A seizure is a sudden and aberrant surge of electrical activity within the brain, resulting in transient alterations in behavior, motor functions, sensory perception, or loss of consciousness. Promptly summon emergency services if the seizure endures beyond a 5-minute duration, leads to physical injury, represents a maiden occurrence, involves individuals with diabetes or pregnancy, or poses a risk of choking due to the presence of ingested substances.
To provide assistance during a seizure episode, prioritize the safety of the individual by refraining from restraining their movements.
1. Instead, ensure a secure environment by eliminating potential hazards and providing head support with a soft object.
2. Refrain from inserting objects into the mouth as there is no risk of tongue swallowing.
3.Time the seizure, maintain vigilant observation of respiration.
4.Offer reassuring verbal communication to the affected person, and upon seizure cessation, transition them gently onto their side, particularly if vomiting or fluid accumulation in the mouth has occurred.
5.Post-seizure, avoid offering sustenance or liquids until complete cessation of the seizure is confirmed. If feasible, designate a companion to remain with the individual for continued monitoring and support.
Seizures can manifest as changes in movement, sensation, awareness, thought, or behavior, depending on the affected brain area. Some seizures involve only part of the brain, while others affect the whole brain.
Before a seizure, there may be an 'aura,' which can include odd smells, déjà vu, tingling, vision disturbances, or emotions like fear or joy. The aura marks the start of a seizure.
During a seizure, the symptoms depend on its type. These can include:
- Loss of consciousness
- Unresponsiveness
- Staring into space (absence seizure)
- Vague or confused behavior
- Numbness or tingling
- Excess saliva
- Increased heart rate
- Hallucinations
- Impaired thinking
- Eye blinking or rolling upwards
Motor (movement) symptoms may involve:
- Stiffening movements (tonic phase)
- Jerking movements (clonic phase)
- Alternating stiffening and jerking (tonic-clonic)
- Loss of muscle tone (atonic), leading to falling
- Tremors or shaking
- Sudden nodding of the head
- Unusual postures
- Repetitive movements like lip smacking or chewing
Most seizures last less than 2 or 3 minutes an d stop without treatment.
After the seizure
There's a post-ictal phase where the person may experience confusion, fatigue, soreness, thirst, weakness, nausea, anxiety, injuries, loss of bladder or bowel control, or a headache. Their memory of the seizure may vary, and it could take hours or even days to fully recover.
Seizures are categorized based on where they start in the brain, awareness during the seizure, and the presence of movement. They fall into three major groups:
1. Focal onset seizures start in a specific brain region (the focus) and may spread to other areas. They were previously known as partial seizures. A person can be fully aware (focal aware) or have altered awareness (focal impaired awareness).
2. Generalized onset seizures affect both sides of the brain from the beginning, often leading to loss of consciousness. They can be further divided into:
- Generalized motor seizures: Involving stiffening and jerking movements (tonic-clonic, previously called grand mal) or other muscular effects.
- Generalized non-motor seizures: Resulting in changes in awareness, staring, or repeated movements like lip-smacking or clothing-pulling.
3. Unknown onset seizures occur when it's unclear where in the brain the seizure originated, often because the person was asleep or alone when it started.
Febrile seizures, which occur in response to fever in young children, typically last a short time and don't have long-lasti ng effects.
Seizures can be caused by various factors, including:
- Epilepsy
- Head injuries
- Brain infections
- Brain tumors or other medical conditions, including strokes
- Birth defects
- Certain prescription medications
Common triggers for seizures in some individuals can include:
- Illicit drugs
- Excessive alcohol consumption or withdrawal
- High or very low blood sugar levels
- Flashing lights
- Lack of sleep
- Extreme stress
- High fever (febrile seizures)
Sometimes, no specific cause or trigger can be identified for a seizure.
Treatment for seizures often involves:
- Ketogenic Diet: A specialized diet may help treat certain seizures in children when medication isn't effective. A doctor or specialist can determine if it's suitable.
- Surgery: Surgery to remove the brain tissue causing seizures is an option for cases resistant to other treatments, especially when seizures originate from the same brain location consistently.
- Vagus Nerve Stimulation: This involves implanting a pacemaker-like device in the chest to send mild electrical signals to the brain via the vagus nerve. It's used when epilepsy doesn't respond to medication and isn't suitable for surgery.
Safety
1. Driving Restrictions: It's a legal requirement that individuals who've experienced a seizure must not drive until their doctor confirms it's safe. Regular reviews with a GP or specialist are essential for both adults and children with epilepsy.
2. Medical Identification: Some individuals with medical conditions like epilepsy wear special identification jewelry, such as MedicAlert, to indicate their need for specific medical care during emergencies.
3. Seizure Detection Devices: Smartwatches and monitors are available to detect seizures and send alerts to family members or caregivers.
4. Safety Precautions: People prone to seizures should exercise caution when swimming, driving, or bathing to minimize risks.
Ways of Preventing Seizures:
- Some individuals experience warning signs or "auras" before a seizure. If possible, they should move to a safe place.
- Others may notice changes in a person about to have a seizure, such as altered appearance, pupil size changes, or unusual behavior. In such cases, guide the person to a safe location.
- Seizures can sometimes be prevented by avoiding triggers such as flashing lights, sleep deprivation, stress, alcohol, or missing medication doses.
Medication: Medication is effective in controlling seizures for 60-70% of individuals. It's crucial to always take the prescribed dosage and avoid missing any doses.
By Andrew Anongu, DailyHealth
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