A seizure is a result of sudden electrical malfunction in the brain that causes the patient to convulse, collapse or have a loss of consciousness. Symptoms depend on what part of the brain is affected.
Classifications and symptoms
Generalized seizures (or local seizures) affect both hemispheres of the brain and are further classified into categories.
- Absence seizures (or petit mal seizures) cause a short loss of consciousness. This type of seizure begins without no warning. Patients are not usually aware they are having a seizure. Symptoms include muscle twitching in the eyelid and face, with muscle tone loss.
- Atonic seizures (or '"drop attack) cause sudden and complete muscle tone loss. This type of seizure results in head drops, a collapse or involuntarily throwing objects.
- Myoclonic seizure cause muscles in the body to contract in rapid and brief motions. If violent, a patient may involuntarily throw objects.
- Tonic-clonic seizure (or grand mal seizure) affects the whole body. This is the most common and well-known of all types. Symptoms include loss of consciousness, collapse, stiffening of the body, violent muscle contractions and difficulty in breathing. Tongue biting and urinary incontinence may occur during tonic-clonic seizures.
Partial seizures (or focal seizures) affect one hemisphere of the brain and can be classified further as:
- Simple partial seizures do not cause a loss of consciousness but impair movement and sensations. Symptoms include shaking of hand or foot on one side of the body, abnormal facial movements, nausea, sweating and memory disturbances.
- Complex partial seizures affect a large part of the brain and cause loss of consciousness or altered consciousness. Symptoms include unusual behavior, fear and repetitive motions.
Non-Epileptic Seizures are similar to epileptic seizures. Symptoms begin gradually and include abnormal posture and convulsions.
Status Epilepticus refer to a serious seizure disorder that happens when a patient experiences one seizure after another. Symptoms include severe muscle contractions, difficulty in breathing and can cause brain damage if untreated.
Causes and risk factors
Epileptic seizures occur without warning and often recurs, resulting in a seizure disorder known as epilepsy.
Non-epileptic seizures often occur when the brain is irritated. Triggers of brain irritation include:
- accidental poisoning
- brain tumor or brain lesions (e.g. bleeding)
- congenital birth defects
- drug overdose
- high fever
- high stress
- infection (brain abscess, meningitis, encephalitis, neurosyphilis, or AIDS)
- kidney or liver failure
- low blood sugar levels
- prescription medications
- rapidly flashing lights
- sleep deprivation
- sudden lack of oxygen
- traumatic head injury
One of the most common complications of seizures is injury to the head or the body due to falling or a sudden collapsing. Aspiration is a possible complication if vomit during the episode gets secreted into the lungs. Biting of the tongue or inside of the cheeks might occur.
Drowning is another complication of seizures, as epileptics are 15 times more likely to drown than those without seizures.
Continuous seizures may result in brain damage or death.
Diagnosis and tests
A doctor evaluates the seizure through a careful assessment of the patient's medical history. The doctor also performs a physical examination and conducts blood tests. Other diagnostic tools include an electroencephalogram (EEG), which traces brain waves during or between seizures to reveal patterns that can help the doctor determine whether the patient does or does not have epilepsy. Imaging evaluations such as a head CT scan or magnetic resonance imaging (MRI) can be used to search for any growths, lesions or other conditions in the brain that may be the cause for the seizures. Positron emission tomography (PET) is used in some research centers to determine areas of the brain producing the seizures.
- Medications. Most seizures can be treated for as long as medications are taken regularly. Prescriptions depend on what kind of seizure a patient has.
- Surgery. The surgical removal of parts of the brain that trigger seizures is another form of treatment. It has been practiced for over 50 years.
- Vagus Nerve Stimulation. Short burts of electricity are directed into the brain via the vagus nerve. Its effect on preventing seizures is still being studied.
Treating the patient at home is appropriate when the patient is known to experience seizures, and if his seizures are brief. According to the Philippine League Against Epilepsy, the following steps can be done when helping out a patient during an acute seizure episode:
- Stay calm.
- Loosen clothing around neck.
- Turn the patient's head to one side to avoid choking and/or aspiration.
- Do not hold the patience down or shake and slap in an attempt to rouse him, as they can injure the patient.
- Do not put anything inside the patient's mouth.
- Call a doctor when it is a first time seizure, of if the seizure recurs or is prolonged (more than 5 minutes)
Taking prescribed anti-seizure medication regularly can help prevent recurrent seizures. The removal of brain tissue where seizures take place is also a preventive measure. For those with severe cases of epilepsy, a special diet is advised to alter body chemistry. Avoiding conditions known to trigger seizures (such as bars with rapid, flashing lights, sleep deprivation) can help prevent seizures from occurring.
Seizures in the Philippines
The following medical centers in the Philippines have available Neurology/Seizure clinics:
- Jose Reyes Memorial Hospital
- Makati Medical Center
- Philippine Children's Medical Center Seizure Clinic
- St. Luke's Medical Center: Comprehensive Epilepsy Program
- UERM Seizure Clinic
- UP-PGH Seizure Clinic
- UST Hospital Seizure Clinic
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- Easing the Seizures, and Stigma, of Epilepsy. The New York Times. (Accessed 23 December 2010)
- Seizures - Overview. University of Maryland Medical Center. (Accessed December 23, 2010)
- Types of Seizures and Seizure Symptoms. WebMD. (Accessed December 23, 2010)* Mayo Clinic Finds Seizure Generation in Brain is Isolated from Surrounding Brain Regions. Mayo Clinic. (Accessed December 23, 2010)
- Advances in Seizure Prevention and Prediction. Mayo Clinic. (Accessed December 23, 2010)*
- Myths and prejudices about epilepsy The Philippine Online Chronicles. (Accessed December 23, 2010)
- What you should know about Epilepsy. Philippine League Against Epilepsy. (Accessed December 23, 2010)