Do you also want to know about this kind of severe and convulsive 'seizure'? Let's talk!

Sometimes you may have seen someone suddenly lose consciousness, convulse, and fall down with mucus coming out of their mouth. Or maybe you have experienced it yourself. This is what we call a seizure. It can be a scary thing. But when you know what it is, there is nothing to be afraid of. Let's see what a seizure is, why it happens, and what to do.

What is this 'seizure'?

Simply put, a seizure is a sudden, abnormal increase in electrical activity between the nerve cells (neurons) in your brain. Think of your brain as a small electrical system. Sometimes this can cause a 'short circuit'. This is when these symptoms appear. Not everyone has a seizure in the same way. Some people may lose consciousness and have convulsions. Others may not, but instead stop what they are doing and stare blankly for a while. They may even feel like their arms or legs are twitching. Some people only have one seizure in their lifetime. Others may have them several times a day. So your experience may be very different from someone else's.

What are the main types of seizures?

Now let's see what the main types of seizures are. There are two main types:

1. Generalized seizures (or generalized onset seizures): This is when electrical activity starts in both sides of the brain at the same time. You may have jerks on both sides of your body, or just one side. Sometimes you may just stand there without any jerks. This type is usually more common in young children and teenagers, but it can happen to anyone of any age.

2. Focal seizures (or focal onset seizures): In this type of seizure, the electrical activity starts on one side of the brain, or in one specific area (a "focus"). Symptoms usually affect one side of the body. You may or may not be conscious during this time. This means you may or may not remember the seizure. Focal seizures can sometimes stop, or they can spread to both sides of the brain.

What are the types of seizures that affect the entire brain (`Generalized seizures`)?

Let's now look in more detail at the different types of seizures that affect the entire brain (`Generalized seizures`).

• `Absence seizures`: In this, you suddenly stop what you were doing, stare blankly, and seem to be unable to hear anything for a while. It's like you've 'gone out of the world' for a while. This goes away on its own in a few seconds.
• `Atonic seizures` (also called `drop seizures`): In this, the body suddenly loses muscle control and falls to the ground.
• `Clonic seizures`: In this, both sides of the body jerk, and there may be loss of consciousness. Sometimes only one side of the body may jerk, and then there may be no loss of consciousness.
• `Myoclonic seizures`: In this, a single muscle or several muscles connected together suddenly jerk. It's like a small jolt, like an electric shock.
• `Secondary generalized seizures`: In this, electrical activity first starts in one part of the brain (`focal seizure`), and then spreads to the entire brain (`generalized seizure`).
• `Tonic-clonic seizures`: This is the type that most people think of when they hear the word `seizure.` First, the muscles of the body stiffen (`tonic phase`), then unconsciousness and the whole body begins to shake (`clonic phase` - `convulsions`).
• Tonic seizures: In this, there is loss of consciousness and the muscles of the body become stiff, but the jerking (convulsions) do not occur.

What are the types of seizures that affect only one part of the brain (`Focal seizures`)?

Now let's look at the types of seizures that affect only one part of the brain (`Focal seizures`).

• Focal seizures (formerly known as simple partial seizures): In this type of seizure, you are aware of what is happening, meaning you feel it, and remember it afterwards.
• Focal seizures (formerly known as complex partial seizures): When a seizure occurs, you lose consciousness, become unaware of your surroundings, and have no memory of what happened afterward.

How common are seizures?

You might be wondering how common these seizures really are. Worldwide, it's estimated that about one in every 10 people will experience at least one seizure in their lifetime. So this isn't all that unusual.

What are the symptoms of a seizure?

The symptoms of a seizure vary depending on the type and severity of the seizure, but common symptoms include:

• Loss of consciousness.
• Uncontrollable body movements (convulsions, muscle spasms, jerking).
• Staring, without looking at anything .

In addition to this, there may be other characteristics:

• Sudden changes in emotions (confusion, fear, happiness, anxiety).
• Toothpick.
• Drooling.
• Eyes moving around unnaturally.
• Loss of urinary or bowel control.
• Making strange noises (like grunting, snorting).

But remember, these symptoms are temporary . They usually last from a few seconds to a few minutes.

What are the stages of a seizure?

Some seizures have several distinct stages, but not everyone experiences all of these stages.

1. Prodrome phase: A few days before the seizure, you may notice changes in your mood and behavior. You may feel dizzy, have difficulty concentrating, or have trouble sleeping.

