A seizure is a sudden, uncontrolled burst of electrical activity in the brain that can cause temporary changes in muscle tone, behaviour, sensations, or awareness. The severity and duration of the episodes of seizures vary, and may be a one-time occurrence. There are several cases of seizure, and understanding them can help with proper and timely management.
What are the causes?
As mentioned earlier, there are different causes of seizures, and the type experienced would determine the approach to managing them.
1. Neurological Disorders
The most common cause of recurrent seizures is epilepsy, which is a chronic condition that manifests via unprovoked seizures. The leading factors in this are numerous, including genetics, brain injuries, and developmental disorders. Brain injuries can happen from accidents or falls, which can lead to seizures. The resulting damage to brain tissue can disrupt normal electrical activity, triggering seizures.
Stroke and brain tumors are other neurological disorders that can cause seizures. While strokes happen when the brain tissue is damaged and electrical activity is altered, tumors can press on the brain tissue, leading to abnormal electrical activity and seizures. Both benign and malignant tumors can cause seizures.
2. Metabolic and Systemic Conditions
Low blood sugar levels (also known as hypoglycemia) can disrupt brain function, leading to seizures. This is particularly common in people with diabetes. Also, imbalances in electrolytes such as sodium, calcium, and magnesium can cause seizures. These imbalances may result from dehydration, kidney disease, or other conditions. Other metabolic and systemic conditions that can be responsible for seizures are infections such as meningitis and high fever, and alcohol and drug withdrawal, especially when done suddenly.
3. Genetic and Developmental Disorders
Some genetic disorders, such as Dravet syndrome and Angelman syndrome, are associated with an increased risk of seizures. This is also the case with cerebral palsy and autism spectrum disorders, which have been found to be associated with a higher incidence of seizures.
4. Other Causes
Other known causes of seizures are lack of sleep, which can lower the seizure threshold and provoke seizures in susceptible individuals, and certain medications that affect the central nervous system. These include certain antidepressants, antipsychotics, and antibiotics.
Types of Seizures
Focal Seizures
Focal seizures, also known as partial seizures, originate in one area of the brain. They can be of various types, including:
- Focal Aware Seizures: The person remains conscious and aware during the seizure. Symptoms may include unusual sensations, sudden emotional changes, or an involuntary jerking of a limb.
- Focal Impaired Awareness Seizures: The person’s consciousness is altered or lost. They may exhibit repetitive movements or behaviors and may not remember the event afterward.
Generalized Seizures
Any type of seizure that involves both hemispheres of the brain can be classified under general seizure. They manifest in different forms:
- Absence seizures: Brief lapses in consciousness, often mistaken for daydreaming. The person may stare blankly and not respond to external stimuli.
- Tonic-Clonic Seizures: Formerly known as grand mal seizures, these involve a combination of muscle stiffness (tonic phase) and rhythmic jerking (clonic phase).
- Atonic Seizures: Also known as drop attacks, they cause a sudden loss of muscle tone, leading to falls and potential injuries.
- Myoclonic Seizures: Involve sudden, brief jerks or twitches of muscles. These can occur in clusters and affect different parts of the body.
How are seizures to be responded to?
Safety Measures:To ensure that the person’s safety is guaranteed, it is important to remove nearby objects that could cause injury. The person needs to be placed on their side to prevent choking and to ensure they have a clear airway.
Stay Calm: Caution must be taken. Nothing should be done to restrain or restrict their movement or put in their mouth. They can be spoken to softly, which will reassure them.
Timing the Seizure: If the seizure lasts longer than 5 minutes, or if multiple seizures occur without full recovery in between, seek emergency medical help immediately.
Seizures are a complex and dynamic health condition that requires a comprehensive approach to management. It is important to understand the underlying causes, recognise the different types, and implement effective management that is essential for the improvement of patient recovery and quality of life.