Seizures
Seizure Overview
A seizure happens when the brain’s electrical system malfunctions, discharging electrical energy in an uncontrolled manner. A resulting surge of energy through the brain can cause unconsciousness and contraction of muscles.
When many people hear the word “seizure” they picture a series of convulsions and uncontrolled body shaking. In fact, not all seizures cause convulsion; some have mild symptoms.
There are two primary types of seizure. Focal (partial) seizures occur in just one part of the brain. Generalized seizures are due to abnormal activity on both sides of the brain.
Symptoms typically last from 30 seconds to two minutes and do not cause lasting damage. A seizure that lasts more than five minutes, or repeated seizures when the patient does not wake up between them, are considered medical emergencies.
There are a variety of causes including medication, high fever, head injury and some diseases. Epilepsy is defined as recurring seizures due to a brain disorder. Other causes are abnormal levels of sodium (salt) or glucose (sugar) in the blood, brain infection including meningitis, congenital brain defects, poisoning, kidney or liver failure, venomous bites, extremely high blood pressure, withdrawal from alcohol and certain drugs, drug abuse, stroke and toxemia (a bacteria-related blood poisoning) in pregnancy.
Wellstar neurologists are skilled and experienced in assessing patients with seizures to determine any underlying diseases or other causes. They also help patients and their families learn how to live with the possibility of seizures and manage and avoid triggers that bring them on.
Symptoms
It can be difficult to tell when someone is having a seizure because some of the symptoms are fairly subtle. Specific symptoms depend on the part of the brain that is involved. Symptoms come on suddenly and can include:
- A brief blackout followed by a period of confusion and not remembering a period of time
- Behavioral changes such as picking at clothing
- Drooling or frothing at the mouth
- Eye movements
- Sounds including grunting and snorting
- Loss of bladder/bowel control
- Emotional/mood changes including anger, fear, panic, joy or laughter
In some cases warning signs occur before the attack. Examples are:
- Fear or anxiety
- Nausea
- Vertigo (dizziness)
- Visual symptoms like bright flashing lights, spots or wavy lines
Risk Factors
Certain factors in your personal and family history may make you more likely to experience seizures than other people. You may wish to note the presence of any of these in yourself or a child and discuss them with your Wellstar physician.
- A baby who is small for its gestational age
- A baby who has seizures in the first month of life
- A baby with brain development problems
- Bleeding into the brain
- Abnormal blood vessels in the brain
- Brain injury or lack of oxygen to the brain
- A head injury followed by seizures
- Brain tumors
- Brain infections including meningitis
- Stroke resulting from blockage of arteries and blood flow
- Cerebral palsy
- Family history of epilepsy or seizures accompanied by high fever
- Fever-related seizures that are unusually long
- Intellectual developmental disabilities
- Alzheimer’s disease
- Use of illegal drugs including cocaine
Other Risk Factors
Other conditions that are also more common in people with seizures:
- Learning problems requiring special help in school
- Symptoms of depression, anxiety or mood changes
- Sleeping problems
- Not succeeding at home, at school or with friends
- Unexplained falls or injuries
- Headache
Seizure Prevention
Although there is no guaranteed way to prevent a seizure, you can take steps that may reduce the chance of having one, or having a recurrence.
- Take all seizure-management and other medications prescribed by your doctor.
- Get plenty of sleep, reduce stress, exercise and eat a healthy diet.
- Make sure a family member records any seizure information or details to share with your doctor.
- Use safety equipment like seat belts and helmets to prevent accidents that could lead to a brain injury.
- Avoid alcohol and other substances.
- Don’t drive if you have uncontrolled seizures.
- If you have uncontrolled seizures avoid activities where loss of awareness could cause significant danger. Examples are climbing at heights, biking and swimming alone.
Seizure Diagnosis
It is important to see your Wellstar neurologist if you believe you have had a seizure or may have one. The symptoms can mirror those of other conditions; that’s why a professional medical diagnosis is so important.
A diagnosis starts with a comprehensive evaluation including medical and family history. Your doctor will examine you and will ask about symptoms, habits and lifestyle.
Tools and Tests
Wellstar neurologists use a variety of diagnostic tools and tests to identify the type and cause of seizures and whether they are related to underlying neurological conditions or other diseases. Among these:
- Blood tests.
- EEG (brain wave tests).
- MRI to produce images of organs and structures in the body.
- Lumbar puncture (spinal tap) to obtain a small sample of cerebral spinal fluid for testing.
Seizure Treatment
Your neurologist will develop a treatment plan based on the results of the examination and test results as well as factors like age, overall health, type and frequency of seizures, your tolerance for specific medications and treatments, and your opinions and preferences.
Medication
Wellstar neurologists use innovative therapies and the newest, proven medications to help control seizures. Your doctor will discuss a medication plan with you, including the importance of compliance and the need to make periodic adjustments to the medicine in order to maximize its benefit.
While you are on seizure medication your doctor may order tests to monitor the effectiveness of the medicine. These could include blood tests, urine tests and EEG (brain wave tests).
EEG testing which can include ambulatory EEG or long term video EEG monitoring.
Vagus Nerve Stimulation (VNS)
Patients whose seizures are not well controlled with medication may benefit from Vagus nerve stimulation (VNS). The procedure sends small pulses of energy to the brain from the Vagus nerve—a large nerve in the neck. A small battery is surgically placed into the chest wall; small wires are attached to the battery and placed under the skin around the Vagus nerve.
The battery is programmed to send energy impulses regularly to the brain. When a patient feels a seizure coming, he or she can activate the impulse, which often stops the seizures.
Your doctor will explain more about the procedure and why you may or may not be a good candidate for it.
Surgery
Wellstar neurosurgeons are highly skilled and experienced in the complex surgery that can relieve seizures in some patients. Depending on the individual situation, an operation may remove the part of the brain where the seizures are occurring. In some cases the surgery may help stop the spread of the abnormal electrical currents in the brain.
Patients may be kept awake during the surgery, as the brain does not feel pain. Also, this lets the neurosurgeon ask the patient to follow basic commands and ensure that key areas of the brain are undamaged.
Surgery is not a solution for everyone with seizures. It may be appropriate for those who:
- Have seizures that cannot be controlled by medication.
- Have seizures that always start in one area of the brain.
- Have a seizure in a part of the brain that can be removed without disrupting important behaviors like speech, memory or vision.
You will likely have many questions for your neurosurgeon. Rest assured that your doctor and the rest of the Wellstar neuroscience team are ready to assist you at every step in the process—before, during and following surgery.
Ongoing Care for Seizures
Most people who have seizures learn to manage their symptoms and enjoy a normal life including productive work and family relationships. It is important to follow your doctor’s treatment plan and live a healthy lifestyle, which includes proper rest, nutrition, exercise and a minimum of stress.