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Seizures

Understanding the Symptoms, Causes and Treatments

Understanding Seizures

It is often very scary to see a family member or friend lose consciousness and start convulsing. To understand how a seizure works, think of your brain like a computer. There are many interconnected parts that communicate with electric impulses. When the computer is working, all the signals reach their desired parts, and everything runs smoothly. Suppose there is a surge of abnormal electric activity. This surge can spread from part to part and overwhelm the computer. The computer may freeze, start running applications on its own, and even shut down all together. Eventually, after the crash, the computer restarts, but it takes longer for everything to return to its normal function.

Similarly, the brain has many nerve cells that communicate via electric impulses. A seizure results when an abnormal surge of electric activity causes our awareness of the world around us to “crash,” just like a computer. A “crash” for our brain may lead to loss of consciousness. Additionally, the surge of electric impulses may activate brain cells that should not be activated, leading to abnormal actions in parts of our body such as convulsions, tongue biting, and loss of bowel or bladder control. Once the abnormal activity ends, the brain, just like the computer, needs a good restart. It can take a few hours after a seizure for the brain to return to its normal settings. During these few hours, the person who had the seizure may be confused, tired, sore, or even weak in the muscles involved in the convulsions. 

Causes of Seizures

What is a provoked seizure?

  • A provoked seizure is a seizure caused by an outside factor that triggers a seizure in the brain. For example, certain habits and behaviors, such as drinking large quantities of alcohol, withdrawing from alcohol, or using certain prescription or recreational drugs can provoke a seizure in the brain. Stress, sleep deprivation, flashing lights, infection, and electrolyte abnormalities can also affect the brain in a way that triggers a seizure.

What is an uprovoked seizure?

  • An unprovoked seizure is a seizure that occurs in the absence of any of the known external seizure triggers. Without these other triggers, we look to the brain for a cause. A prior stroke, a brain tumor, or tissue damage from a prior brain injury may all put patients at risk for seizures.  However, even if no structural cause is found in the brain, a seizure without any of the above triggers is considered an unprovoked seizure.

Symptoms of Seizures

  • Temporary confusion, staring, loss of consciousness 
  • Fear, anxiety, or déjà vu before the episode
  • Uncontrollable jerking of the arms and legs
  • Tongue biting
  • Incontinence of bowel or bladder
  • Confusion, sleepiness after the episode

Diagnosing Seizures

As with other conditions, we start the diagnosis process for seizures by discussing the health history with the patient and performing a physical examination. A good history can differentiate a seizure from other conditions that can cause someone to lose consciousness, such as syncope, heart disease, or lack of oxygen in the blood. Examination can point us toward or away from seizure as the cause. Additional testing, such as an MRI of the brain or an electroencephalogram (EEG) to assess your brain wave activity may also be performed. Epilepsy is diagnosed when two or more unprovoked seizures occur or when a patient has one unprovoked seizure and is determined to be at risk for future seizures.

Treatment Options

How do we treat seizures?

  1. Anti-epileptic drugs
  2. Epilepsy surgery
  3. Avoidance of seizure triggers

 

How do we treat epilepsy?

Anti-epileptic drugs (AEDs) are the main treatments for epilepsy. For patients who do not have improvement with the first AED, switching to another AED or trying two or more AEDs together is warranted. Patients who continue to have seizures despite two or more AEDs on maximum doses are candidates for epilepsy surgery. Epilepsy surgery is a procedure in which the part of the brain thought to be causing the seizures is removed with the goal of reducing or eliminating the number of seizures.

 

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Dr. Sommer Ebdlahad

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Reviewed by: Dr. Sommer Ebdlahad.

Reviewed by: Dr. Sommer Ebdlahad.