epilepsy

What is a seizure?

A seizure is a symptom, not a disease. It happens when nerve cells in the brain don’t work right and there is a sudden abnormal electrical signal in the brain. The seizure can cause strange sensations and behavior. Sometimes it causes muscle spasms and a change in or loss of consciousness.

The 2 most common types of seizures are:
focal or partial seizures, which begin in just a part of the brain but sometimes may spread to involve all of the brain
generalized seizures , which seem to involve all areas of the brain from the start of the seizure.

A common feature of partial seizures is the sensing of something that others are not aware of. For example, you may see flashing lights, have a particular taste in your mouth, or hear noises not seen or heard by others. Sometimes partial seizures also cause some numbness or jerking of the limbs. You may be awake and remember what happened, or you may lose consciousness for a short time.

There are 2 types of generalized seizures based on the pattern of the attack:
A grand mal seizure is a seizure that starts with a loss of consciousness and falling down, followed by a brief period of rigid muscles and a 1- to 2-minute period of violent, rhythmic jerking. The seizure ends with a few minutes of deep sleep before you are conscious again. You will probably not remember the seizure. You may be drowsy for hours after the seizure.
An absence or petit mal seizure is a short period of staring, fluttering eyelids, or twitching of muscles in your face. You do not lose consciousness. You are awake, but you are not able to understand what is going on around you. It’s not possible to pay attention at work or school when you are having petit mal seizures. You will probably not remember the seizure. Petit mal seizures usually begin when you are a child. Each seizure may last only 10 to 30 seconds, but hundreds may happen each day.

One seizure right after another or one very long seizure is called status epilepticus. The symptoms are usually those of a grand mal seizure. This can be life threatening because it can keep you from getting enough oxygen. It is a medical emergency.

If you have had several seizures and no cause can be found that can be corrected with treatment, your healthcare provider may diagnose seizure disorder, which is also called epilepsy.
How does it occur?

Seizures can happen for many different reasons, but most seizures have no known cause.

Seizures can be a symptom of many diseases and conditions, including:
head injury
brain injury at birth
brain infections such as meningitis or encephalitis
brain tumor
stroke
drug and alcohol abuse
withdrawal from alcohol and drugs such as narcotics, cocaine, tranquilizers, and sleeping pills
metabolic imbalances, such as low blood sugar or low blood sodium.
What are the symptoms?

Symptoms of a seizure can include:
aura, a peculiar sensation that occurs just before a seizure and may give you warning that a seizure is about to happen (for example, you may see flashing lights or hear noises)
rapid eye blinking or staring
twitching of the face
smacking of the lips
shaking or jerking of the arms and legs
stiffening of the body
crying or moaning
hallucinations, which may be visual or involve other senses such as hearing, touch, or taste
intense feelings of fear or déjà vu (the feeling that what you are experiencing has happened before even though you know it hasn’t)
loss of consciousness
loss of control of your bladder muscles so that you wet yourself
loss of bowel control
falling suddenly for no clear reason
not responding to noise or words for brief periods
appearing confused or in a haze
nodding the head
breathing problems from choking on food or saliva
vomiting.

You may be drowsy for several minutes after the seizure.
How is it diagnosed?

Your healthcare provider will examine you and take your medical history. You may have blood tests and one or more of the following safe and painless tests or scans to look for possible causes of your seizures:
EEG, which measures electrical activity in the brain
MRI (magnetic resonance imaging) scan, which uses magnetism, radio waves, and a computer to produce a picture of the inside of your head
CT (computed tomography) scan, in which X-rays are taken of your brain at different angles and then combined by a computer.
How is it treated?

The treatment for seizures depends on the cause. If you have a medical problem that is causing the seizures, such as diabetes, you will be treated for that problem.

Your healthcare provider may prescribe an anticonvulsant drug. This medicine will help prevent seizures. Your healthcare provider will adjust the dosage to minimize any side effects from the drug. If you keep having seizures while you are taking medicine, your healthcare provider will:
Check the level of the medicine in your blood.
Make sure you are taking your medicine as prescribed.
Make sure you aren’t drinking alcohol or using illegal street drugs.
Check to see if you are taking other medicines that may interfere with the anticonvulsant.

