What are Seizures?
A Seizure is a neurological disorder which can be explained as hyperactivity of the cranial nerves. It manifests in the form of convulsions or a fit which last(s) for about half a minute to a minute. Abnormal electrical impulses in the brain cause sudden changes in a person’s behavior, thus causing a seizure. In some people a seizure may be an isolated incident. But if seizures occur frequently the ailment is referred as epilepsy.
Symptoms of Seizures
The symptoms of seizures would depend on the severity of the attack. Also, there are some symptoms that occur just prior to a seizure and some during.
A) Symptoms just before a seizure:
a. Numbness in a particular part of the body
b. Memory loss (short-term)
c. Experience of “flashes of lights” in the eyes
d. Fear and palpitation
e. Confusion
B) Symptoms during a seizure:
a. Dilated pupils
b. Profuse perspiration
c. Cramps
d. Unconsciousness
e. Falling to the ground
f. Involuntary spasms or jerks of some muscles
g. Foaming at the mouth
h. Lack of awareness
i. Involuntary urination during seizure
j. Rolling of eyes
k. No after-knowledge of the incident.
Sometimes, seizures can be so mild that they go unnoticed. The only outward signs may be rapid blinking of the eyes and an unusually confused state of mind.
Caution: Sometimes the seizure is violent and causes a lot of spasms or contractions of numerous muscles. At such times, it is very important to place a handkerchief or some piece of cloth between the lips of the patient to prevent the tongue being bitten involuntarily. But care should be taken that the person does not choke on it.
Diagnosis of Seizures
As unconsciousness is one of the major symptoms of a seizure, a mild seizure can be sometimes misdiagnosed as a mere faint due to fatigue or a collapse due to myocardial infarction (heart attack). But if there is a family history of neurological disorders, then neurological diagnostic tests may be carried out. In severe cases there is no doubt because involuntary urination, spasms in muscles and foaming at the mouth are very specific to seizures.
The diagnostic tests carried out are:
Blood test: Blood sugar levels are checked to see if hypoglycemia, a causative factor, is present.
Electroencephalogram (EEG): This test is the most effective method of diagnosing a seizure as it produces a graph of the electrical waves of the brain. Any abnormality would show on the graph.
CT scan / MRI: Computer Tomography scan or Magnetic Resonance Imaging are sometimes undertaken to check for abnormal brain activity, to see if any part of the brain has experienced physical trauma, abnormal growths, etc which could be the cause of seizure.
Causes of Seizures
Some of the factors causing seizures are:
Physical injury: An injury to the head can be the cause of damage to a part of the brain. This may go undetected for a while. Later on, it may manifest in the form of a seizure.
Trauma: A person may either witness or experience an extremely traumatic incident, e.g. homicide. This can sometimes cause a seizure, especially if there is a family history for emotional disorders.
Infections: Meningitis or Encephalitis infections can cause a seizure.
High fever: A very high fever, like that with typhoid or pneumonia, can sometimes trigger a seizure. But this would be a one-off incident or an isolated incident. It would not necessarily indicate that the person is prone to seizures.
Deformity: Any congenital abnormality of the arteries or veins, especially those connected with the brain, can cause seizures.
Physiological intolerances: A person may be intolerant to anesthetics, strong antidepressants, etc. Such medications can sometimes trigger a seizure. Again, cessation of the drug would give immediate relief. On the other hand, sudden withdrawal from essential anticonvulsants can also cause seizures.
Chronic ailments: Other disorders like hypoxia (less oxygen) or hypoglycemia (low sugar levels), etc can also lead to the occurrence of seizures.
Abnormal growth: Tumors, abscesses, etc in the brain can cause abnormal electrical impulses and seizures.
Withdrawal symptom: A seizure could be one of a group of symptoms due to withdrawal from illicit harmful drugs like cocaine or from alcohol.
Stroke: A hemorrhagic (bursting of blood vessel) stroke or one caused by thrombosis (blood clot) can result in a seizure.
Caution from flashing lights: Those who are at risk from seizures are vulnerable when looking at psychedelic or bright, flashing lights normally seen in discos and video games; especially any design like concentric circles. This can cause dizziness and even a mild seizure.
Types of Seizures
Seizures can be classified in various ways.
