Seizures

Definition

A seizure is the physical findings or changes in behavior that occur after an episode of abnormal electrical activity in the brain.

See also:

• Generalized tonic clonic seizure
• Partial (focal) seizure
• Petit mal (absence) seizure
• Epilepsy
• Fever (febrile) convulsions (seizures in children with high fever)

Alternative Names

Secondary seizures; Reactive seizures; Seizure - secondary; Seizure - reactive

Considerations

There are a wide variety of possible symptoms of seizures, depending on what parts of the brain are involved. Many, if not all, types of seizures cause loss of awareness and some cause twitching or shaking of the body.

However, some seizures may be hard to notice because they consist of staring spells that can easily go unnoticed. Occasionally, seizures can cause temporary changes in sensation or vision.

Symptoms of seizures come on suddenly, over just seconds to a minute, and may include:

• Change in consciousness, so that you can't remember some period of time
• Change in emotion, like unexplainable fear, panic, joy, or laughter
• Change in sensation of the skin, usually spreading over the arm, leg, or trunk
• Changes in vision, including flashing lights, or (rarely) hallucinations (seeing things that aren't there)
• Loss of muscle control and falling, often very suddenly
• Muscle movement such as twitching that might spread up or down an arm or leg
• Muscle tension/tightening that causes twisting of the body, head, arms, or legs
• Tasting a bitter or metallic flavor

Symptoms may stop after a few minutes, or continue for 15 minutes. They rarely continue longer.

Shaking of the entire body when it occurs should last a few minutes and stop within 5 minutes.

Call your health care provider if

If this is the first time someone has ever had a seizure, or if this is an unusually long seizure in someone who has a seizure disorder, call 911 or your local emergency number immediately. These symptoms can be caused by life-threatening conditions, such as a stroke or meningitis.

Report all seizures (even a mild one) to the health care provider. If the person is known to have epilepsy or recurrent seizures, their doctor should be notified so that medications can be adjusted or other instructions given.

What to expect at your health care provider's office

Often, a person who has had a new or severe seizure will be seen in an emergency room, rather than a doctor's office.

The health care provider will try to diagnose the type of seizure based on the symptoms.

Other medical conditions that can cause a seizure or similar symptoms will be ruled out. Disorders that may cause similar symptoms include fainting, TIA or stroke, rage or panic attacks, migraine headaches, sleep disturbances, and conditions that cause loss of consciousness.

The following tests may be done:

• Blood tests
• CT scan of the head or MRI of the head
• EEG (usually not in the emergency room)
• Lumbar puncture (also called a spinal tap)

The need for further tests or treatment depends on a number of factors.

• A single seizure due to an obvious trigger (such as fever or a drug) is treated by eliminating or avoiding that trigger.
• A new seizure without an obvious trigger will require further testing and possible treatment.
• A seizure in a person with known epilepsy will require tests to make sure the patient is taking the correct dose of their medicines. A possible change in medicines may be needed.

Prevention

Instructions for taking any prescribed medications should be strictly followed. Family members should observe and record any seizure information to make sure the person gets proper treatment.

Good health habits may help to control seizures. Because sleep deprivation, stress, and a poor diet can contribute to increased seizures, good sleep habits, stress reduction, proper exercise, and sound nutrition may help.

There is no specific way to prevent all seizures. Use helmets when appropriate to prevent head injury. This will lessen the likelihood of a brain injury and subsequent seizures. Avoid recreational drugs. People with epilepsy should take medication as directed and avoid excessive amounts of alcohol.

People with uncontrolled seizures should not drive. Each state has a different law that determines which people with a history of seizures are allowed to drive. People with uncontrolled seizures also should avoid activities where loss of awareness would cause great danger, such as climbing to high places, biking, and swimming alone.