Temporal lobe seizure Health Article

Treatment

The goals of treatment are to perform emergency measures, if necessary, and to reduce the rate of future seizures.

Emergency treatment may not be required, unless the seizure becomes generalized or consciousness is lost. First-aid measures should be performed as appropriate, including protection from injury, prevention of breathing vomit or mucus into the lungs, and airway protection or assistance with breathing.

Record details of the seizure and report them to the health care provider. Important details include date and time of the seizure, how long it lasted, which body parts were affected, type of movements or other symptoms, possible causes and other factors which provide information about the episode (such as what immediately preceded it).

The treatment of causes may stop the occurrence of seizures. This may include medical treatment of seizure disorders like epilepsy, surgical repair of tumors or brain lesions, and other treatments as needed.

Oral anticonvulsants (anti-seizure medications taken by mouth) are used to prevent or reduce the number of future seizures. Response is individual, and the medication and the dosage may have to be adjusted repeatedly.

Multiple, repeated seizures are usually treated with long-term use of an antiepileptic drug.

Follow-up includes reviewing the need for drugs at least yearly. Drugs may be required indefinitely. Monitoring the level of medicine in the blood is important to continue control of seizures, and to reduce side effects.

Pregnancy, lack of sleep, skipping doses of medications, use of recreational drugs (including alcohol), or illness may cause seizures in a person with a previously well-controlled seizure disorder.

Use of informational jewelry or cards (such as Medic-Alert or similar) that indicate a seizure disorder may be advised. These accessories may help in obtaining quick medical treatment if a seizure happens.

Expectations (prognosis)

Seizures can occur as a single event or be recurrent. Seizures that recur with no identified causes are most commonly a chronic, lifelong condition termed epilepsy.

Seizures that occur once or in a single cluster are commonly caused by an acute condition, such as brain injury. They may occur secondary to an isolated incident, but can then develop into a chronic seizure disorder. Seizures within the first 2 weeks of a brain injury do not necessarily mean that a chronic seizure disorder will develop.

Serious injury can occur if seizure happen while driving, or when operating dangerous equipment. Each state has different policies on driving restrictions. Swimming and bathing without supervision are also not recommended. Contact sports are not advisable. These activities may be restricted for persons with poorly controlled seizure disorders.

Complications

• Progression to generalized seizures
• Repeated seizures (epilepsy)
• Prolonged seizures, closely occurring seizures (status epilepticus)
• Injury from falls, bumps, biting self, etc.
• Injury from seizure occurring during driving or operating machinery
• Breathing fluid, such as saliva, during a seizure can cause pneumonia
• Permanent brain damage (stroke or other damage)
• Side effects of medications (with or without observable symptoms)

Calling your health care provider

Go to the emergency room or call 911 if:

• This is the first time the person has had a seizure, or this is a new type or prolonged seizure
• This is an emergency situation
• If sequential seizures occur, or if there is repeat seizure activity where consciousness is not regained in between seizures (status epilepticus).
• Any new symptoms occur, including possible side effects of medications, such as changes in mental status (drowsiness, restlessness, confusion, sedation, or others), nausea or vomiting, rash, loss of hair, tremors or abnormal movements, problems with coordination

Prevention

Treatment of any lesions or disorders may reduce the seizures. In many cases, epilepsy is caused by a genetic disorder and may not be preventable.

References

Goetz, CG. Textbook of Clinical Neurology. 2nd ed. St. Louis, Mo: WB Saunders; 2003.

Marx J. Rosen's Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis, Mo: Mosby; 2002.