Seizures: Understanding and Overview

Seizures

About 1 in 10 people may have a seizure in their lifetime. Learn more about causes, symptoms, treatments, and what you can do to keep a person experiencing a seizure safe.

A seizure is the result of abnormal electrical activity in the brain. The severity, duration, and presentation of seizures may vary, which can make it difficult to distinguish seizure from other conditions without the help of a specialist.  Some individuals who experience a seizure may appear confused, others can fall and shake. Regardless of the severity of seizure, it can be extremely disconcerting to the person experiencing it and to those around them. Most seizure disorders can be controlled with medication. It is important to schedule a neurological consultation to manage seizures.

Causes

There are a number of factors that can cause seizures, some of which are still unknown.  Often, we associate seizures with epilepsy, but they can be epileptic or non-epileptic in origin. Non-epileptic seizures can be caused by triggers such as high fever or metabolic disorders, and commonly occur after a stroke, a head injury, meningitis, or another illness. Most of the patients experiencing recurrent seizures, in the absence of triggers, are diagnosed with epilepsy.  

Symptoms

Specific symptoms of a seizure can help medical professionals to diagnose the type of seizure you experienced. Most seizures last from 30 seconds to 2 minutes or longer. Seizures that last longer than 2 minutes require immediate medical attention. Common signs of seizure may include:

• Temporary confusion
• A staring spell
• Uncontrollable jerking movements of the arms and legs
• Loss of consciousness or awareness
• Cognitive or emotional symptoms, including fear and anxiety

Types of Seizures

Depending on how they start, seizures are generally described as being generalized onset or focal onset, simple or complex, and primary or secondary:

• Generalized Onset Seizures – These seizures occur when the excess electrical activity occurs in both sides of the brain at once and without warning.  Often, there is a genetic aspect to these types of seizures. Common subtypes of generalized seizures include:

• Tonic-clonic (or grand mal) seizure: It’s the most common subtype. Arms and legs get stiff, and breathing may stop for a bit. 
• Focal Onset Seizures – These partial seizures only occur on one side of the brain and can be caused by a number of issues including injury, tumor, or a stroke.

• Simple focal seizures: These seizures can cause twitching or cause a person to experience a strange taste or smell.
• Complex focal seizures: These seizures can make a person appear confused and unresponsive for several minutes.   
• Secondary generalized seizures: These seizures spread from one side of the brain to both sides, and can last for several minutes.

The Phases of a Seizure

There are four generally recognized phases to a seizure: prodromal phase, aura, the ictal phase, and the post-ictal phase. Different seizures can affect people differently, varying in symptoms and progression of stages, with some individuals only experiencing some of the following:

1. Prodromal phase precedes a seizure. It is a subjective feeling that may occur several hours or days prior to a seizure. A person can experience confusion, anxiety, headache, tremor, and mood disturbances.

2. Many people may experience an aura - one of the earliest short-term signs of an impending seizure. Some symptoms of aura may include:

• Vision loss or blurring
• Flickering vision
• Hallucinations
• Déja vu (feeling of familiarity with a person, place, or thing without having experienced it)
• Ringing or buzzing
• Strange, offensive smells
• Out-of-body sensation
• Nausea/ stomach ache
• Numbness
• Tingling
• Dizziness
• Head, arm, or leg pain
• Subtle arm or leg twitching

3. The ictal phase describes the time between the beginning and the end of the seizure. It may include the following symptoms:

• Confusion
• Memory lapses
• Distractedness
• Sense of detachment
• Eye or head twitching movement in one direction
• Inability to move or speak
• Loss of bladder and/or bowel control
• Pale/flushed skin
• Hearing loss
• Strange sounds
• Vision loss, blurring, flashing vision
• Chewing or lip-smacking
• Unusual physical activity such as dressing/undressing
• Walking/running
• Pupil dilation
• Difficulty breathing
• Racing heart
• Sweating
• Tremors
• Twitching
• Arm or leg stiffening
• Numbness
• Drooling

4. There are often lingering symptoms after a seizure is over, comprising the post-ictal phase. Some individuals recover rather quickly while others take some time.  Symptoms of the third phase of the seizure include:

• Drowsiness
• Confusion
• Memory loss
• Nausea
• General malaise
• Body soreness
• Difficulty finding names or words
• Headaches/migraines
• Thirst
• Arm or leg weakness
• Hypertension
• Feelings of fear, embarrassment, or sadness

Seizure First Aid 

Call 911 and proceed to your nearest emergency room if at least one of these are true:

• The person is experiencing a seizure for the first time
• The person has difficulty breathing
• The seizure lasts for more than several minutes
• The person is experiencing multiple seizures
• The person has a health condition such as diabetes, hypertension

Treatment of Seizure and Epilepsy 

If you believe you or a loved one have experienced some of the common signs of seizures, or have been diagnosed with seizure at the hospital, it is important to be seen by a specialist as soon as possible. The staff at NY Neurology Associates includes a team of doctors who work with each patient to understand their specific neurological needs and design a treatment plan. Schedule a consultation with a seizure/ epilepsy specialist today by calling (646) 679-6609 or requesting an appointment below.

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