures entirely or reduce how often they happen. These diets can help when medications don't work. If surgery isn't possible, such diets can be an alternative for some people.

In many instances, a seizure isn’t preventable. But maintaining a healthy lifestyle can give you the best chance at reducing your risk. You can do the following:

Don’t take illegal substances.

Engage in stress-reducing techniques.

Exercise regularly.

Eat a balanced diet and drink plenty of fluids.

Get plenty of sleep.

If you've had one seizure in the past, it's important to watch for signs of another. If you have a second seizure, seeing a healthcare provider as soon as possible is very important. Seizures cause changes in your brain that make it easier to have more seizures, so early diagnosis and treatment are key.

If a healthcare provider diagnoses you with epilepsy, you can help yourself by doing the following.

Take your medication as prescribed : Taking your anti-epilepsy medications can make a huge difference in seizure frequency and severity. It's important that you keep taking your medications even if you feel better. You should never stop taking your medications without talking to your provider.

Talk to your provider about alternatives : If you want to taper off or switch your medications, your healthcare provider determine if this is possible and guide you on how to do it safely.

See your provider as recommended : Your healthcare provider will set up a schedule for you to see them. These visits are especially important to help with managing your conditions and finding the right medications or treatments.

Don’t 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 your risk of seizures, such as flickering lights or sleep deprivation, it’s important to avoid those triggers. Doing so can help you better control your seizures.