Seizure

• A seizure is a temporary disruption of brain activity, causing varied physical and mental effects.
• Seizures are categorized into focal (starting in one area) and generalized (affecting both sides of the brain).
• Causes range from genetic factors and brain injuries to infections and strokes.
• Providing appropriate first aid during a seizure is crucial for the person’s safety.
• Knowing when to seek emergency medical attention is vital for seizure management.

What is a Seizure?

A Seizure refers to a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain. This electrical surge can manifest in various ways, from brief staring spells to convulsions involving the entire body. While a single seizure can be triggered by temporary factors like high fever, low blood sugar, or alcohol withdrawal, recurrent seizures without an identifiable trigger are characteristic of epilepsy.

Globally, approximately 50 million people have epilepsy, making it one of the most common neurological diseases worldwide, according to the World Health Organization (WHO). Understanding what a seizure entails is the first step toward effective management and support for affected individuals.

Types of Seizures: Symptoms and Causes

The classification of seizures helps in diagnosis and treatment, with different types of seizures explained based on where they begin in the brain and how they affect consciousness. Seizures are broadly categorized into focal onset and generalized onset, each with distinct seizure symptoms and causes.

• Focal Onset Seizures: These begin in one area of the brain.
  • Focal Aware Seizures: The person remains conscious and aware. Symptoms might include involuntary jerking of a limb, sensory disturbances (e.g., strange smells or tastes), or emotional changes (e.g., sudden fear). Causes often include localized brain injury, tumors, or strokes.
  • Focal Impaired Awareness Seizures: Consciousness is altered or lost. The person may stare blankly, make repetitive movements (automatisms like lip smacking or fumbling), or wander. They may not remember the seizure. Causes are similar to focal aware seizures but may involve more extensive or critical brain regions.
• Generalized Onset Seizures: These affect both sides of the brain from the outset.
  • Tonic-Clonic Seizures (formerly Grand Mal): Characterized by a sudden loss of consciousness, body stiffening (tonic phase), and then rhythmic jerking (clonic phase). The person may cry out, lose bladder control, and bite their tongue. Causes can be genetic predispositions, metabolic imbalances, or widespread brain dysfunction.
  • Absence Seizures (formerly Petit Mal): Brief episodes of staring into space, often mistaken for daydreaming. They typically last only a few seconds, and the person usually has no memory of them. More common in children, often linked to genetic factors.
  • Myoclonic Seizures: Brief, shock-like jerks of a muscle or group of muscles. The person is usually conscious. Often occur in the morning and can be a symptom of certain epilepsy syndromes.
  • Atonic Seizures (Drop Attacks): Sudden loss of muscle tone, causing the person to fall to the ground. Consciousness is usually briefly impaired. These can lead to significant injury.

Other causes of seizures include infections (like meningitis), high fever, head trauma, stroke, brain tumors, and certain genetic conditions. In many cases, the exact cause remains unknown.

First Aid for Seizures

Knowing how to provide effective first aid for seizures is crucial for ensuring the safety and well-being of someone experiencing one. The immediate goal is to protect the person from injury and to monitor them until the seizure subsides.

• Stay with the person: Do not leave them alone. Time the seizure if possible.
• Keep them safe: Move furniture or other objects away from the person. If they are on the ground, place something soft and flat (like a folded jacket) under their head.
• Turn them gently onto one side: This helps keep the airway clear and prevents choking on saliva or vomit.
• Loosen tight clothing: Especially around the neck, to aid breathing.
• Do NOT restrict movements: Do not hold the person down or try to stop their movements.
• Do NOT put anything in their mouth: This can cause injury to their teeth, jaw, or your fingers.
• Stay calm and reassure them: Once the seizure ends, they may be confused or tired. Speak calmly and let them rest.
• Call for emergency medical help (911 or local emergency number) if:
  • The seizure lasts longer than 5 minutes.
  • The person has difficulty breathing or stops breathing after the seizure.
  • Another seizure starts soon after the first one.
  • The person is injured during the seizure.
  • The person is pregnant or has an underlying health condition like diabetes or heart disease.
  • This is their first seizure.

After the seizure, remain with the person until they are fully alert and able to communicate. Offer comfort and support, and help them find a safe place to rest if needed.