Seizures (or nervous spasms) are a condition in which a surge of uncontrolled electrical activity occurs between brain cells, causing temporary abnormalities in muscle strength, movements (stiffness, trembling, or sagging), behaviors, sensations, or states of consciousness. This According to the Johns Hopkins University School of Medicine website.
Seizures are not all the same. A seizure can be a single event caused by something severe, such as medications. When a person suffers from recurring seizures, this is known as epilepsy.
Symptoms of seizures vary and can include a sudden change in consciousness or complete loss of consciousness, unusual sensations or thoughts, involuntary twitching or stiffening of the body, or severe stiffness and twitching of the extremities with loss of consciousness (convulsion).
Types of nervous spasms
There are two main categories or groups of seizures:
Firstly. Focal Seizures
secondly. “Generalized-onset Seizures”, which includes the following subtypes
- “Absence Seizures” “Petit Mal Seizures”
- Myoclonic seizures
- Tonic and Atonic Seizures (“Drop Attacks”)
- “Tonic, Clonic and Tonic-Clonic” seizures (formerly called Grand Mal)
Firstly. Focal seizures
Focal seizures begin in one area and can spread across the brain and cause mild or severe symptoms, depending on how the electrical discharges spread.
Focal seizures are also called partial seizures because they start in one area of the brain.
Focal seizures can be caused by any type of focal injury that leaves scar tissue. A medical history or MRI will identify the cause (such as trauma, stroke, or meningitis) in about half of people who have focal seizures.
Developmental scars—those that occur as part of fetal development and early brain development—are common causes of focal seizures in children.
Focal seizures can start in one part of the brain and spread to other areas, causing mild or severe symptoms, depending on how much of the brain is affected.
Initially, a person may notice minor symptoms, referred to as aura. The person may have altered emotions or feel that something is about to happen (a hunch). Some people with aura describe a growing stomach sensation that feels like a roller coaster ride.
As the seizure spreads through the brain, more symptoms appear. If the abnormal electrical activity involves a large area of the brain, a person may feel confused or dazed, or experience slight tremors, muscle stiffness, or grasping or chewing movements. Focal seizures that cause altered consciousness are called nonaware focal seizures or complex partial seizures.
The electrical activity of a seizure can remain in one sensory or motor area of the brain, resulting in a perceived focal seizure (also called a simple partial seizure). The person is aware of what is happening, and may notice unusual sensations and movements.
Focal seizures can develop into major events that spread throughout the entire brain and cause tonic-clonic seizures. These attacks are important for treatment and prevention because they can cause respiratory problems and injuries.
secondly. General seizures
Generalized seizures are waves of abnormal nerve discharges throughout the cerebral cortex at approximately the same time. The most common cause is an imbalance in the “brake” (inhibitory circuits) and “accelerator” (excitatory circuits) of electrical activity in the brain.
Generalized seizures may have a genetic component, but only a few people with generalized seizures have family members with the same condition. There is a slight increased risk of generalized seizures in children or other family members of a person with generalized seizures, but the severity of seizures can vary from person to person. Genetic testing may reveal the cause of generalized seizures.
Generalized seizures can begin as focal seizures that spread to both sides of the brain. They can also occur as “generalized onset” seizures where seizure activity begins simultaneously on both sides of the brain. Generalized seizures usually begin during childhood and are similar to a rising thermostat or a flash of light.
Types of general seizures:
1- Absence seizures (petit mal seizures)
Childhood absence seizures appear as brief staring attacks in children, usually beginning between the ages of four and six. Children usually outgrow these seizures. Absence seizures in children begin a little later and can continue into adulthood; People with these types of seizures may have tonic-clonic seizures in addition to the absence of seizures in adulthood.
2- Myoclonic seizures
Myoclonic seizures consist of sudden twitches of the body or limbs that can include the arms, head, and neck. Spasms occur on both sides of the body in groups, especially in the morning. When these seizures develop in adolescence along with tonic-clonic seizures, they are part of a syndrome called childhood myoclonic epilepsy. People may also experience myoclonic seizures as part of other conditions associated with epilepsy.
3- Tonic and flaccid seizures (“falling seizures”)
Some people, usually those with multiple brain injuries and intellectual disabilities, experience tonic seizures consisting of sudden stiffness in the arms and body, which can cause falls and injuries. Many people with tonic seizures have a syndrome called Lennox-Gastaut syndrome. This condition may involve intellectual disability and multiple types of seizures, including tonic seizures. People with Lennox-Gastaut syndrome can have a characteristic EEG pattern called a pulse and a slow wave.