Medicine is the main treatment for seizures, but several new treatments are being evaluated. These include:
surgery on the area of the brain where the seizures occur
stimulation of a nerve in the neck by a device placed under the skin.
How long will the effects last?

It is not possible to know how long seizures will be a problem for any one person. Absence seizures often stop by the time you are an adult. You may keep having other types of seizures. Depending on the type of seizures you have and how often you have them, after a time your healthcare provider may recommend that you try to slowly decrease your medicines. You usually need to have not had any seizures while on medicine for at least 3 years before this is even considered. During this time it is very important to avoid driving a car or other activities where your life or the lives of others might be in danger if you had a seizure. Never stop taking your medicine without first checking with your provider.
How can I take care of myself?

Your friends and family should know first aid for seizures and CPR. When you have a seizure, they should:
Help you lie down on a bed or the floor.
Loosen clothing around your neck and remove eyeglasses.
Not try to hold you down. If possible, they should roll you onto your left side and gently hold you there. This position will help keep you from choking on vomit if you start vomiting. Objects should be moved away from you to avoid injury.
Check to make sure you are breathing.
Not put anything in your mouth. (The risk of biting your tongue is less than the danger of inhaling or being injured by anything put in your mouth. You will not swallow your tongue.)
Not move you during a seizure unless there is danger of injury.
After the seizure is over, let you rest while you wake up.

Someone should call 911 for emergency help if you are having a seizure and:
It is the first time you have had a seizure.
You have stopped breathing.
The seizure lasts 5 minutes or longer.
You have another seizure soon after the first one stopped.
You are not fully awake within a few minutes after the seizure.
Your lips or face look blue.
You fall and hit your head during a seizure.
A seizure happens after a head injury.

If you are having a seizure and not breathing, someone should start giving you CPR and keep giving it until the ambulance arrives.

If you keep having seizures one right after another or have one seizure for a long time, it is dangerous because you may not be getting enough oxygen. It is a medical emergency and you will need help.

Ways to care for yourself include:
Follow the treatment prescribed by your healthcare provider. Take medicine exactly as prescribed. Do not increase how much you take or how often you take it.
Eat a healthy diet and create a balance of work, rest, recreation, and exercise in your life.
Wear a medical ID bracelet or necklace so others will know about your condition.
Tell family, friends, and co-workers what to do if you have a seizure.
If your seizures are not well controlled, you should avoid high-risk activities that would be unsafe if you had a seizure. Some examples of risky activities might include swimming alone, cycling on a highway, scuba diving, or skiing. Ask your healthcare provider which activities are safe for you.
Avoid high-risk jobs that involve heavy or fast-moving equipment, heights, bodies of water, or other situations where you or others might be injured if you have a seizure.
Ask your provider when you may safely drive a car again. Check with your state’s Department of Motor Vehicles for rules about reporting a history of seizures.
Keep a positive attitude and develop ways to lessen stress.
Keep all of your follow-up appointments with your provider.
Call your healthcare provider if:
You have side effects from your medicine.
You keep having seizures and you are taking your medicine correctly.
The seizures change–for example, they happen more often or last longer.
You are a woman who takes medicines to prevent seizures and you want to get pregnant or you are pregnant.
You have any symptoms that worry you.

For more information, call or write:

Epilepsy Foundation of America
Phone: 800-332-1000
Web site: http://www.epilepsyfoundation.org
How can I help prevent seizures?

To help prevent further seizures:
Take your medicine as directed. Never skip a dose or stop taking your medicine without first checking with your provider.
Make sure you get enough sleep every night. Getting too little sleep can be a major cause of seizures if you have a seizure disorder.
Avoid alcohol.
Avoid mood-altering drugs, including stimulants and sedatives.
If you start having a fever, lower it right away with aspirin or acetaminophen. (Check with your healthcare provider before you give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto-Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye’s syndrome.)

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