Seizure
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Seizures (or convulsions) are temporary alterations in brain function expressing themselves into a changed mental state, tonic or clonic movements and various other symptoms. They are due to temporary abnormal electrical activity of a group of brain cells.
The treatment of seizures is a subspecialty of neurology; the study of seizures is part of neuroscience.
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Signs and symptoms
Seizures can cause involuntary changes in body movement or function, sensation, awareness, or behavior. A seizure can last from a few seconds to status epilepticus, a continuous seizure that will not stop without intervention. Seizure is often associated with a sudden and involuntary contraction of a group of muscles. However, a seizure can also be as subtle as marching numbness of a part of body, a brief loss of memory, sparkling of flashes, sniffing an unpleasant odor, a strange epigastric sensation or a sensation of fear. Therefore seizures are typically classified as motor, sensory, autonomic, emotional or cognitive.
There are more than 20 different types of seizures. Seizures are often associated with epilepsy and related seizure disorders, although head trauma, intoxication, infection, metabolic disturbances, withdrawal symptoms (from sedatives such as alcohol, barbiturates and benzodiazepines) and space-occupying processes in the brain (abscesses, tumors) may also cause them. Seizures in (or shortly after) pregnancy can be a sign of eclampsia.
Some medications produce an increased risk of seizures and electroconvulsive therapy (ECT) deliberately sets out to induce a seizure. Many seizures have unknown causes.
Symptoms experienced by a person during a seizure depend on where in the brain the disturbance in electrical activity occurs. Some seizures may be frightening to onlookers. A person having a tonic-clonic seizure (also known as a grand mal seizure) may cry out, lose consciousness and fall to the ground, and convulse, often violently. A person having a complex partial seizure may appear confused or dazed and will not be able to respond to questions or direction. Some people have seizures that are not noticeable to others. Sometimes, the only clue that a person is having an absence (petit mal) seizure is rapid blinking or a few seconds of staring into space.
Types
Some seizure types are:
- petit mal seizure (an absence seizure, or very brief loss of consciousness)
- partial (focal) seizure (usually a motor or sensory seizure that is restricted to one side of the body)
- partial complex seizure (characterized by brief loss of consciousness, behavioral, emotional symptoms, loss of memory and automatisms; temporal lobe and frontal lobe seizures are often in this category)
- generalized tonic-clonic seizure (grand mal seizure; motor seizure of both sides of the body)
- atonic seizure (also known as a "drop attack"), during which brief loss of muscle tone and consciousness cause abrupt falls.
It is still disputable whether a febrile seizure has to be regarded as an epileptic disorder or not. In general, a patient with two or more episodes of seizures is accepted to have epilepsy (a condition also known as a seizure disorder.) Many people with epilepsy perceive "auras": telltale sensations such as strange lights, unpleasant smells or odd sensations before their seizures.
A person who is going into seizures of any kind continuously, with little or no time separating one from the next, is said to be in "status epilepticus." This is the most dangerous situation possible with regard to seizures. It requires immediate emergency intervention, usually through the injection of appropriate anti-seizure drugs, or the person will die. When the person in "status" is pregnant, the stakes are even higher.
Diagnosis
An isolated abnormal electrical activity recorded by an electroencephalography examination without a clinical presentation is not called a seizure. Nevertheless, they may identify background epileptogenic activity, as well as help identify particular causes of seizures.
Management
If an individual has a grand mal seizure (generalized), the first thing witnesses must do is calm down, stop panicking (an understandable reaction, though), and help the victim. They need to ensure that the victim's airway is clear and open to maintain breathing. This may be ensured by putting the individual into a semi-supine position and applying strong upward pressure on the chin. Potentially sharp or dangerous objects should also be moved from the vicinity, so that the individual does not hurt him or herself. Witnesses also need to summon paramedics so that any injuries sustained during the seizure can be treated and the victim can be monitored in a safe hospital environment for subsequent seizures or status epilepticus.
External links
- MEDLINEplus: Seizures (http://www.nlm.nih.gov/medlineplus/seizures.html)