SEIZURES: Explained in Simple Terms

A seizure is an outward manifestation of an abnormality in the brain. Seizures happen when there is abnormal and excessive electrical activity in the brain.

Let’s break this down:

The brain has many cells known as neurons. These neurons are in charge of transmitting information to other cells of the body and help us to respond appropriately to our environment.

You can think of each neuron as having two “switches:”

• An “ON” switch (excitatory switch) and
• An “OFF” switch (inhibitory switch).

The switches regulate each neuron and make sure that it does not transmit signals unnecessarily. A normally functioning brain is in a constant balance between on and off. This way, it’s able to respond to the environment without getting overstimulated.

When a group of neurons is perpetually switched on (excited) and excessively transmits information at the same time, it can result in a seizure.

Causes of Seizure

·       Genetics

Although, in some cases, there is a relative who also has (or has had) seizures, seizure disorders are not necessarily familial. This means that a person who does not have a family history of seizures can have a seizure. They may have abnormalities in their genes that can cause them to have seizures.

·       Trauma

People who have suffered head injuries in the past may develop seizures depending on the impact and severity of the injury. Some brain surgeries can also predispose to seizure disorders.

·       Infections

Infections like meningitis and encephalitis can cause seizures.

·       Eclampsia

Hypertension in pregnancy can lead to seizures.

·       Drugs

Drugs like opioids, cocaine, certain antibiotics, and certain amphetamines can cause seizures. Some people may also experience seizures when they stop using drugs or bingeing alcohol. In this case, it is regarded as a withdrawal symptom.

·       Vascular Events

Problems like stroke, hypertensive encephalopathy, or poor oxygen supply to the brain can also cause seizures.

·       Autoimmune Disorders

“Autoimmune” means that the body is fighting itself as if it is fighting a disease. Sometimes, this can result in seizures.

·       Cancer

Some cancers, especially cancers in the head or brain, can cause seizures.

·       Unclear Causes

In some people, there is no clear reason or explanation for why they have seizures. Some cases of epilepsy are just like that.

Types of Seizure

Seizures are usually grouped based on the part of the brain that is misfiring. If just one part or one hemisphere of the brain is affected, it is different from if the entire brain is affected.

Generalised Seizures

Have you ever seen someone fall and pass out during a seizure? If yes, you have witnessed a generalised seizure.

Generalised seizures happen when both sides of the brain are misfiring. There are different types of generalised seizures, and all of them are associated with loss of consciousness.

Types of Generalized Seizures

• A seizure where the affected person becomes stiff, all their muscles become flexed, and they lose consciousness is known as a Generalized Tonic Seizure.
• If all the muscles seem to become flaccid or weak suddenly, and the person passes out, it is known as a Generalized Atonic Seizure.
• A seizure that involves forceful muscle contractions along with loss of consciousness is known as a Clonic Seizure.
• The most common type of generalised seizure is a Clonic-Tonic Seizure, which involves a fast and repetitive switch between tonic and clonic seizures. It manifests as loss of consciousness, violent jerking, and muscle contractions.
• Have you ever seen someone randomly space out and become unresponsive to everything around them? You may call their name, wave a hand in their face, or even tap them, but they remain unresponsive. Such a strange occurrence may be an episode of Absence Seizure.

Focal Seizures

When there is an abnormal misfiring in just one part of the brain, it is known as a partial or focal seizure. The outward manifestation of a partial seizure depends on the part of the brain that is misfiring. For instance, if the frontal part of the brain is affected, it may manifest as abnormal body movement. Some other symptoms of a focal seizure include:

• Salivation
• Abnormal taste in the mouth
• Perceiving abnormal smell
• Hearing abnormal sounds
• Briefly seeing things that are not there

In many cases of focal seizure, the affected person is awake and aware of what is happening. This type of seizure is known as Simple Focal Seizure or Simple Partial Seizure.

In some cases, the person may not be fully conscious during the seizure, and he/she may not remember what happened after. This type is known as a Complex Focal Seizure.

Prevention of Seizures

Prevention of seizures involves prompt treatment of the causes of seizures. For instance:

• If you are pregnant, go for your routine ante-natal clinic and follow your doctor’s advice so as to prevent eclampsia.
• Avoid using psychogenic drugs like cocaine.
• Avoid alcohol.
• If you are hypertensive, ensure you use your medications and manage your blood pressure in order to avoid hypertensive encephalopathy or stroke.
• If you have diabetes, adhere to your doctor’s instructions in order to prevent diabetic encephalopathy.
• Treat any other underlying disease that can lead to seizures, such as infections, kidney diseases, and liver diseases.

Aside from all these, some other triggers of seizures that should be avoided include:

• Bright lights
• Loud sounds
• Stress
• Sleep deprivation
• Intense emotions

Diagnosis of Seizures

In order to determine whether a person has a seizure disorder and what the cause and necessary treatment is, a doctor will:

• Ask questions extensively
• Examine the body
• Run some tests to rule
• Request for brain imaging such as a CT scan or MRI
• Request for an Electroencephalogram (EEG), which will show the electrical activity of the brain.

Treatment of Seizures

• Medications like anticonvulsants may be prescribed to suppress or prevent seizures.
• Medications may be given to treat an underlying cause of the seizure.
• Surgery may be done to remove brain tumours.
• A ketogenic diet may be recommended.
• Nerve stimulation