People with diffuse brain disorders may also experience atonic seizures, characterized by a sudden loss of body tone leading to collapse, often accompanied by injuries. A series of short tonic seizures followed by a relaxed seizure is called a tonic-clonic seizure. Tonic and tonic seizures are often treated with specific medications and sometimes nerve stimulation and diet therapies.
4- Tonic, clonic, and tonic-clonic seizures (formerly called grand mal seizures)
Tonic-clonic seizures can develop from any type of focal or generalized seizure. For example, a focal seizure can spread to both sides of the brain and cause tonic-clonic seizures. A cluster of myoclonic seizures can become persistent and develop into a tonic-clonic seizure. Generalized onset tonic-clonic seizures can occur alone or as part of another syndrome such as juvenile myoclonic epilepsy (JME) or juvenile absence epilepsy during adulthood.
Symptoms of seizures
Symptoms of seizures vary depending on their type and severity, but may include:
- Loss of consciousness.
- Uncontrollable movements (convulsions, muscle spasms, tremors).
- Stare.
- Other symptoms may include:
- Sudden emotional changes (confusion, fear, joy, anxiety).
- Teeth grinding.
- Drooling.
- Abnormal eye movements.
- Loss of bladder or bowel control.
- Making noise (purring or snoring).
- These symptoms are temporary and only last a few seconds to minutes.
Stages of seizures
Stages or phases of seizures include:
- Prodromal phase: Before a seizure, you may notice changes in mood or behavior, feel dizzy or have trouble concentrating. Days before a seizure, you may have trouble sleeping.
- Aura phase: Just before the first symptoms of an attack appear, you may notice vision changes, headache, dizziness, nausea, anxiety or fear, and changes in your senses (such as taste, sound, smell, and feeling).
- Seizure phase: This phase occurs when a seizure occurs. You will experience symptoms of a seizure.
- Post-seizure phase: Immediately after the seizure ends, you may feel confusion, fatigue, pain, strong emotions, and more.
Not everyone who has an attack goes through all the stages, especially aura. Many seizures come on suddenly and you don’t realize any early signs.
Warning signs of a seizure
Warning signs of a seizure may include:
- Sensory symptoms: seeing bright lights or distortions in how things appear, hearing unexpected sounds, sudden unexpected tastes (metallic or bitter) or strange smells and feelings on your skin (numbness or tingling).
- Emotional changes: Strong feelings such as fear or joy, a feeling of repetition of an experience (when a new experience feels familiar in some way) or a feeling of repetition of an experience (when a familiar experience feels new in some way).
- Autonomic symptoms: These symptoms affect the body systems that your brain operates automatically, such as sweating, secreting a lot of saliva (drooling), upset stomach, and pale skin.
Not everyone experiences warning signs before a seizure occurs.
Treating seizures
Treatment for seizures varies based on the type, severity, and cause. Your health care provider may recommend the following:
- Managing any underlying causes or conditions: Your health care provider will first treat any underlying conditions, such as stroke or low blood sugar. This may prevent future attacks, according to the Cleveland Clinic.
- Take anti-seizure medications: Medications may help prevent seizures or reduce their frequency.
- Surgery: Surgery may reduce the frequency and severity of seizures by treating the area in your brain where seizures start (focal point).
- Brain stimulation: Your surgeon will implant a device in your brain to deliver a mild electrical current. The current interferes with the abnormal electrical activity and attempts to stop it. There are different types of brain stimulation available, such as vagus nerve stimulation.
- If certain types of treatment don’t work, your health care provider may recommend changing the foods you eat. A low-carb or no-carb (keto) diet may reduce the frequency of your seizures. Studies are underway to learn more about the effectiveness of dietary changes in relation to seizures.
Seizure medications
Medications can help you manage seizures by:
- Stop the seizure while it is occurring.
- Prevent future seizures.
- Reducing the severity of seizures.
- Reducing the frequency of seizures.
Common medications for seizures include but are not limited to:
Benzodiazepine.
- Carbamazepine.
- Diazepam.
- Gabapentin.
- Lamotrigine.
- Oxcarbazepine.
- Phenytoin.
- Pregabalin.
- Valproic acid.
Your health care provider will give you regular follow-up appointments after you start taking a new medication to measure its effectiveness. It may take several months before you and your caregiver find the right medication and dose for you. Always continue to take your medications as directed, even if you feel better.
Studies show that an estimated 33% of people who take anti-seizure medications see their seizure symptoms stop completely. Another 33% say they see symptoms less frequently after taking anti-seizure medications.
Can seizures be prevented?
Seizures are unpredictable, so they cannot be completely prevented. The best thing you can do is avoid potential causes or triggers, such as managing your blood glucose levels or protecting yourself from illness and injury.