How Can You Tell the Difference Between a Stroke and a Seizure?

Medically reviewed by Debra Sullivan, PhD, MSN, RN, CNE, COI on June 27, 2016Written by James Roland on June 27, 2016

Overview

A stroke and a seizure are both serious and affect your brain activity. The causes and effects they have on your brain health are different, however. A stroke occurs due to a disruption of blood circulation in the brain, while a seizure occurs due to a surge of electrical activity in the brain. In addition, a stroke can permanently affect your thinking and muscle control. The impact of a seizure is usually temporary.

Symptoms

Strokes and seizures share some symptoms, such as:

  • headaches
  • feelings of numbness or tingling in parts of the body
  • confusion
  • difficulty speaking or understanding words that someone is saying to you

Severe strokes or seizures may also cause you to lose consciousness.

Symptoms of seizures

Seizures tend to have beginning, middle, and end stages. You may not notice when one stage ends and another begins. Each phase of a seizure has a unique set of symptoms.

The beginning stage of a seizure may begin minutes, hours, or even longer before the actual seizure. One feature of this stage is an aura, which is a change in your vision and other senses. You may be particularly sensitive to light, or you may see strange lights and colors that no one else can see. Your sense of smell and taste may also become distorted. Other signs before a seizure may also include dizziness and feelings of anxiety.

The middle stage of a seizure is known as the ictal phase. During this part of a seizure, you may lose consciousness or you may zone out for several minutes or longer. You may have trouble hearing or seeing, or you may experience hallucinations.

During a seizure, you may:

  • blink excessively
  • drool
  • lose control of your muscles
  • twitch or experience muscle freezing
  • bite your tongue
  • sweat excessively
  • repeat actions, such as walking or getting dressed and undressed
  • experience temporary incontinence

The end stage is called the postictal phase. You may experience the following during this stage:

  • sleepiness
  • confusion
  • memory loss
  • fear

Symptoms of a stroke

Unlike a seizure, which may have warning signs that are noticeable hours or even days before the event, a stroke tends to occur pretty suddenly. You may suddenly have a violent headache and other symptoms. These symptoms often include:

  • numbness or pain on one side of the body
  • facial drooping
  • trouble walking
  • a sudden lack of coordination
  • incoherent speech
  • difficulty understanding words that are spoken to you

If symptoms develop and worsen, or don’t go away, you’re likely having a stroke.

What causes a stroke and a seizure?

The two main types of stroke are ischemic and hemorrhagic.

An ischemic stroke is much more common than a hemorrhagic stroke. It occurs due to a blockage in an artery that supplies blood to the brain. The blockage could be from a blood clot that lodges in the artery or that blocks blood flow in one of the carotid arteries. These arteries take blood up the sides of the neck to the brain.

A hemorrhagic stroke occurs when a blood vessel in the brain bursts. As a result, blood leaks into surrounding tissue and the flow of blood stops at the point where the artery ruptured. One of the most common causes of a hemorrhagic stroke is high blood pressure. This is because high blood pressure, or hypertension, can weaken an artery, making it more likely to burst.

High blood pressure is also one of many potential causes of a seizure. Other causes range from being overheated and experiencing withdrawal after quitting alcohol or medications to snake bites and epilepsy. Epilepsy is a brain disorder that leads to frequent seizures if it isn’t controlled by medicine.

Risk factors

Risk factors for epilepsy

If you have epilepsy, you’re at a high risk for seizures. Having a family history of seizure disorders may also raise your risk of seizures.

Experiencing a head injury increases your risk of seizures, but they may not appear right away. You may go several months or more than a year before you have a seizure related to your injury. A stroke may also trigger a seizure, either immediately or after you’ve recovered from the stroke.

Risk factors for stroke

The primary risk factors for stroke are cardiovascular disease, high blood pressure, and abnormal heart rhythms, known as arrhythmias. Arrhythmias allow blood to pool and form a clot in the heart. Additional risk factors for stroke include:

  • diabetes
  • carotid artery disease
  • smoking
  • advanced age
  • a family history of stroke or cardiovascular disease

Some of these risk factors, such as high blood pressure and smoking, are controllable with lifestyle changes and, when needed, medications.

Diagnosis

If you suspect you’re having a stroke, seek emergency medical help right away. A doctor will perform an exam and listen to your heart. If it looks like you’re having a stroke, you’ll have an emergency imaging study. This will help the doctor see what’s happening in your brain. These imaging studies include CT or MRI scans.

These kinds of imaging tests may also be helpful in diagnosing a seizure. Blood tests and a physical exam are also part of the diagnostic process. It’s also important that you or someone who witnessed the seizure can tell the doctor about what happened.

Treatment

If you get to a hospital within three hours with an ischemic stroke, you may be eligible for an injection of tissue plasminogen activator (tPA). It’s known as a clot-busting drug, and it can help restore healthy blood flow. Some people may safely be able to receive tPA up to 4 1/2 hours after a stroke begins. The main risk with tPA is serious bleeding because it interferes with your blood’s clotting ability.

Your doctor can also insert certain device into an artery and guide them to the location of a clot to retrieve the clot and restore blood flow.

Your care after a stroke will depend on the severity of the stroke. Physical therapy is usually required, especially if the stroke compromised your ability to walk or use your hand. Your doctor may also prescribe a blood thinner and blood pressure-lowering medication. You’ll be advised to make lifestyle changes, such as quitting smoking, losing weight, and getting regular exercise when you’re physically able.

Dozens of medicines are available to control and prevent seizures. The right medication for you depends on the type of seizures you have. You may need to try a few different medicines and doses to get the right combination for you. Seizure medications are usually taken daily to help prevent these episodes.

Rest is usually advisable after a seizure. Finding a calm and quiet setting is helpful. It can take hours to recover fully.

Outlook

You can have a mild stroke that leaves you with minimal complications or a more serious stroke that causes permanent disability or even death.

If you receive treatment quickly after a stroke, your odds of a good recovery are much better. If you participate in rehabilitation, you also improve your chances of a full recovery. For some people, stroke recovery is a lifelong journey.

Once you find the right medication to control your seizures, living with epilepsy can be manageable. If epilepsy isn’t the cause of your seizures, you should talk to your doctor about treating the underlying cause of your seizures.

Tips for prevention

If you’ve had a seizure or an episode that you think was a seizure, talk to your doctor about getting a diagnosis. Don’t assume that seizures are inevitable. Be proactive about seeking help to control and prevent seizures.

If you have risk factors for stroke, such as high blood pressure or smoking, take steps now to control those, such as:

  • quitting smoking
  • following a healthy diet
  • exercising at least 150 minutes per week
  • taking medications as prescribed

Seizures and strokes can be serious. However, you may be able to keep them from interfering with your health and quality of life by taking preventive steps and proper care.

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