What Is a Seizure?
A seizure is abnormal electrical activity in the brain that happens quickly. It may go nearly unnoticed. Or, in serious cases, it may cause unconsciousness and convulsions, when your body shakes uncontrollably.
Seizures usually come on suddenly. How long and serious they are can vary. A seizure can happen to you just once, or over and over. If they keep coming back, that's epilepsy, or a seizure disorder. Less than 1 in 10 people who have a seizure get epilepsy.
Types of Seizures
Generalized seizures involve your entire brain from the start. Common subtypes include:
- Tonic-clonic (grand mal). This is the most common subtype. Your arms and legs get stiff, and you may stop breathing for a bit. Then your limbs will jerk around. Your head will move about, as well.
- Absence seizures (petit mal). You lose awareness briefly when you have one of these. Children get them more often than adults. Typically, they last only a few seconds.
- Febrile seizures. These are convulsions a child may have from a high fever caused by an infection. They can last a few minutes but are usually harmless.
- Infantile spasms. These usually stop by age 4. The child's body gets stiff suddenly and their head goes forward. Many kids who have these get epilepsy later in life.
Partial (focal) seizures
There are two types:
- Focal onset aware seizure. You remain conscious during the seizure, which is very brief (usually less than 2 minutes). You may or may not be able to respond to people while it's happening.
- Focal onset impaired awareness seizures can cause unconsciousness. You may also do things without knowing it, like lip smacking, chewing, moving your legs, or thrusting your pelvis.
Seizures can have different symptoms depending on the type of seizure, but may include:
- Uncontrollable, spastic movements of your body, particularly your arms or legs
- Stiffening and then loosening of limbs or muscles
- Loss of consciousness
- Staring into space
- Sudden emotional states that can include a feeling of doom, deja vu, fear, or euphoria
- Sweating and nausea
- Involuntary movements of your tongue or mouth, screaming, or crying
- Rapid blinking
- Falling to the ground
Seizures can happen with no explanation, but there are also conditions and events that can bring them on, including:
- Brain tumors
- Head injuries
- Electrolyte imbalance
- Very low blood sugar
- Repetitive sounds or flashing lights, as in video games
- Some medications, like antipsychotics and some asthma drugs
- Withdrawal from some medications, like Xanax, narcotics, or alcohol
- Use of narcotics, such as cocaine and heroin
- Brain infections, like meningitis
- A high fever
Your doctor will ask for details about your seizure and do a neurological exam. This will include asking questions about your emotional state and testing your motor skills and mental functioning. Then they may order one or more of the following tests:
- Blood tests or a spinal tap to look for an infection
- Electroencephalography (EEG) during which a technician will attach electrodes to your brain to monitor the electrical activity inside it
- An imaging test such as an MRI, CT, or PET scan to look for any problems in your brain
If your seizures are happening frequently, your doctor may give you a more involved test in which electrodes are inserted into your brain through small holes in your skull. This can also be the first step in epilepsy surgery.
Seizure Treatment and Lifestyle Management
It's possible to have only one seizure and not require treatment, but if your seizures continue, there are several ways your doctor may suggest treating them, including:
- Medication. Anti-seizure medications can cause some serious side effects, so you and your doctor will consider all the options and may need to try a few before you find one that's effective and least likely to cause side effects.
- Surgery. If your seizures always come from the same place in your brain, it may be possible for a neurosurgeon to remove just that portion of your brain to stop the seizures.
- Vagus nerve stimulation. Your vagus nerve is the longest nerve in your skull, running all the way from your brain to your stomach. A specialist can implant a medical device under the skin of your chest that will send electrical signals along your vagus nerve to your brain and limit seizures. Sometimes you still need to take medication.
- Responsive nerve stimulation. A device implanted into your brain spots and then stops seizures.
- Deep brain stimulation. Surgeons put devices into certain brain areas and then implant a pacemaker-like machine in your chest. It can send electrodes to those regions to prevent or stop seizure activity.
What you can do to help with seizures
- Talk to your doctor about following a ketogenic diet, which is high in fat and protein and very low in carbohydrates. It has been shown to be helpful with reducing how often you have seizures.
- Get good sleep. Lack of sleep can be a trigger for seizures.
- Take any medications as directed.
- Pay attention to what things trigger your seizures and try to avoid them.
- Wear a seizure alert device that can alert your caretakers when you are having a seizure. It does not prevent seizures from happening, but it can allow you to have more freedom and less worry.