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Seizures: Types, Symptoms, and Treatment

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Seizures: Types, Symptoms, and Treatment

A seizure or convulsion happens suddenly. There's rarely any signal. Nor can the person about to have a seizure say, “Watch out! Here comes a seizure!” The person hasn't a clue that a seizure is about to occur—unless he or she has had them in the past. Symptoms can be dramatic and scary to behold (which is usually what's called a grand mal seizure), or they can be so mild that the few seconds of lost consciousness goes by without anyone being aware of it (which is called an absence or a petit mal seizure).

Seizures Come in Many Sizes and Shapes

There are more than 20 types of seizures, which are distinguished by determining where the electrical signaling in the brain misfired and how far the “brainstorm” spreads. If the misfiring occurs in the area of the brain that governs the movement of a particular limb, only that limb will jerk spasmodically. If the misfiring occurs in the area of the brain that controls vision or hearing, a person might suffer from hallucinations. And if the misfiring occurs in the limbic system, which covers the emotional arena, a person might become hysterical and anxious. (See Why Head Injuries Are So Dangerous.) These singularly symptomatic seizures are called “partial” or “focal” seizures.

Usually, people know they have seizures; it's a condition many people have had to deal with since birth. Those people usually wear Medic Alert bracelets or necklaces to alert others of their condition, and they usually carry appropriate anti-epileptic medication (such as Klonopin or Dilantin). These people know what to do and what to expect. There is no need to take one of them to an emergency ward when he suffers a seizure.

The symptoms of a grand mal or partial seizure can include the following:

• A sudden loss of consciousness combined with a fall to the ground
• Rigid body stance, followed by uncontrollable spasms, jerking, or twitching
• Eyes rolled upward
• Face and lips turn blue
• Foaming at the mouth or drooling
• Loss of bladder or bowel control
• Biting of the tongue
• Temporary breathing stoppage

A seizure can last as long as 90 seconds.

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Why Seizures?

First Aids

Epilepsy is a disorder of the nervous system that starts with a burst of abnormal electrical activity within the passageways of the brain. This misfiring causes a “glitz” in the normal brain function, which is outwardly displayed as a convulsion or seizure that occurs again and again over time. The hallmark of epilepsy is the quick way in which a seizure takes place. A flickering light or a lack of sleep can trigger a seizure.

There are many reasons why people have convulsions or seizures. Epilepsy is the most common, but there are other causes:

• High fever
• Head injury
• Alcohol withdrawal
• Drug use or withdrawal
• Brain tumors
• Poison
• Electric shock
• Hyperventilation
• Shock (because not enough oxygen is being sent to the brain)
• Hypotension (which is very low blood pressure)
• Hypoxia (a decrease of oxygen in the arteries)
• Hypoglycemia (low blood sugar), especially in a diabetic

The Dangers of Seizures

As we have pointed out, seizures by themselves are not necessarily dangerous except when they occur for the first time in an otherwise healthy individual. But because of the possibility that an underlying medical condition has caused the convulsion, it's important to get the person to the emergency ward for help as soon as the seizure has passed.

The other danger of seizure is purely environmental. A person can have a seizure and fall to a hard floor, injuring his or her head. A person can have a seizure while swimming, and he or she will be in danger of drowning. A person can have a convulsion while driving, which brings up a lot of serious side effects. And, if a seizure lasts longer than five minutes, there is always the possibility of heart, kidney, or brain damage.

Because of the potential dangers in these situations, people should be aware of each other's medical history, especially when traveling on business or pleasure. Medication storage should be noted, and everyone should know what to do for first aid care if a person in the group has a seizure.

Waiting for the Seizure to Subside: The “DON'Ts” of First Aid

There's very little you can do while someone is having a seizure except to move any furniture out of harm's way. You can loosen the person's clothing and try to help him to the ground as he starts to fall.

However, there are a lot of things you should NOT do when a seizure is taking place. These “do nots” are critical.

DO NOT…

• Attempt to restrain the person having the seizure. You can cause the person to tear muscles or break a bone.
• Force anything between the person's teeth. This can result in broken teeth—or a broken finger—yours.
• Throw ice cold water on the person in the hopes it will “shake” him or her out of it. Not only will splashing water have no effect, but it can cause the person to choke!

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Before You Put the Band-Aid On

It's often said that placing a pencil or tongue depressor between the teeth of a person having a seizure helps prevent him or her from biting off the tongue.

Wrong. Although it's almost been de rigueur in health education (and movies about Alexander the Great and Caesar of Rome), this technique does nothing. The worst that can happen is that a person will bite his or her tongue and it will bleed. If you place something else in the person's mouth like a pencil or tongue depressor, he or she may break it and swallow part of it.

After the Fall: Treatment When the Seizure Is Over

After the victim comes out of a convulsion, there are some first aid steps to take to ensure comfort and safety:

1. Call for emergency help. If possible, try not to leave the victim's side (in case there are any complications).
2. Check for any medic alert bracelets or neck tags, if the person is not a family member or close friend. It is possible the person is an epileptic or has another condition that requires specific medical attention. Be ready to tell the emergency team when they arrive.
3. Check the victim's breathing. If he or she is still not breathing, or breathing with difficulty, perform mouth-to-mouth resuscitation.
4. As the person comes out of the seizure, do not startle him or her. Do not act panicky or ask any questions. Let him or her rest. After a seizure, a person might be confused, very sleepy, or even combative and violent. Don't be alarmed. It's a normal part of “coming out” of a seizure.
5. Turn the person's head (or his or her entire body) to the side to prevent choking if he or she vomits.
6. Observe whether there are any burns around the victim's mouth. If there are, it's possible the convulsions were due to poisoning.
7. The person who suffered the seizure might fall into a deep sleep at this point. He or she might snore quite loudly. It's quite common and nothing to be alarmed about.

Ouch!

If a child starts having convulsions during the course of such childhood illnesses as measles or mumps, they could reflect serious problems in the nervous system. You should call your pediatrician immediately.

Seizures in Children

Although seizures in children are the most frightening of all, they, too, are relatively harmless after the convulsions have passed. In childhood, the first signs of epilepsy might appear. Further, high fever or severe gastrointestinal upsets can cause convulsions. Seizures can also become a permanent or temporary aftereffect of rheumatic fever.

However, it's important to seek medical care immediately if this is the first seizure you've seen. It can be a symptom of something serious, and medication might be needed.

If a child is having a seizure, you should follow the same first aid procedures as with an adult—with one exception. If the seizure is the result of high fever, follow these first aid steps instead of the earlier ones:

1. Give your child baby ibuprofen or acetaminophen after the seizure has passed.
2. Sponge him or her off with lukewarm water. (Warm water is more soothing than cold.)
3. Never place your child in the tub. If your child has another seizure, he or she could drown!

These three measures should lower your child's temperature without causing dangerous side effects. By lowering the temperature, you decrease the chances of another seizure.