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Seizure

Alternate Names

  • convulsion
  • fit
  • epilepsy

Definition

Seizures are caused by sudden, large discharges of electrical impulses from brain cells. A seizure may involve a wide variety of symptoms, depending on the part of the brain affected and the type of seizure.

Risks

What are the causes and risks of the injury?

Seizures may be caused by many conditions, diseases, injuries, and other factors. These may include conditions such as the following:
  • traumatic brain injury (either recent or long ago)
  • previous brain surgery
  • stroke (current or past)
  • drugs (illicit or prescribed)
  • withdrawal from alcohol, benzodiazepines etc
  • infections such as brain abscess, meningitis or encephalitis
  • metabolic conditions such as diabetes, hypoglycemia, thyroid dysfunction, and liver or kidney diseases
  • abnormalities in the blood vessels of the brain
  • acute bleeding into the brain, such as a subarachnoid hemorrhage
  • brain tumors
  • chromosomal abnormalities
  • congenital diseases or conditions
  • postanoxic brain injury
  • extreme high blood pressures
  • problems associated with pregnancy
  • toxic exposures such as lead etc

Prevention

What can be done to prevent the injury?

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. A sudden withdrawal from certain medicines, such as phenobarbital or diazepam, can also cause seizures. It's important to follow the healthcare provider's prescription for decreasing or stopping a medicine or alcohol.
It is important to follow the healthcare professional's prescription for decreasing or stopping a medicine or alcohol. Keeping blood pressure under control reduces the risk of stroke which can lead to seizures. People with epilepsy need to take their medicines as prescribed to lower the risk for 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 epilepsy. Once it is diagnosed, individuals can lower their risk of seizures by:
  • avoiding excess alcohol
  • avoiding illegal drugs, especially marijuana and cocaine
  • getting enough sleep
  • limiting intake of stimulants such as caffeine
  • recognizing and avoiding known factors that trigger their own seizures
  • seeking prompt treatment for fever and illness
  • taking all medicines as prescribed

Diagnosed

How is the injury recognized?

Seizure is diagnosed primarily by a medical history and physical examination performed by a physician. Symptoms listed below endorsed by an individual can be suggestive of seizure:
  • a sudden change in behavior
  • acute confusion
  • loss of bowel and bladder control
  • loss of consciousness
  • episodic twitching or jerking of the arms, legs, or both
Other types of seizures may produce more subtle symptoms.
Tests that may help in clarification of symptoms suggestive of seizure include:
  • electroencephalogram (EEG)
  • MRI of the brain
  • blood and urine tests
If the physician is concerned about an infection involving the brain, a spinal tap may be obtained.

Treatments

What are the treatments for the injury?

The treatment for seizure is dependent on the cause. A first-ever seizure may not require any medication, particularly if a treatable cause is found, such as an infection or drug withdrawal.
A second seizure without a known cause would warrant antiepileptic medication. If the seizure is due to a tumor, stroke, or history of traumatic brain injury, antiepileptic medication may be started even after the first-ever seizure.
When a seizure occurs, the first treatment is to keep the person safe. Anyone giving first aid to a person having a seizure should follow these steps:
  • If possible, move furniture and other sharp objects away from the person.
  • If the victim starts to vomit, roll him or her on his or her side.
  • If possible protect the person from falling and from hitting his or her head.
  • Stay with the victim and get help from his or her healthcare professional.
  • Try to prevent the victim from hurting him or herself or someone nearby.
When someone has a seizure, it's important that bystanders do not:
  • move the victim, unless he or she is in serious danger
  • place fingers in the victim's mouth
  • restrain the victim
  • slap the victim or try to stop him or her from convulsing
  • try to give rescue breaths or CPR during the seizure
Contact emergency medical services right away if:
  • the victim has never had a seizure before
  • the victim had a seizure while in water
  • seizures are lasting longer than 2 minutes
  • the victim has other health problems such as diabetes or high blood pressure
  • the victim is having many seizures
  • the victim is ill, has a fever, seems very weak, or is drunk
  • the victim is not able to be awakened between seizures

Side Effects

What are the side effects of the treatments?

Antiepileptic medications are associated with various side-effects depending on the particular drug used. Many may cause drowsiness particularly at first. Tests may be warranted to screen for any untoward effects on the liver, kidney, or bone marrow when the medication is first started.

After Treatment

What happens after treatment for the injury?

An individual with seizure disorder will need routine follow-up with a physician. If the cause of seizure is a tumor, drug withdrawal, infection, or stroke, these conditions will need to be addressed by the individual's healthcare professionals.
State laws differ, but generally require an individual who has had a seizure to refrain from driving for a period of time. This information should be provided by the treating physician to an individual where these restrictions apply. Swimming and bathing alone or unsupervised should also be avoided.

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