Understanding Seizures

Causes, Symptoms, & Treatment

 

Most people have heard of seizures, and many people know someone who’s had a seizure – after all, they’re not a particularly uncommon occurrence. However, there’s a lot more to know about seizures than many people realize. Here, we explore different types of seizures, as well as what causes them and how they can be managed for those with seizure disorders. 

 

By Anna Hill

 

Dr. Ashish Kabir
Neurologist and
Epilepsy Specialist,
Hamilton Physician Group

What Is a Seizure?

According to Dr. Ashish Kabir, a neurologist with Hamilton Physician Group, “The technical definition of a seizure is a burst of uncontrolled electrical activity between brain cells that causes temporary abnormalities in muscle tone or movements (stiffness, twitching, or limpness), behaviors, sensations, or states of awareness.” If a person experiences two seizures without identifiable cause that occur more than 24 hours apart, they are typically diagnosed with epilepsy. Most seizures last between 30 seconds and two minutes, but if one lasts longer than five minutes, it’s classified as a medical emergency. 

There are different types of seizures, but they all fall under two major umbrellas of classification: focal seizures and generalized seizures. The cause for both types is often unknown. Luckily, many seizure disorders can be managed with medication and guidance from your doctor. 

 

Causes

There are a variety of things that can cause seizures. While not all seizures qualify as epilepsy, epilepsy is one of the most common causes. “Epilepsy signifies a high risk of ongoing seizures which can occur as unprovoked seizures,” explains Dr. Jake McKay, a neurologist and epilepsy specialist with Erlanger Neurology. “To have a diagnosis of epilepsy, you must either have two unprovoked seizures separated in time, or one unprovoked seizure and either an abnormal EEG (brainwave test) or brain MRI (brain-imaging test).”

Outside of epilepsy, several health conditions can predispose people to seizures, the most common of which is stroke in individuals over the age of 35. Brain tumors can also lead to seizures, which are often the key indicator that someone has a brain tumor. “Additionally, meningitis and encephalitis, which are infections of the brain covering and of the brain tissue itself, can cause seizures acutely and predispose to epilepsy long-term,” says Dr. McKay. Genes can also play a role, as some types of epilepsy are passed down through a genetic mutation.

Other causes of seizures also include: 

  • High fever
  • Sleep deprivation
  • Flashing lights or moving patterns
  • Head trauma
  • Certain medications such as pain relievers, antidepressants, or smoking cessation therapies
  • Abnormalities in the brain’s blood vessels
  • Autoimmune disorders
  • Recreational drug use
  • Alcohol misuse

 

 

Dr. Jake McKay Neurologist and Epilepsy Specialist, Erlanger Neurology

Dr. Jake McKay
Neurologist and Epilepsy Specialist,
Erlanger Neurology

Symptoms

Seizure symptoms vary widely in type and in severity depending on which form of seizure is occurring. The most common symptoms of seizures include temporary confusion, uncontrollable jerking of the limbs, staring spells, loss of awareness or consciousness, and cognitive or emotional symptoms such as fear or anxiety. However, there are usually significant differences in symptoms of focal seizures versus generalized seizures. 

Focal seizures.

These seizures occur as a result of abnormal electrical activity in one specific area of the brain and can be split into two subtypes where symptoms are concerned. The first is a focal seizure where consciousness is not lost. A focal seizure where consciousness is retained usually involves emotional symptoms such as sudden joy, fear, or anger. They can also cause involuntary jerking movements and alter the senses, affecting the way things look, feel, smell, or sound, and can induce nausea. These symptoms can often make diagnosis tricky as they can be confused for other neurological disorders or a mental illness. The second type of focal seizure involves impaired awareness or consciousness, which can lead to a dreamlike state or trance. Those who experience this type of seizure might not remember having it or even be aware that it occurred. 

Generalized seizures.

Unlike the focal type, generalized seizures are caused by abnormal electrical activity throughout the entire cortex of the brain. These are more likely to occur in children or those with a family history of seizures, but can also be brought on by things like sleep deprivation or substance misuse. There are several different types of generalized seizure, including but not limited to:

  • Absence seizures, which were previously known as petit mal seizures, usually occur in children and are often characterized by staring off into space or subtle repetitive body movements.
  • Tonic-clonic seizures, formerly known as grand mal seizures, can cause abrupt loss of consciousness as well as muscle spasms and loss of bodily control. 
  • Myoclonic seizures, which cause sudden jerks or twitches in different parts of the body but do not cause loss of consciousness.
  • Atonic seizures, often known as “drop” seizures, which lead to loss of muscle control that causes the body to collapse or for the head to suddenly drop. 

While not all seizures are medical emergencies, it’s important to seek medical counsel if you’re experiencing one for the first time.

 

 

Complications

Unfortunately, seizures can cause other health complications or affect other areas of someone’s life. “Seizure patients can often suffer from depression, migraines, and other diseases, and some of the medications used to treat seizures can cause complications as well,” says Dr. Kabir. “Patients with epilepsy who may become pregnant have additional considerations as well regarding the management of their disease before, during, and after pregnancy.” More immediate complications involve injury that might result from falls, and frequent uncontrolled seizures have been known to negatively affect short-term memory. 

 

Diagnosis & Treatment 

There are several different diagnostic options for seizures, the most common of which is an electroencephalogram (EEG). “This test is performed by placing electrodes on the head using a gel, which allows the EEG machine to record the electrical fields of the brain,” explains Dr. McKay. “There may be certain sparks of electricity (epileptiform discharges) or seizures themselves seen on EEG, which would indicate a high risk of epilepsy.” To rule out epilepsy caused by structural abnormalities in the brain, an MRI scan is often done as well. 

Once the tests have been performed and the patient’s medical history has been discussed with their neurologist, an official diagnosis will open a gateway for treatment. “The patient will likely be treated with antiseizure medications initially, and this will completely stop seizures in patients about 70% of the time,” says Dr. Kabir. “The remaining 30% of patients who have treatment-resistant seizures may require additional treatment, but over half of those patients can become seizure-free with complex treatment such as surgery if that is the appropriate course to take.” 

If you’ve been experiencing any of the symptoms above, don’t hesitate to reach out to a medical provider. Not all types of seizures involve uncontrollable shaking and collapse, but it’s important to remember that there’s a path to treatment and management for every type.