Seizures are caused by sudden, spontaneous discharges of electrical impulses from brain cells that can spread to other brain cells. Generalized tonic-clonic seizures were formerly called grand mal seizures and result when these spontaneous discharges are diffuse, involving both sides of the brain.
Neurons are the nerve cells within the brain. They coordinate movement, thinking, personality, and sensory activities. Neurons communicate with each other through electrical discharges. A seizure occurs when excitable neurons give off abnormal electrical discharges.
There are different types of seizures depending on where the excitable neurons are located and by the symptoms and signs they cause.. Epilepsy is diagnosed when an individual has a repeating pattern of seizures.
Seizures are divided into two main types: generalized and partial. Generalized seizures affect the entire brain. The person loses consciousness or awareness of the environment. Partial seizures affect only one part of the brain. Generalized tonic-clonic seizures affect the whole brain.
Generalized tonic-clonic seizures often have the following characteristics: begin suddenly without warninginvolve stiffening of the body (the tonic phase)include jerking of the arms and legs (the clonic phase)cause confusion following the seizureinclude loss of bladder controllast 1 to 2 minutes, with consciousness returning up to 15 minutes later
Seizures have many causes; however, the causes of generalized seizure typically include: failure to take prescription anti-seizure medications as directed, in an individual with a known seizure disordergeneralization of a partial seizure due to the spread of the abnormal electrical discharge to both sides of the brain metabolic disturbances such as hypoglycemia (low blood sugar) and electrolyte disturbances such as low sodium, calcium, or magnesiumalcohol or drug use or withdrawalchromosomal abnormalitiescongenital diseases or conditionsacute, severe high blood pressurepregnancy and its complicationsadvanced liver diseaseAlzheimer's disease or other types of dementiahereditary diseasesinfections involving the brain, including encephalitis, brain abscess, and bacterial meningitiskidney failure, such as chronic renal failurehypoxic/anoxic injury during birth or in the uteruspoisonous insect bites or stingshigh fever, especially in young childrenlead poisoningoverheatingthyroid diseasewithdrawal from some medicines, including those used to treat seizures
For individuals with a known seizure history, adhering to the anti-seizure medication regimen prescribed by the healthcare professional is the best prevention. Proper management of conditions such as diabetes mellitus, thyroid disease, kidney disease, and liver disease can help prevent seizures related to complications from these disorders.
In addition, by reducing excessive alcohol use, a person decreases his or her risk of seizures. However, if a person with alcoholism stops drinking completely, the risk of withdrawal seizures increases in the short term. A sudden withdrawal from certain medicines, such as phenobarbital, or benzodiazepines such as diazepam (i.e., Valium), clonazepam (i.e., Klonopin), or alprazolam (i.e., Xanax) can also cause seizures. It's important to follow the healthcare provider's prescription for decreasing or stopping a medicine or alcohol.
Keeping blood pressure under control reduces a person's risk of seizures. It also helps prevent stroke, which can lead to seizures. Protection against head injury is critical for all ages. Following sports safety guidelines for children, adolescents, and adults can prevent some injuries. Many times, there is no way to prevent the onset of epilepsy.
Individuals with epilepsy can reduce their risk of further seizures by: avoiding excess alcoholavoiding illegal drugs, especially marijuana and cocainegetting enough sleeplimiting intake of stimulants such as caffeinerecognizing and avoiding known factors that trigger their own seizuresseeking prompt treatment for fever and illnesstaking all medicines as prescribed
Diagnosis of seizures begins with a medical history and physical exam. The healthcare professional will ask about contributing illnesses or injuries. An electroencephalogram (r EEG) will be ordered. An EEG measures electrical activity within the brain. If a seizure occurs during the EEG, the abnormal activity can be detected. However, a normal EEG does not rule out seizures simply because it may not have been done at the time seizure activity was occurring.
Other tests that may be ordered include: blood tests to look for underlying diseases or conditionscranial CT scan to look for abnormalities in the braincranial MRI to provide a closer look at brain structurespositron emission tomography (PET) scans, to identify the abnormal brain area
Seizures can lead to physical injury from falling. Epilepsy may interfere with school or work.
Generalized tonic-clonic seizures are not contagious and pose no risk to others.
Medicines used to treat seizures are known as anticonvulsants. Common anticonvulsants include the following: carbamazepine (i.e., Tegretol)clonazepam (i.e., Frisium)diazepam (i.e., Valium)gabapentin (i.e., Neurontin)lamotrigine (i.e., Lamictal)phenobarbital (i.e., Solfoton)phenytoin (i.e., Dilantin)primidone (i.e., Mysoline)valproate sodium (i.e., Epilim)
If a person's seizures are not controlled with medicine, a vagal nerve stimulator may be used. A small pacemaker-like box is inserted under the skin of the chest. It sends regular electrical discharges to the vagus nerve in order to disrupt the abnormal electrical charges. A vagal nerve stimulator does not involve any surgery on the brain.
People with severe, uncontrollable seizures may be candidates for brain surgery. The surgeon opens the skull with a craniotomy. He or she then removes the abnormal brain tissue.
Underlying problems, such as a brain tumor, may require further treatment. A person with epilepsy may be embarrassed or depressed. Counseling about the condition may help the individual and the family. Support groups exist for those with epilepsy.
Medicines used to treat seizures may cause side effects. The side effects depend on the medication; however, drowsiness is a common side effect of anti-seizure medication.
Insertion of a vagal nerve stimulator involves a small risk for bleeding, infection, or a reaction to the anesthetic. Risks of these types from a craniotomy are somewhat larger.
Many anticonvulsants decrease the effectiveness of oral contraceptives.
Many substances interfere with the action of anticonvulsants. These include over-the-counter medicines, prescription medicines, and herbal remedies. Individuals with seizures should consult their healthcare professionals before taking any new products.
Individuals with seizures may be able to drive if they can remain seizure-free. Laws governing driving vary from place to place.
People with seizures can participate in most activities of regular life. They may be advised to avoid hazardous activities. Federal law prohibits discrimination in employment. There are also laws precluding people with epilepsy from certain jobs, such as commercial trucking. A person with seizures should use an identification bracelet or card informing others of the condition.
Blood is tested regularly to monitor the levels of anticonvulsants. Any new or worsening symptoms should be reported to the healthcare professional.