2. Aura phase: You may experience some signs before the first symptoms of a seizure begin. These may include changes in vision (seeing bright lights, seeing things distorted), headaches, dizziness, nausea, feelings of fear, anxiety, and changes in your senses (changes in taste, smell, sound, and touch).

3. Ictal phase: This is when the seizure actually occurs. This is when you will experience the symptoms mentioned earlier.

4. Postictal phase: Once the seizure is over, you may experience confusion, extreme fatigue, body aches, and strong emotions (sadness, anger, happiness).

The important thing is that not all seizures have this pre-signal phase called ``Aura.`` Most often, seizures come on suddenly, without any warning.

What are the warning signs before a seizure?

Some people may experience warning signs before a seizure occurs, but this is not common for everyone.

• Sensory symptoms: seeing bright lights, seeing things differently, suddenly hearing strange sounds, suddenly feeling strange tastes (such as metallic, bitter) or smells, strange sensations in the skin (such as numbness or tingling).
• Emotional changes: Sudden onset of strong emotions (fear, happiness), feeling like something has happened before even though it is new (`déjá vu`), or feeling like something new even though it is very familiar (`jamais vu`).
• Autonomic symptoms: These are symptoms that affect the body systems that are automatically controlled by your brain. Examples include sweating, drooling, an upset stomach, and pale skin.

What are the causes of seizures?

Why do seizures occur? As I mentioned earlier, the main cause of this is a sudden, abnormal, uncontrolled increase in electrical activity between the nerve cells (`Neurons`) in your brain. These nerve cells communicate with each other through electrical signals. During a seizure, the affected brain cells send these signals to other cells in the surrounding area without control. This excessive spread of electrical activity is what causes the symptoms of a seizure.

The causes of seizures can be divided into two main categories:

1. Provoked seizures (or nonepileptic seizures): These are caused by a temporary condition or a specific event (called a trigger). This means that the seizure is triggered by something.

2. Unprovoked seizures (or epileptic seizures): These occur spontaneously, without any apparent cause. They can occur frequently. These seizures are the main symptom of the condition called epilepsy.

Sometimes, no clear cause can be found for seizures. We call these `idiopathic seizures`.

What are the triggers for a seizure?

There are not the same triggers for everyone, but here are some common ones:

• Abnormal blood sugar levels (too low or too high).
• Some medications (such as `Wellbutrin®` or `bupropion`).
• Bright, flashing or flickering lights.
• Heat illness.
• High fever.
• Sleep deprivation.
• Stress.
• Drug or alcohol use (especially withdrawal symptoms when stopping alcohol).

If you have frequent seizures, it is very important to keep a record of what you were doing and what your environment was like before the seizure. This information will help your doctor figure out what your triggers are.

What other medical conditions can cause seizures?

Seizures can be caused by a variety of other medical conditions. Here are a few examples:

• Abnormalities in the blood vessels of the brain (`Aneurysms`).
• Brain tumors.
• Lack of oxygen to the brain (`Cerebral hypoxia`).
• Cerebrovascular disease.
• Diabetes.
• Severe head injuries (`Severe concussion` and `traumatic brain injury`), especially in cases of loss of consciousness.
• Diseases that gradually weaken the brain, for example, Alzheimer's disease or frontotemporal dementia.
• High blood pressure and seizures (`Eclampsia`) during pregnancy.
• Electrolyte problems, especially low levels of sodium (hyponatremia), calcium, or magnesium.
• Epilepsy - This is characterized by frequent seizures without an obvious cause.
• Genetic conditions.

There may be other reasons:

• Hormonal changes (`Hormone-related changes`).
• Infections (especially encephalitis, meningitis, or sepsis).
• Inflammation from autoimmune conditions.
• Mental health problems (called `psychogenic seizures`), for example `conversion disorder`.
• Problems with brain development that occur at birth (`Congenital brain abnormalities`).
• Strokes.
• Ingestion of toxins (carbon monoxide poisoning, heavy metal poisoning).
• Snakebites or other venomous animal bites.

Who is at higher risk of developing seizures?

Anyone, at any age, can have a seizure. However, some people are at a slightly higher risk:

• For those with other medical conditions.
• If someone in the family has had seizures (genetic influence).
• For children (under 18 years old).
• For those over 50 years old.

What are the possible complications of seizures?