A) By amount of brain affected:
Focused type: Here the brain is affected in only one section. In some mild cases, the patient does not experience any short term memory loss or lack of awareness of his/her surroundings. Also, other parts of the body or muscles may not be affected.
General type: In this type, both sides of the brain are affected. Unconsciousness would lead to loss of memory for a while and lack of awareness of surroundings. Also, muscle spasms, foaming at the mouth, etc would occur.
B) By frequency of episodes:
Isolated: Seizures which occur due to infections, fever, use of anesthetic or drug, etc are isolated cases and usually do not occur again when the cause is gone/removed.
Epilepsy: When seizures are recurrent, then the disorder is called Epilepsy. Epilepsy usually has a genetic cause. Other non-hereditary causes of epilepsy are uremia (increased toxicity in blood), withdrawal symptoms, head injury, etc. With every recurrence severity may increase. An epileptic fit is generalized. The patient falls down unconscious, is unaware of surroundings, there may be foaming at the mouth and will not recall the symptoms later.
C) By duration of seizure:
“Staring” fit: When a person stares blankly into space for about 15 to 20 seconds in mid sentence without any conscious thought, it is a case of “staring” seizure. This occurs more in children. Hampered learning and short attention span are the first signs of this problem. Other physical symptoms are frequent smacking of lips, fumbling hands, sudden stoppage of voluntary movements, etc. There may be mild jerks or spasms of the muscles but not foaming in the mouth or unconsciousness. The person will have the ability to think clearly immediately afterwards, so the individual episode does not have a long-lasting adverse effect on the brain. But, this can become more frequent and hence progressive.
Epilepsy: (See above). An epileptic fit may last from half a minute to one minute.
Seizure of Temporal lobe: This is a focal type of seizure. It is long-lasting and recurrent. It occurs due to some trauma to the temporal lobe caused by congenital defect, head injury, tumor, etc. Besides the usual symptoms, fear and palpitation, hallucinations, nausea and vomiting, twitching of lips, rolling of eyes, tingling sensation, excessive salivation, loss of memory, vision problems, problems with speech, etc are also present. This too lasts up to a minute.
Treatment of Seizures
Anticonvulsants: The medication used in treatment of seizures, whether mild or otherwise, is barbiturates. These cause dreamless sleep and soothe the nerves. They suppress the over-activity of the cranial nerves.
Other precautions: There is a list of safety-measures that need to be followed by other people around a patient of seizures:
01) Be alert and look for signs of onset – falling down could cause head injury or fractures
02) Others around should not try to physically suppress the violent jerks/spasms
03) A soft cloth should be placed between the teeth to prevent the tongue being cut
04) Sharp knives, cutlery, etc should be moved away from the person as soon as a seizure occurs
05) An ambulance should be called if it is a first episode
06) In case of recurrent epilepsy, the instructions given by the attending neurologist should be followed
07) A companion while shopping, traveling, etc is safer
08) The person should avoid standing close to parapets, ledges, French windows, on top of steep staircases, etc
09) A patient should avoid driving
10) Any odd behavior during a seizure can be misinterpreted by the police as aggression so a companion would prove doubly safe
11) The duration of the seizure should be noted, as any episode lasting more than 4-5 minutes can become life-threatening.
Living with Seizures
A person undergoing treatment for seizures has to face a lot of difficulties. First of all, barbiturates cause the patient to sleep so soundly that even in an emergency like a sudden fire in the house, the patient cannot be roused and moved to safety. Secondly, if a seizure occurs when the person is traveling alone, strangers around may not be able to get help in time. Long term use of anticonvulsants can cause various other diseases like panic-anxiety disorders, sleep disorders (due to habit), episodes of sudden anger or otherwise depression, low self-esteem, short term memory problems, lack of attentive power, etc. In some cases long-term medication may also result in osteoporosis or cardiovascular disorders.
Prevention of Seizures
Seizures have a genetic cause in most cases. Also, the onset of the disease cannot be recognized by the person himself/herself or by the others around. Hence, one cannot truly say that seizures are preventable. But some amount of care can be taken:
A) Avoid undue stress
B) Prevent children from witnessing or experiencing traumatic events
C) Alcohol and cigarettes should be avoided
D) Illicit drugs are completely taboo
E) Keep general good health with a balanced diet
F) Avoid bright flashing lights like those in discos or video games
G) Doing some form of relaxing exercises like yoga can be useful.
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