Medical Conditions Related to Brain Injury: Seizures
Types of Seizures
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What Is A Seizure?
Seizures, sometimes referred to as electrical storms, are the result of abnormal electrical activity in the brain. Affected by certain conditions, or triggers, anyone can experience a seizure. A triggers may involve a blow to the head, drug or alcohol toxicity, missed medication, poor nutrition, infections and high fever, consumption of large amounts of fluid, flashing lights, emotional stress or extreme fatigue, fear, hyperventilation, anxiety etc.
Symptoms of Seizures
- auras
- altered consciousness
- flashing lights in your head
- metallic taste in your mouth
- smell of fragrances that others do not smell
- hearing music that others do not hear
- convulsions
- muscle spasms or twitching
- feeling separate or disconnectedness from others
- feelings of disembodiment or observing yourself from afar
- vague longing or yearning
- raging
- crying or laughing for no apparent reason
Does One Seizure Mean Someone Has Epilepsy?
A single seizure does not equal "epilepsy." In fact, a single seizure caused by the above triggers does not mean that it will ever happen again. However, when seizures recur without any obvious triggers or cause, then a person may be considered to have epilepsy. These triggers or factors do not cause seizures, rather they are thought to lower the threshold so that seizures can occur. A person does not cause seizures to occur at will. Nor can they consciously call up a seizure, nor control one that is already in progress.
Repeated brain seizures characterize a seizure disorder known as epilepsy. Approximately 10 percent of Americans will experience a single seizure episode during their lifetime. Only about 3 percent of these people will go on to develop epilepsy.
Grand Mal Seizures
A grand mal seizure—also known as a tonic-clonic seizure — is a common type of seizure, characterized by loss of consciousness, falling down, loss of bowel or bladder control, and rhythmic convulsions. A typical grand mal seizure consists of a 15- to 20-second period with muscle rigidity (tonic phase), followed by a one- to two-minute period of violent, rhythmic convulsions (clonic phase). During a grand mal seizure, a person may appear bluish as blood oxygen levels lessen due to impaired breathing during the seizure. After the seizure, the person may experience a headache and drowsiness or confusion.
If a generalized convulsion is prolonged (5 or more minutes) or if it is followed by a second seizure before complete recovery (person is awake and interactive), it is time to seek medical assistance.
Temporal Lobe Seizure
Temporal lobe seizures, also known as complex partial seizures, are one of the most common types of seizures in adults. They are considered "partial" because the electrical misfiring involves some but not all of the brain, yet they are complex because they impair one’s consciousness. While the area of brain involved in this seizure activity is predominately the temporal lobe, other parts of the brain can give rise to these seizures.
Most temporal lobe seizures, a form of warning or "aura" precedes the actual seizure. This may take the form of a mental picture, an odor, an unusual sensation, or the perception of a voice or music.
The seizure is characterized by diminished awareness while still conscious, as though the person is on 'auto pilot'. It may include repetitive, non purposeful acts e.g., lip smacking, swallowing, picking at things, or garbled or semi-random speech. After the episode there may confusion lasting few minutes, possibly with sleepiness. The person in this state may walk around, as if with purpose. Sometimes aggressive behavior may be apparent during this phase. Such aggression is not well-focused, not 'thought-out' and can often be avoided by leaving the person alone for a few minutes.
There is total amnesia for the period of the seizure and possibly some amnesia, or loss of memory for events just preceding and following it. In some persons, this type of seizure precedes a generalized convulsion as the electrical signal spreads out from one part of the brain to the entire brain. Half the people with complex partial seizures also have grand mal seizures. Grand mal seizures that occur in someone who has complex partial seizures are called secondary generalized seizures. Repeated seizures characterize a disorder called epilepsy.
Simple Partial Seizures
Seizures that involve only part of the brain are known as partial seizures. And those that do not involve an alteration of awareness are classified as simple. Simple partial seizures commonly follow brain trauma, such as stroke, hemorrhage, malformation, or tumor. They usually involve brief rhythmic cycles of face twitching, accompanied by jerking movements of a hand, arm or leg. Generally, this type of seizure lasts for a few minutes. In some individuals, they signal the onset of a generalized or convulsive seizure. Occasionally, they last for hours or days.
Petite Mal Seizures
Petite mal seizures, also known as absence attacks, or primary generalized seizures, occur almost exclusively in children. Typically they affect people younger than 20, with children between the ages of 6 and 12 most likely to experience them. This type of seizure can run in families. Most children with petit mal seizures have otherwise normal neurological systems. Many can expect to outgrow the disorder.
Petite mal, or absence, seizures are characterized by an abrupt interruption of consciousness without convulsion. During the typical, seconds-long episode there is a zoning out, rarely with chewing, swallowing, or blinking automatisms. The individual usually continues doing what he was doing, despite the seizure, yet his actions are void of intention, automated. Interaction is not possible during the episode. Following the seizure, the child often continues in the activity that engaged him prior to the seizure’s onset as though a lapse did not occur. In their subtlety, petite mals can be easily missed. Sometimes children with these seizure are misdiagnosed with learning or behavioral problems.
Diagnosing Seizure Activity
A person with symptoms described in this article should talk with their doctor. He or she will then ask you about your medical history, inquiring about past seizures experiences in your family to help identify the nature of your symptoms. A number of tests will confirm if seizure activity is the cause of these symptoms:
- Electroencephalography (EEG). This procedure measures the waves of electrical activity your brain produces. Small electrodes are attached to your scalp with paste or an elastic cap while you lie still. You remain still during the test, but at times you may be asked to breathe deeply and steadily for several minutes or to stare at a patterned board. At times, a light may be flashed in your eyes. These actions are meant to stimulate your brain. The electrodes pick up the electrical impulses from your brain and send them to the EEG machine, which records your brain waves on a moving sheet of paper or digitally on a computer screen.
- Magnetic resonance imaging (MRI) or computerized tomography (CT) scan. Images taken of your brain may help determine what's causing your seizures and can rule out other disorders such as a stroke or a brain tumor.
- Blood tests. These tests may reveal a chemical imbalance in your blood or presence of toxic substances. Blood tests may also exclude other causes of seizures.
Treatment for Seizures
If the regularity and intensity of seizures is disruptive or dangerous to a person’s life, your doctor may recommend anti-seizure medication. More than twenty medications are available to treat seizures. If these medicines do not successfully prevent seizures, other methods may be tried, including surgery, a special diet or vagus nerve stimulation (VNS).
What Non-Medical Treatments Help To Prevent Seizures?
Lifestyle management always improves health to some degree, even to reduce one's tendency for seizures. A healthy diet, proper water intake, regular rest and adequate sleep, along with the avoidance of alcohol, caffeine, stimulants, and street drugs will have a beneficial influence.