characterized by recurrent seizure disorder of brain function
characterized by a loss of consciousness, sensory disturbance and
generalized convulsions. There are many
types of seizures, depending primarily on what part of the brain is
involved .There are two primary types of seizures: petit mal
(brief lapses or clouding of consciousness) and grand mal (child
loses consciousness, falls, becomes rigid and has involuntary muscle
contractions -- less common than petit mal). Epilepsy cannot be
cured but can be controlled by medication.
Many people will have a single
seizure at some time in their lives, but this does not mean that
they have epilepsy. If a person has epilepsy it means they have had
more than one seizure that began in the brain.
A diagnosis of epilepsy is made after
a person has had more than one epileptic seizure. When a person has
had a seizure they may not remember what happened. This means it can
be helpful to have information from someone who saw the seizure
A number of investigations, including
blood tests, an electroencephalogram (EEG) and scans such as
computerized tomography (CT) or magnetic resonance imaging (MRI) may
provide additional information. However, these tests cannot confirm
or rule out a diagnosis of epilepsy.
Some causes of seizure include:
imbalance such as low blood sugar or sodium
toxic chemicals or drugs of abuse
is a physical condition that starts in the brain - a neurological
condition. It is a symptom that the way a person's brain works is
sometimes disrupted. When this happens, a person may suddenly have a
seizure. Almost any type of behavior that
happens repetitively may represent a seizure.
What is a seizure?
epileptic seizure (often called a fit and sometimes an attack, turn
or blackout) happens when ordinary
brain activity is suddenly disrupted. The seizures
described here are epileptic and arise from the brain.
seizures can take many forms, since the brain is responsible for
such a wide range of functions, including:
of these functions may be temporarily disturbed during the course of
very young children have convulsions when there is a sudden rise in
their body temperature and this is called a 'febrile convulsion'.
This is not classified as epilepsy.
How can seizures be
are many different types
of seizures. Not all of them involve convulsions. When
naming seizures, it is important to use terms which describe what is
happening during the seizure and to avoid terms such as 'mild' or
'major' which do not describe the event.
person with epilepsy can experience more than one type of seizure.
The frequency, length and pattern of seizures tends to be fairly
constant for each person, although it may change in the longer term.
If a person becomes aware of any changes to their seizures it may be
helpful to have a review of their epilepsy and its treatment.
partial seizures the disturbance in brain activity begins in or
involves one part
of the brain. These seizures are sometimes known as 'focal'
seizures. A person's experiences during the seizure will depend on
which part of the brain is being affected.
seizures consciousness is not impaired. The seizure
may be confined to either rhythmical twitching of one limb or
part of a limb, or to unusual tastes or sensations such as pins
and needles in a specific part of the body. Simple partial
seizures sometimes develop into other sorts of seizures and so
they may be referred to as a 'warning'
partial seizures differ from simple partial seizures
in that consciousness is affected and so the person may have
limited or no memory of the seizure. The seizures may be
characterised by a change
in awareness as well as automatic movements such as
fiddling with clothes or objects, mumbling or making chewing
movements, or wandering about and general confusion. The person
may respond if spoken to. Complex partial seizures most often
involve the temporal lobes of the brain, in which case the
person may be said to have 'temporal lobe epilepsy', however
they can also affect the frontal, parietal and occipital lobes.
some people either of these partial seizures may spread to
involve the whole of the brain. This is called a secondarily
generalised seizure and the person will lose
consciousness. If this spread is rapid, the person may not be
aware of the partial seizure onset.
these seizures the whole of the brain is involved and consciousness
is lost. They often occur with no warning and the person will have
no memory of the event. The seizure may take one of the following
most recognised type of seizure is the generalised tonic-clonic
convulsive seizure, sometimes called a 'grand mal'
seizure. In the first part of the seizure the person becomes
rigid and may fall. The muscles then relax and tighten
rhythmically causing the person to convulse. At the start of the
seizure the person may bite their tongue or cry out. Breathing
may become laboured and they may be incontinent. After the
seizure the person may feel tired, confused, have a headache and
may need to rest to recover fully.
there is general stiffening of the muscles without rhythmical
jerking. The person may fall to the ground with consequent risk
of injury but generally recovery is quick.
seizures, also known as drop attacks. These involve a
sudden loss of muscle tone, causing the person to fall. Again,
there is consequent risk of injury but recovery is generally
seizures involve brief and abrupt jerking of one or
more limbs. These often happen within a short time of waking up,
either on their own or with other forms of generalised seizure.
seizures occur most commonly in children and are
sometimes referred to as 'petit mal'. The person experiences a
brief interruption of consciousness and becomes unresponsive.
