Seizures

1. Brief Introduction

Seizures are waves of abnormal electrical activity in the brain. Seizures can make you pass out, or move or behave strangely. Most seizures last only a few seconds or minutes. Epilepsy is a condition that causes people to have repeated seizures. But not everyone who has had a seizure has epilepsy. Problems such as low blood sugar or infection can also cause seizures. Other problems such as anxiety or fainting spells can cause events that look like seizures.

2. Symptoms

There are different kinds of seizures. Each causes a different set of symptoms. People who have "tonic clonic" or "grand mal" seizures often get stiff and then have jerking movements. People who have other types of seizures have less dramatic changes. For instance, some people have shaking movements in just 1 arm or in a part of their face. Other people suddenly stop responding and stare for a few seconds.

3. When To See a Doctor?

If you have never had a seizure before and you have one, you (or whoever is with you) should call for an 120 ambulance. Having a seizure can be a sign that something is wrong with your brain.

4. What If Anti-seizure Medicines Do Not Work for Me?

If you keep having seizures even after trying different medicines, you might have other options. Some people have surgery to remove the part of their brain that is causing seizures. Others get a device put in their chest that helps control seizures. If your seizures are not under control make sure to take other safety steps. For example, do not swim without someone else nearby who could help you if you started having a seizure. And avoid activities that could result in you falling from a height.

4.1 Examination Options

 ◆ Blood tests may be done to check for problems (such as low or high blood sugar) that may have caused your seizure, and to check for markers in the blood that could point to the type of seizure you had.

 ◆ Lumbar puncture (spinal tap) may be done after a seizure to check for signs of infection. This is usually done in an emergency room, if the individual does not seem to be recovering normally from the seizure, or if the person has a fever or other signs of brain infection. During this test, a needle is inserted into the space surrounding the spinal cord and a fluid sample is taken. The sample is checked for bacteria or other signs of signs of infection, such as an abundance of white blood cells.

 ◆ Electroencephalography (EEG) may be done to check for abnormal electrical activity in the brain. During this test, electrode pads are placed on your scalp. The clinician may try to induce an abnormality in the EEG by having the EEG technician use flashing lights or ask you to hyperventilate. Both of these maneuvers may produce abnormalities in your brain waves, which could be helpful in determining your diagnosis.

 ◆ Brain imaging studies, such as MRI or CT scans, may be done to check for tumors, strokes, or other structural problems in the brain. However, these tests are often normal in people with epilepsy.

4.2 Surgical Options

 ◆ Surgery to remove the portion of the brain causing the seizures or severing the connection between the two halves of the brain can reduce or eliminate seizures in some people.

 ◆ Others may benefit from laser ablation treatment or treatment with an implanted electrical device such as a vagal nerve stimulator, responsive cortical neurostimulation device, or deep brain stimulator. 

5. How Can I Reduce My Chances of Having More Seizures?

◆ Take your medicines exactly as directed – at the right times, and at the right doses.

◆ Tell your doctor about any side effects you have. That way the 2 of you can find the best medicine for you.

◆ Be careful not to let your prescription run out. (Stopping anti-seizure medicine suddenly can put you at risk of seizure.)

◆ While on anti-seizure medicines, check with your doctor before starting any new medicines. Anti-seizure medicines can interact with prescription and non-prescription medicines, and with herbal drugs. Mixing them can increase side effects or make them not work as well.

◆ Avoid alcohol. Alcohol can increase the risk of seizures, affect the way seizure medicines work, and increase side effects from anti-seizure medicines.