Seizures

Seizures are surprisingly common, but not everyone has convulsions. Symptoms can vary by type of seizure—and even person to person. When they become more than a fluky, one-time event, proper treatment and lifestyle tweaks can help prevent future episodes.
By Stephanie Booth
August 09, 2021

A sudden burst of abnormal brain activity is called a seizure. Not everyone convulses or loses consciousness when this happens. Some people look like they're staring off into space. Others become unaware of what's going on around them for a few minutes. Many seizures are quite mild, and don't cause long-term health problems, but they can still be unsettling to experience, or to watch unfold. If you have repeated seizures, different types of medications and lifestyle changes can help.

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What Is It?

About 86 billion nerve cells in your brain are constantly communicating with each other through tiny electrical impulses. If this complex system glitches, it can cause an unexpected "electrical storm," or what we know as a seizure.

During a seizure, your muscles can suddenly become weak or you could have uncontrollable movements. It's also possible to have a temporary change in behavior or lose awareness of what's going on around you.

Seizures are surprisingly common — about 1 in every 100 people has experienced at least one. Some happen because of a specific reason, like very low blood sugar or an extremely high fever. But if you have more than two seizures with no clear causes, you have a brain disorder that's known as epilepsy. Epilepsy is the fourth most common neurological condition in the world.

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Types

There are many different types of seizures, but they're generally classified into one of three groups based on how and where affect your brain.

A generalized seizure impacts both sides of your brain. The most well-known example is what's called a tonic-clonic seizure. During the "tonic" phase, your muscles stiffen, then you lose consciousness and fall to the ground. Next comes the "clonic" stage, when your arms and legs begin to jerk uncontrollably.

A focal, or partial, seizure starts in a specific area of your brain. When you're awake and aware during it, it's known as a focal aware seizure. If you're confused or lose awareness, you have what's called a focal impaired awareness seizure.

If no one sees your seizure (for instance, you live alone), your doctor will categorize it as an unknown onset seizure. They can't be sure where it began in your brain, or the symptoms you had.

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Symptoms 

The symptoms you have will depend on the type of seizure you experience. (And even then, they vary from person to person.)

If you have a general on-set seizure, you could have:

  • Rhythmic jerking movements.
  • Loss of muscle control in your arms and legs.
  • Muscle tension.
  • Body spasms.
  • Staring spells.
  • Muscle twitching.
  • Rapid blinking.
  • Loss of consciousness.

The signs of a focal onset seizure include:

  • Jerking movements.
  • Limp or weak muscles.
  • Body spasms.
  • Repeated automatic movements like clapping, chewing, or lip smacking.
  • Feeling hot or cold.
  • Racing heart.
  • Goosebumps.
  • Strange taste or smell.
  • Emotional symptoms, like fear or anxiety.
  • A sense of déja vu.
  • Staring into space.

An unknown onset seizure may include convulsions or spasms, or you could stop moving altogether and "blank out."

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Causes

A number of things can bring on a seizure, including:

  • High fever.
  • Lack of sleep.
  • Medications (including some pain relievers and antidepressants).
  • Flashing lights or another visual stimulant.
  • Very low blood sodium.
  • High or low blood sugar.
  • Autoimmune disorder.
  • Traumatic brain or head injury.
  • Using drugs like amphetamines or cocaine.
  • Too much alcohol.
  • COVID-19.
  • Central nervous system infection.
  • Stroke.
  • Brain tumor.

Epilepsy can be caused by multiple factors, but most of the time, it's unclear why someone has it.

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Diagnosis

To figure out the type of seizure you had and search for a possible cause, your primary care doctor or a neurologist can look at:

Your health history. Your doctor will ask a number of questions about your health and any factors that may have contributed to the seizure, like a recent high fever, head injury, or drug or alcohol use.

Blood work. These tests can check for underlying health issues that could have triggered your seizure.

A neurological exam. A neurologist can test how well your brain and the rest of your body are functioning.

EEG (electroencephalogram). This test painlessly records electrical impulses in your brain and can identify any recent abnormal activity.

Brain imaging. Sometimes an MRI (magnetic resonance imaging) or CT (computed tomography) scan are used to gather information as well.

Spinal tap. This procedure can check for things like infection, brain bleed, or nervous system inflammation that may have caused your seizure.

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Treatment

If your doctor thinks your seizure was a one-off event, they may decide no treatment is needed for the time being.

If your seizures do reoccur, the goal of treatment will be to try to limit how often they happen. That typically includes:

Antiseizure Medication. Because different options are available, it can take time to find the right kind and dose that works for you. (Many can also cause side effects like weight gain, changes in mood, and fatigue, so you'll need to find a medication you can tolerate.)

Diet. A keto diet that's high in fat and extremely low in carbohydrates is sometimes used to try to prevent seizures.

Stimulation Devices. Different types of implants can send signals to your brain to interrupt and correct abnormal brain activity.

Surgery. If other treatments don't help, your doctor may suggest a surgical procedure. These can range from laser therapy that blasts brain cells that are responsible for causing seizures to physically removing the area of your brain where the seizures are originating.

Stress Relief. If you have seizures that aren't caused by epilepsy, your doctor could suggest counseling. A therapist can help you learn to connect your thoughts and feelings with how you act. Antidepressants or anti-anxiety medications may also be part of your treatment.

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Prevention

To try to avoid seizures, you can:

Make Healthy Everyday Choices. Little things that have a big impact on your physical and mental health include:

  • Getting enough sleep.
  • Staying hydrated.
  • Being active.
  • Managing your stress.
  • Limiting alcohol and tobacco.

Identify your triggers. After you have a seizure, write down:

  • Details about the seizure (how long it lasted and what happened).
  • Recent foods you ate.
  • What activities you were doing before the seizure.
  • Any prescription drugs, over-the-counter medications, vitamins, and herbal supplements you're taking.

You can share these details with your doctor.

Take Your Medication as Prescribed. Don't stop or adjust your dosage without first speaking to your doctor.

Be Proactive. While talking to others can't prevent you from having another seizure, it can help you worry less about what could happen if you do. Talk to the people you regularly spend time with, like your friends, family members, and co-workers. Talking about it may feel awkward at first, but their support will be a huge help.

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