Seizures

Imagine your world being literally turned upside down, and in that moment there's nothing you or anyone else can do about it. Your mind puts a hold on time, as your body moves uncontrollably, stiffens or twitches. If you're having a seizure, it may feel something like that, except the world is as it always has been. It is you who is changing - whether by an electrical disruption in the brain (Read about "The Brain"), emotional trauma, medication or some other physical or psychological condition. According to the National Institute of Neurological Disorders and Stroke (NINDS), doctors have described more than 30 different types of seizures. Some may last just a few seconds, others a few minutes, and it's even possible to have one seizure, and never have another again. More than 2 million people in the United States have experienced an unprovoked seizure or been diagnosed with epilepsy. A single seizure does not mean a person has epilepsy. Only when a person has had two or more seizures is he or she considered to have epilepsy, according to NINDS. First seizures, febrile seizures, nonepileptic events, and eclampsia (Read about eclampsia in "Preeclampsia") are examples of seizures that may not be associated with epilepsy.

Precautions

If you are with someone who has a seizure, the American Academy of Neurology (AAN) says to keep calm, help the person to the floor and loosen clothing around the neck. After that, AAN says do NOT put anything into the persons mouth, but you should remove any sharp or hot objects nearby that could injure the person, turn the person on one side so saliva can flow out of their mouth and place something such as a cushion under their head. If you know the person has epilepsy, AAN says an ambulance is probably unnecessary. However, an ambulance can be appropriate if:

• the seizure continues for more than five minutes
• you don't know if the person has epilepsy
• the person is pregnant, diabetic, or seems otherwise ill

Epilepsy

Epilepsy is a brain disorder in which clusters of nerve cells, or neurons, in the brain can misfire. This in turn can lead to unusual sensations, emotions and behaviors; it can also cause convulsions, muscle spasms and loss of consciousness.

(Read more in "Epilepsy")

Nonepileptic Seizures

A seizure that looks like an epileptic seizure, but is not caused by an electrical change in the brain is called a nonepileptic seizure. According to the Epilepsy Foundation (EF), nonepileptic seizures often resemble epileptic seizures both in the way they look and in the way the person having the seizure feels. EF says sometimes even trained medical professionals who are witnessing the seizure cannot tell the difference between an epileptic and nonepileptic episode.

There are two types of nonepileptic seizures. According to EF, they are:

• physiologic
• psychogenic

A physiologic nonepileptic seizure may be caused by a number of conditions that can trigger seizures. According to EF, they include:

• changes in heart rhythm (Read about "Arrhythmia")
• sudden drops in blood pressure
• very low blood sugar
• sleep disorders (Read about "Sleep")
• movement disorders
• vascular lesions (Read about "Vascular Lesions of the Central Nervous System")

A psychogenic nonepileptic seizure appears to be caused by emotional trauma or excessive stress. (Read about "Stress")

Diagnosing seizures can be done through special monitoring. EF says an electroencephalogram or EEG (Read about "EEG - Electroencephalograph") can test brain waves during an actual seizure. According to EF, it's the most accurate way to diagnose nonepileptic seizures. Certain blood tests (Read about "Laboratory Testing") may also help in determining whether the episode is epileptic or nonepileptic. Once the data is thoroughly evaluated, experts can work on a treatment plan. Medication and/or counseling are just some of the ways that may help eliminate these episodes. EF says the outcome of treatment is usually better than for that of people with epilepsy.

Febrile Seizures

Convulsions brought on by a high fever in small children are called febrile seizures. According to NINDS, a child experiencing a febrile seizure will often lose consciousness, shake, move limbs, become rigid or twitch. Most febrile seizures last just a minute or two, but they can be shorter and longer than that. NINDS says that approximately one in 25 children will have at least one febrile seizure, and many of them will have more before they turn 5 years of age. Febrile seizures usually occur in children between 6 months and 5 years.

There are a few factors that can increase a child's risk for having recurrent febrile seizures. According to NINDS, they include:

• having the first seizure before 15 months of age
• frequent fevers
• having an immediate family member with a history of febrile seizures
• having a seizure shortly after a fever has started or when the temperature is low

Although febrile seizures may look frightening, NINDS says it is unlikely the child will be injured. According to NINDS, there is no evidence that this type of seizure causes brain damage. Here are some things a parent can do, according to NINDS that can help prevent injury or possible choking.

• remain calm
• place child on a protected surface, like the floor
• do not restrain the child during convulsion
• place child on stomach to prevent choking
• remove all items in the child's path
• never place anything in the child's mouth

NINDS also recommends that the child be taken to a doctor for evaluation as soon as possible, especially if he or she shows signs of a stiff neck, lethargy or vomiting.

Nonfebrile Seizures

Seizures that occur without a fever are called nonfebrile seizures. They are not uncommon, according to the American Academy of Pediatrics (AAP). Most nonfebrile seizures are a one-time event. AAP says they may be caused by a temporary interruption in normal brain functioning. If the seizures are recurrent, they may be epileptic seizures and could be a chronic problem.

AAP recommends that if your child has two or more seizures you should talk to your doctor. Tests can be performed to determine if epilepsy is present.

Partial or Focal Seizures

Partial or focal seizures occur in just one part of the brain. According to NINDS, about 60 percent of all people with epilepsy suffer from focal seizures. (Read about "Epilepsy") There are two types of focal seizures, simple and complex.

In a simple focal seizure, the person will remain conscious, but may experience a number of feelings like joy, anger or sadness. The senses may also be affected. According to NINDS the person may see, smell, taste, hear, or feel things that aren't even there.

In a complex focal seizure, there is a change in or loss of consciousness. People having such a seizure may act strangely. They may blink, twitch or even walk in circles. These seizures usually last just a few seconds.

Generalized Seizures

A generalized seizure is caused by abnormal neuronal activity on both sides of the brain. It may result in a number of physical symptoms like falls, muscle spasms and loss of consciousness. NINDS lists several types of generalized seizures and their symptoms. They include:

• absence seizure: staring and jerking or twitching muscles
• tonic seizures: stiffening of muscles in the back, legs and arms
• clonic seizures: repeated movement of the upper body, arms or legs
• atonic seizures: loss of normal muscle tone
• tonic-clonic seizures: stiffening of the body, repeated jerking of limbs, and loss of consciousness

Diagnosis and treatment options

Other conditions may be confused with seizures and/or epilepsy, such as syncope and stroke (Read about "Syncope/Fainting" "Stroke"). Therefore, if you are experiencing seizures, it's important to get an accurate diagnosis. Diagnosis can include a number of tests such as electroencephalography (EEG), which is a recording of your brain-wave activity. (Read about "EEG - Electroencephalograph") CT, MRI and PET can also be used. (Read about "CT Scan - Computerized Tomography" "MRI - Magnetic Resonance Imaging" "PET - Positron Emission Tomography")

Treatment for seizures depends upon the type of seizure the person is having. Sometimes, a person may have one seizure and never have another. In some cases of nonepileptic seizures, professional counseling may be all the patient needs. If seizures continue to happen, anticonvulsant medications may be necessary. The specific medication used depends on the person's age, type of seizure and side effects. For some patients, a special diet called the ketogenic diet (low in carbohydrates and high in protein) may be indicated. Other treatment options include surgery (Read about "Neurosurgery") and vagus nerve stimulation (in which small pulses of energy are sent to the brain from the vagus nerve in the neck). It's important that all treatment options be discussed with the patient's physician.