During a seizure, there is a high risk of injury , as people often lose consciousness and fall. Accidents can occur when falling, or while doing something else (such as driving a vehicle, operating machinery, or climbing a height). When the body jerks, limbs can hit hard objects, resulting in cuts, bruises, and even broken bones.

Status epilepticus is a dangerous condition. It occurs when a seizure lasts for more than five minutes, or when another seizure occurs before the person has fully recovered from one seizure. This is a life-threatening medical emergency. It can cause brain damage and even death.

There is also a strong connection between seizures and mental health. People who have seizures are more likely to develop mental health problems such as anxiety and depression . This is because seizures can interfere with daily activities and the things they enjoy. You may feel anxious and worried about having another seizure. You may not be able to sleep at night wondering when the next one will come. If you have a seizure in front of others, you may feel embarrassed and may not want to go out or spend time with friends. Since seizures are something that happens outside of your control, it is normal to have these feelings. A mental health counselor can help you manage these feelings.

How do you recognize a seizure?

A doctor, usually a neurologist, diagnoses a seizure. This involves a physical exam, a neurological exam, and other tests. During these tests, the doctor will ask about your symptoms, your medical history, and whether anyone in your family has had similar conditions.

It is very helpful to bring someone who witnessed your seizure with you to see the doctor. Since you may not remember what happened at the time, that person can tell the doctor the details.

What tests are done to diagnose seizures?

These tests help confirm whether you are actually having a seizure, and if so, what caused it. One of the most important things in diagnosing a seizure is to find out if there is a specific place in the brain (`focal point`) where the seizure begins. Once this `focal point` is found, it is easier for the doctor to plan treatment.

Here are some of the tests used to diagnose seizures:

• Blood tests.
• CT scan (`Computed tomography (CT) scan`).
• EEG test (`Electroencephalogram (EEG)`). This measures the electrical activity of the brain.
• Genetic tests.
• MRI scan (Magnetic resonance imaging (MRI)).
• PET scan (Positron emission tomography (PET) scan).
• Spinal tap or lumbar puncture.

If the doctor suspects that there is an injury or complication caused by the seizure, he or she may also order tests. The doctor will tell you (or someone who makes medical decisions for you) what tests are being done and why.

What are the treatments for seizures?

Treatment for seizures varies depending on the type, severity, and cause. Your doctor may suggest treatments such as:

• Treating the underlying cause or condition: The doctor will first try to treat the underlying condition that caused the seizure (such as a stroke or low blood sugar). This may help prevent future seizures.
• Taking antiseizure medications: These medications can stop seizures or reduce the frequency of seizures.
• Surgery: Removing or modifying the focal point in the brain where seizures begin can reduce the frequency and severity of seizures.
• Brain stimulation: A surgeon inserts a small device into your brain. This delivers an electrical current to the brain. This current disrupts the abnormal electrical activity and tries to stop it. There are several types of brain stimulation, one example is vagus nerve stimulation.

If some treatments don't work, your doctor may suggest changing your diet. Some studies have shown that a low-carb or ketogenic diet can reduce the frequency of seizures. However, this is still being researched.

What are the medications used for seizures?

Medications can help manage seizures by:

• It stops as soon as a seizure occurs.
• Prevents future seizures.
• Reduces the severity of seizures.
• Reduces the frequency of seizures.

Here are some common medications for seizures (these are just examples; your doctor will determine which medication is right for you):

• `Benzodiazepine`
• `Carbamazepine`
• `Diazepam`
• `Gabapentin`
• `Lamotrigine`
• `Oxcarbazepine`
• `Phenytoin`
• `Pregabalin`
• `Valproic acid`

After you start a new medication, your doctor will check you regularly to see how well it is working. It may take several months for you and your doctor to find the right medication and dosage. Even if you feel better, it is very important to continue taking your medication as your doctor tells you.

Studies show that about 33% of people who take antiseizure medications experience complete relief from their seizure symptoms. Another 33% report that their symptoms decrease in frequency after taking the medication.

Can seizures be prevented?

Because seizures are a sudden event, they cannot be completely prevented. The best thing you can do is to avoid things that can cause seizures, or `triggers`. For example, control your blood sugar levels, and protect yourself from illnesses and injuries.

What happens if I have a seizure? What should I expect?

Less than half of people who have had one seizure without a cause will have another. However, if a second seizure occurs, doctors usually start antiseizure medications. In a provoked seizure, the risk of having another seizure depends on what caused the first seizure. If that cause can be treated, you are less likely to have another seizure (unless the same situation that caused the first seizure reoccurs).

