What are seizures?
Seizures are changes in the brain’s electrical activity. These changes can cause dramatic, noticeable symptoms, or in other cases no symptoms at all.
The symptoms of a severe seizure include violent shaking and a loss of control. However, mild seizures can also be a sign of a significant medical problem, so recognizing them is important.
Because some seizures can lead to injury or be a sign of an underlying medical condition, it’s important to seek treatment if you experience them.
The International League Against Epilepsy (ILAE) introduced updated classifications in 2017 that better describe the many different types of seizures. The two major types are now called focal onset seizures and generalized onset seizures.
Focal onset seizures
Focal onset seizures used to be referred to as partial onset seizures. They occur in one area of the brain.
If you know that you’re having a seizure, it’s called a focal aware seizure. If you’re unaware when the seizure occurs, it’s known as a focal impaired awareness seizure.
Generalized onset seizures
These seizures start in both sides of the brain simultaneously. Among the more common types of generalized onset seizures are tonic-clonic, absence, and atonic.
- Tonic-clonic: These are also known as grand mal seizures. “Tonic” refers to muscle stiffening. “Clonic” refers to the jerky arm and leg movements during the convulsions. You will likely lose consciousness during these seizures that can last for a few minutes.
- Absence: Also called petit-mal seizures, these last for only a few seconds. They can cause you to blink repeatedly or stare into space. Other people may mistakenly think you’re daydreaming.
- Atonic: During these seizures, also known as drop attacks, your muscles suddenly go limp. Your head may nod or your entire body could fall to the ground. Atonic seizures are brief, lasting about 15 seconds.
Unknown onset seizures
Sometimes no one sees the beginning of a seizure. For example, someone may wake up in the middle of the night and observe their partner having a seizure. These are called unknown onset seizures. They are unclassified because of insufficient information about how they started.
You can experience both focal and generalized seizures at the same time, or one can happen before the other. The symptoms can last anywhere from a few seconds to 15 minutes per episode.
Sometimes, symptoms occur before the seizure takes place. These can include:
- a sudden feeling of fear or anxiousness
- a feeling of being sick to your stomach
- a change in vision
- a jerky movement of the arms and legs that may cause you to drop things
- an out of body sensation
- a headache
Symptoms that indicate a seizure is in progress include:
- losing consciousness, followed by confusion
- having uncontrollable muscle spasms
- drooling or frothing at the mouth
- having a strange taste in your mouth
- clenching your teeth
- biting your tongue
- having sudden, rapid eye movements
- making unusual noises, such as grunting
- losing control of bladder or bowel function
- having sudden mood changes
Seizures can stem from a number of health conditions. Anything that affects the body also may disturb the brain and lead to a seizure. Some examples include:
- alcohol withdrawal
- a brain infection, such as meningitis
- a brain injury during childbirth
- a brain defect present at birth
- drug abuse
- drug withdrawal
- an electrolyte imbalance
- electric shock
- extremely high blood pressure
- a fever
- head trauma
- kidney or liver failure
- low blood glucose levels
- a stroke
- a brain tumor
- vascular abnormality in the brain
Seizures can run in families. Tell your doctor if you or anyone in your family has a history of seizures. In some instances, especially with young children, the cause of the seizure may be unknown.
If you don’t get treatment for seizures, their symptoms can become worse and progressively longer in duration. Extremely long seizures can lead to coma or death.
Seizures also can lead to injury, such as falls or trauma to the body. It’s important to wear a medical identification bracelet that tells emergency responders that you have epilepsy.
Doctors can have a difficult time diagnosing seizure types. Your doctor may recommend certain tests to diagnose a seizure accurately and to help ensure that the treatments they recommend will be effective.
Your doctor will consider your full medical history and the events leading up to the seizure. For example, conditions such as migraine headaches, sleep disorders, and extreme psychological stress can cause seizure-like symptoms.
Lab tests may help your doctor rule out other conditions that can cause seizure-like activity. The tests may include:
- blood testing to check for electrolyte imbalances
- a spinal tap to rule out infection
- a toxicology screening to test for drugs, poisons, or toxins
An electroencephalogram (EEG) can help your doctor diagnose a seizure. This test measures your brain waves. Viewing brain waves during a seizure can help your doctor diagnose the type of seizure.
Treatments for seizures depend on the cause. By treating the cause of the seizures, you may be able to prevent future seizures from occurring. The treatment for seizures due to epilepsy include:
- surgery to correct brain abnormalities
- nerve stimulation
- a special diet, known as a ketogenic diet
With regular treatment, you can reduce or stop seizure symptoms.
Clear the area around a person who’s having a seizure to prevent possible injury. If possible, place them on their side and provide cushioning for their head.
Stay with the person, and call 911 as soon as possible if any of these apply:
- The seizure lasts longer than three minutes.
- They don’t wake up after the seizure
- They experience repeat seizures.
- The seizure occurs in someone who is pregnant.
- The seizure occurs in someone who has never had a seizure.
It’s important to remain calm. While there’s no way to stop a seizure once it’s begun, you can provide help. Here’s what the American Academy of Neurology recommends:
- As soon as you start noticing the symptoms of a seizure, keep track of time. Most seizures last between one to two minutes. If the person has epilepsy and the seizure lasts longer than three minutes, call 911.
- If the person having the seizure is standing, you can prevent them from falling or injuring themselves by holding them in a hug or gently guiding them to the floor.
- Make sure they’re away from furniture or other objects that could fall on them or cause injury.
- If the person having the seizures is on the ground, try to position them on their side so that saliva or vomit leaks out of their mouth instead of down their windpipe.
- Don’t put anything into the person’s mouth.
- Don’t try to hold them down while they’re having a seizure.
After the seizure
Once a seizure is over, here’s what to do:
- Check the person for injuries.
- If you couldn’t turn the person onto their side during their seizure, do so when the seizure is over.
- Use your finger to clear their mouth of saliva or vomit if they’re having trouble breathing, and loosen any tight clothing around their neck and wrists.
- Stay with them until they’re fully awake and alert.
- Provide them with a safe, comfortable area to rest.
- Don’t offer them anything to eat or drink until they’re fully conscious and aware of their surroundings.
- Ask them where they are, who they are, and what day it is. It may take several minutes to become fully alert and be able to answer your questions.
It can be challenging to live with epilepsy. But if you have the right support, it’s possible to live a full and healthy life.
Educate friends and family
Teach your friends and family more about epilepsy and how to care for you while a seizure is occurring.
This includes taking steps to reduce the risk of injury like cushioning your head, loosening tight clothing, and turning you on your side if vomiting occurs.
Find ways to maintain your current lifestyle
Continue your usual activities if possible, and find ways to work around your epilepsy so you can maintain your lifestyle.
For instance, if you’re no longer allowed to drive because you have seizures, you may decide to move to an area that’s walkable or has good public transportation or use ride-share services so you can still get around.
If you live with someone with epilepsy, there are some things you can do to help that person:
- Learn about their condition.
- Make a list of their medications, doctors’ appointments, and other important medical information.
- Talk to the person about their condition and what role they would like you to play in helping.
If you need help, reach out to their doctor or an epilepsy support group. The Epilepsy Foundation is another helpful resource.
In many instances, a seizure isn’t preventable. However, maintaining a healthy lifestyle can give you the best chance at reducing your risk. You can do the following:
- Get plenty of sleep.
- Eat a healthy diet and stay well hydrated.
- Exercise regularly.
- Engage in stress-reducing techniques.
- Avoid taking illegal drugs.
If you’re on medication for epilepsy or other medical conditions, take them as your doctor recommends.