See also:

• Seizure—Child
• Seizure Disorder—Child

Definition

A seizure happens when there are certain types of abnormal electrical activity in the brain. During a seizure, you may:

• Lose consciousness
• Stare into space
• Have convulsions—abnormal jerking of the muscles
• Experience abnormalities of sensation or emotion

If you have two or more seizures that are not due to an illness or other trigger, then it is considered a seizure disorder. This condition is also known as epilepsy. Seizure disorders may be classified by the part of the brain they affect and the kinds of symptoms they cause. One way to categorize into two important groups is:

• Generalized seizure disorder—onset is throughout the brain, not from a single focal location
• Partial seizure disorder (focal seizure)—begins within certain areas of the brain

Causes

Seizures are caused by abnormal brain function. For many people, it is not known what causes the malfunction. Some known causes include:

• In newborns:
  • Congenital brain abnormalities (present at birth)
  • Birth injuries that deprive the brain of oxygen
  • Metabolic disorders
  • Maternal drug use
  • Infection
• In infants and children:
  • Febrile seizure —caused by spike in fever in a baby or very young child
  • Brain tumor
  • Infections ( encephalitis, cerebritis, brain abscess)
• In children and adults:
  • Congenital conditions
  • Genetic
  • Head trauma—common cause (eg, concussion, skull fracture, bleeding inside of the skull, oxygen deprivation due to near-drowning)
  • Infections (eg, encephalitis, cerebritis, brain abscess)
  • Stroke
  • Brain tumor
• In elderly:
  • Stroke
  • Trauma
  • Brain tumor
  • Degenerative diseases (eg, Alzheimer’s disease)

Risk Factors

Factors that may increase your chance of developing seizures or a seizure disorder include:

• Previous brain injury—seizure disorder usually develops within one year of injury
• Previous brain infection
• Abnormal blood vessel that has formed in the brain
• Brain tumor
• History of stroke
• History of complex febrile seizures
• Use of certain medications or recreational drugs
• Stopping the use of medications, recreational drugs, or alcohol
• Drug overdose
• Exposure to toxins (eg, arsenic, lead, or carbon monoxide)
• Family history of seizure disorders
• Alzheimer’s disease
• Toxemia during pregnancy
• Chemical abnormalities—decreased or excess blood sodium or glucose, low blood calcium
• Liver or kidney failure
• Severe, untreated high blood pressure
• Chronic diseases (eg, lupus, polyarteritis nodosa, porphyria, sickle cell disease, Whipple’s disease)
• Syphilis
• Cysticercosis—an infection caused by a pork tapeworm

If you already have a seizure disorder, the following factors can increase your chance of having a seizure:

• Sleep deprivation
• Alcohol
• Hormonal changes, such as those that occur at points during the menstrual cycle
• Stress
• Flashing lights, especially strobe lights
• Use of certain medications
• Missing doses of anti-epileptic medications

Symptoms

There are many kinds of seizure disorders with a variety of symptoms, such as:

• Aura—a sensation at the start of a seizure, may involve the perception of an odd smell or sound, visual symptoms, or unusual stomach sensations
• Staring
• Loss of consciousness
• Repeated jerking of a single limb
• Generalized convulsion with uncontrollable jerking of muscles throughout the body
• Hand rubbing
• Lip smacking
• Picking at clothing
• Perception of an odor, sound, or taste
• Loss of bladder or bowel control
• Postictal state—a state of drowsiness, alteration in responsiveness, and/or confusion that commonly occurs after a generalized tonic-clonic seizure; may last minutes, hours, or days

Symptoms of generalized seizure disorders include:

• Generalized tonic-clonic seizures—loss of consciousness, stiffening, uncontrollable jerking of muscles throughout the body
• Absence seizures—staring, eye blinking, or eye rolling

Symptoms of partial seizure disorder include:

• Complex partial or temporal lobe seizures:
  • May lose contact with reality, stop purposeful activity, and begin a series of automatic gestures (eg, lip smacking, hand-wringing, or picking at clothing)
  • May appear as a brief moment of confusion or loss of attentiveness
  • May have a perception of unusual sights, sounds, or smells
• Simple partial seizures:
  • Does not involve a loss of contact with reality or a loss of consciousness
  • Single area of the body may move uncontrollably (eg, leg or arm shaking)
  • May include the perception of an odor, sound, or taste, or an unrelated emotion

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. You may need to see a neurologist. These doctors specialize in the nervous system and brain.

Your bodily fluids may be tested. This can be done with:

• Blood tests
• Lumbar puncture

Images may be taken of your bodily structures. This can be done with:

• MRI scan
• CT scan
• Magnetoencephalography (MEG)
• Positron emission tomography (PET)
• Single photon emission computed tomography (SPECT)

Your brain activity may be evaluated. This can be done with Electroencephalogram (EEG).

Treatment

The goals of treatment are to:

• Treat the underlying cause (if known)
• Prevent seizures—may be done through medications, surgery, or special therapies
• Avoid factors that stimulate seizure activity

Prevention

There are no known ways to prevent every type of seizure disorder. You can take steps to prevent brain injuries that could lead to seizures:

• Always wear a helmet when using bikes, rollerblades, skateboards, or scooters.
• Wear protective headgear when playing contact sports.
• Dive in safe depths of water.
• Always wear a seatbelt.
• Avoid using street drugs.
• If your baby or child has a high fever, get treatment right away.
• Get prenatal care. If you have high blood pressure during pregnancy, get proper treatment.
• If you have a chronic condition, get proper care.

If you have a severe seizure disorder, some changes may be needed to prevent serious injuries, such as:

• Avoid driving, if advised to do so by your doctor.
• Do not swim or bathe alone.
• Do not work on ladders or ledges.
• Avoid or modify athletic activities.

Talk to your doctor about these kinds of issues.

National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov

Epilepsy Ontario http://www.epilepsyontario.org

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FDA approves new drug to treat severe form of epilepsy. US Food and Drug Administration website. Available at:
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2008/ucm116980.htm
Published November 20, 2008. Accessed November 18, 2014.

FDA approves Potiga to treat seizures in adults. US Food and Drug Administration website. Available at:
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm258834.htm
Published June 13, 2011. Accessed November 18, 2014.

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