Medications can stop seizures or reduce their frequency. However, sometimes you have to try several medications (or a combination of medications) to find the one that works for you.

In some cases, seizures may be difficult to control with medication alone. In such cases, the doctor may recommend surgery, a special diet, or other treatments.

If you have frequent seizures, your doctor will tell you about precautions that can help you stay safe. You can wear or carry a medical ID bracelet or card. This will let others know what to do if you have a seizure.

How long has it been since you had a seizure?

Seizure symptoms usually last from a few seconds to a few minutes, with a maximum duration of 15 minutes. However, if several seizures occur in a row (this is a medical emergency), symptoms may last longer.

What will my future outlook be for seizures?

Because everyone's seizure experience is different, the outlook can vary greatly. It depends on several factors:

• Did you find a reason?
• Can that cause be treated and managed?
• What type of seizure did you have?
• How severe was the seizure and how long did it last?
• Is this your first seizure?
• Do you have an underlying medical condition for which seizures are a common symptom?
• What treatments are available to manage this type of seizure?

Your doctor is the best person to give you the most up-to-date information about what to expect. Be sure to ask him or her if you have any questions.

When should I see a doctor?

If you have a seizure for the first time in your life , or if you lose consciousness and don't know the cause, you should definitely go to the emergency room . If you are alone and think you are having a seizure for the first time, you should see or talk to a doctor as soon as possible.

If you have had a seizure before, it is important to be aware of the signs of another one. If you have a second seizure, it is very important to see a doctor as soon as possible. This is because seizures can cause changes in your brain, making it more likely to have another seizure. Therefore, it is best to get a diagnosis and start treatment as soon as possible.

If someone has frequent seizures, it may not be necessary to call an ambulance after each seizure. However, even if you know why you had the seizure, the injuries caused by it may still require medical attention.

What questions should I ask my doctor?

If you have a seizure, you can ask your doctor questions like these:

• Why did I have this seizure?
• How do I avoid `triggers`?
• What kind of treatment do you recommend for me?
• Are there any side effects of the treatment?
• Will I have another seizure?
• How can I stay safe?

What types of seizures affect children?

Children can have seizures too. The same causes of seizures in adults often affect children. Here are some of the most common types of seizures and seizure disorders in children (these are just examples):

• Absence seizures (also called childhood absence epilepsy).
• Epilepsy in children.
• Febrile seizures.
• Infantile spasms.
• Juvenile myoclonic epilepsy.
• `Lennox-Gastaut syndrome`.
• `Tonic-clonic seizures`.

Is it safe to get pregnant if I have seizures?

Yes, you can have a safe pregnancy if you have epilepsy. But your doctor will want to check you and your baby's health regularly. Some anti-epileptic drugs are not suitable for use during pregnancy. Your doctor will then be able to give you safer alternative medications to help control your symptoms. If you have any questions or concerns about this, the best person to talk to is your doctor.

While seizures may seem like something you see on TV or in movies, they may be something you or a loved one experience every day, or even more often. They are actually unpleasant to experience, and even more frightening to watch. You may feel like you are not yourself before, during, and after a seizure, and it can take time to recover.

Even if your seizures are out of your control, a doctor can help you deal with the symptoms early. Your doctor may teach you ways to manage your underlying condition, or help you identify and avoid triggers. Medications can help reduce frequent seizures, and surgery may be an option if other treatments don't work.

What are the most important things we want to take home from this story? (Take-Home Message)

Okay, so here are some things to keep in mind from what we've talked about:

• A seizure is an abnormality in the electrical activity of the brain. Although it can be scary, there are treatments available depending on the cause and type.
• Not all seizures are the same. Some people have jerking movements, some people just stare at you. The symptoms can vary greatly.
• If you have a seizure for the first time without any reason, or if you lose consciousness, seek medical advice immediately. Even if it happens a second time, see a doctor immediately.
• It is very important to take the medication prescribed by your doctor exactly and on time. Don't stop taking it on your own.
• Find out what your `triggers` are and try to avoid them.
• You are not alone. There are doctors, family, and friends who can help and support people with seizures. Take care of your mental health too.
• Status epilepticus (seizures lasting more than 5 minutes or continuous seizures) is a medical emergency. It requires immediate hospitalization.

If you or someone you know has any further questions about seizures, don't be afraid to talk to a doctor. They will help you.

` Seizure, Epilepsy, Brain Disease, Neurological Disease, Symptoms