They may appear 'blank'
or 'staring' usually without any other features,
except perhaps for a fluttering of the eyelids. Absence seizures
often last for only a couple of seconds and as they are subtle
they may go unnoticed.
seizure patterns may not fit into any of the above categories or may
include elements of different seizures. These are called
people experience seizures only during sleep. As these will usually
be at night they are called nocturnal
seizures. These seizures could also occur during the day
if the person were to fall asleep. This does not describe the form
that the seizures take, only the time when they occur.
seizures last for the same amount of time for each person and
usually stop of their own accord. However, in some circumstances
seizures are not self-limiting and do not stop, or one seizure
occurs after another with no recovery period in between. This
situation is known as status epilepticus. This can occur in any type
of seizure, however it is a medical
emergency requiring medical intervention if it occurs
with a tonic-clonic seizure.
ambulance should be called if the seizure lasts for 2-3 minutes
longer than normal, or if it lasts for more than 5
minutes and the usual duration of a seizure is not known.
some people seizures are triggered by certain stimuli, which may
differ from one individual to another. Identifying these triggers
can help to avoid situations where seizures might occur. Such
triggers may include lack of sleep, stress, alcohol or flickering
lights. If seizures are triggered by flickering lights this is
called photosensitive epilepsy.
If the seizures are related to
another medical condition, identification and treatment of that
medical condition is the key to prevention. If anticonvulsant
medication is prescribed, taking the medication on the recommended
schedule and not missing medication is important.
people with epilepsy are quite sensitive to alcohol. If this
pattern develops, avoid alcohol. Others may have seizures only
after ceasing heavy alcohol intake. The key to prevention is
avoidance of alcohol.
deprivation and stress certainly may increase the frequency of
seizures in some people with epilepsy.
Seek Medical Care
A first seizure is a reason to visit
your doctor or a hospital's emergency department. For someone with a
diagnosed seizure disorder, a change in seizure patterns or more
frequent seizures are reasons to see the doctor.
Visits to a hospital's emergency
department are not needed for everyone with a seizure. Some seizures
are emergencies, as in the following cases:
seizure that continues for more than 5 minutes
confusion or unconsciousness
sustained during a seizure
The first task facing the doctor is
to decide if the event was a seizure or some other condition, such
as fainting, that may mimic a seizure.
doctor will take a history about the facts that surrounded the
event. Any eyewitness accounts will be very helpful. Family
history, social history, and past medical history are important
any medicine containers, including prescription drugs, to the
hospital to help the doctor make the diagnosis.
neurological examination will be performed. This may include
some tests not usually performed in other physical examinations,
such as strength and reflex testing.
on the history and physical examination, laboratory work may be
ordered. This might include blood or urine testing.
testing such as MRI, CT scans, or EEG (brain wave patterns) may
to treat epilepsy
Anti-epileptic drugs - AEDs
Up to 70% of people with epilepsy
have their epilepsy controlled with anti-epileptic drugs.
AEDs prevent seizures from happening, but don't cure epilepsy. There
are many AEDs, and the type someone takes will depend on the type of
seizures they are having.
In some people the tendency to have
seizures decreases with time and they may be able to stop taking
their AEDs. Other people may have to continue taking AEDs for the
long term even if their seizures have stopped. This may happen if
the underlying cause of the seizures, for example a scar on the
brain, is still there.
A small proportion of people may
benefit from epilepsy surgery - neurosurgery. This is only
considered in people whose seizures can be shown to arise in one
area of the brain.
Vagus nerve stimulation
VNS is a relatively new type of
treatment for epilepsy. It aims to reduce the number, length and
severity of seizures a person has. It involves a mild electrical
stimulation of the left vagus nerve, a large nerve in the neck. VNS
doesn't cure epilepsy and usually a person would continue taking
care with epilepsy varies with the frequency and type of seizures.
It is important to take anticonvulsant medication regularly to
a seizure occurs, an observer can use common sense to prevent
the person's head.
any tight neckwear.
the person on his or her side.
not hold the person down or restrain the person.
not place anything in the mouth or try to pry the teeth apart.
The person is not in danger of swallowing his or her tongue.
seizure characteristics—length, type of movements, direction of
head or eye turning. These characteristics may help the doctor
diagnose the type of seizure
Article by: Ms. Preeti Chande