What Causes Seizures: Their Complications And Treatment Options

11 Aug What Causes Seizures: Their Complications And Treatment Options

Seizures can be frightening for both the person experiencing them and those around them.

Whether caused by a condition like epilepsy or occurring as an isolated event, seizures result from disrupted electrical activity in the brain.

Understanding what seizures are, their causes, and how to manage them is critical to providing timely care and support.

Note: For expert evaluation and management of seizures, consult Dr. Vivek Pratap Singh, a neuropsychiatrist in Patna Bihar to receive specialized care tailored to your needs.

What Is A Seizure?

A seizure is a sudden, abnormal electrical disturbance in the brain that disrupts normal function, causing changes in movement, behavior, sensations, or consciousness.

Seizures vary widely, from intense tonic-clonic seizures (involving convulsions and loss of consciousness) to subtle staring spells, muscle twitches, or odd sensations.

Their presentation depends on the brain area affected and the extent of abnormal activity.

Some seizures involve full awareness, while others impair consciousness.

A single seizure may result from triggers like high fever, low blood sugar, or head injury, but recurrent, unprovoked seizures may indicate epilepsy.

What Happens During a Seizure?

During a seizure, the brain’s neurons, which communicate through electrical and chemical signals, fire abnormally or excessively due to an imbalance between excitatory and inhibitory signals.

This surge of abnormal electrical activity disrupts normal brain function, causing symptoms that depend on the affected brain area.

These may include uncontrolled jerking or stiffening (e.g., tonic-clonic seizures), staring spells, confusion, sudden fear, or unusual sensations.

Some seizures involve loss of consciousness, while others do not.

Most seizures last seconds to a few minutes and stop on their own, but a seizure lasting over 5 minutes or multiple seizures without full recovery (status epilepticus) is a medical emergency requiring immediate care.

Different Types of Seizures

Seizures are classified based on where they begin in the brain and how they affect a person.

The two main categories are focal seizures and generalized seizures.

When the starting point of a seizure isn’t known, it’s called an unknown onset seizure.

Take a look at different seizures types…

1: Focal Seizures (Partial Seizures):

Focal seizures originate in a specific area of the brain and may or may not affect consciousness.

• Simple Focal Seizures: These affect sensation, emotion, or motor control without loss of consciousness. The person may experience tingling, dizziness, or involuntary movements but remains fully aware.
• Complex Focal Seizures: These impair consciousness or awareness. The person may appear confused, stare blankly, or perform purposeless, repetitive movements such as chewing or hand-rubbing.

2: Generalized Seizures:

They involve both sides of the brain and usually affect the whole body.

• Tonic-Clonic Seizures (Grand Mal): Characterized by stiffening of muscles followed by jerking and loss of consciousness.
• Absence Seizures (Petit Mal): These are characterized by very transient spells of blank staring and are observed in children.
• Myoclonic Seizures are characterized by very brief muscle jerks.
• Atonic Seizures: This refers to a sudden loss of strength in some muscles. It causes the patient to fall.
• Tonic Seizures: Changes in muscle tone occur in these seizures, and one may observe the sudden stiffening of muscles.
• Clonic Seizures: These are rhythmic jerking movements usually involving both sides of the body.

3: Unknown Onset Seizures

This category is used when the beginning of the seizure is not known.

This might be the case if the seizure was not witnessed or if the person lives alone and has seizures during the night.

As more information is gathered, an unknown onset seizure may later be reclassified as a focal or generalized seizure.

What Causes Seizures?

Seizures can result from various acute and chronic conditions. Identifying the cause is crucial for prevention and targeted treatment.

Common causes of seizures include:

• Epilepsy: A chronic neurological disorder characterized by recurrent, unprovoked seizures due to abnormal brain electrical activity. It is the most common long-term cause of seizures.
• High Fever (Febrile Seizures): In young children, a rapid rise in body temperature can trigger seizures. These typically last a few minutes and are not considered chronic unless recurrent.
• Head Injury: Trauma from accidents, falls, or sports can disrupt normal brain function, leading to seizures either immediately or later after the injury.
• Stroke: Brain damage from a stroke, particularly in older adults, can trigger seizure activity.
• Brain Infections: Infections such as meningitis, encephalitis, or brain abscesses can cause inflammation of brain tissue, provoking seizures.
• Brain Tumors: Both benign and malignant tumors can disrupt brain activity, leading to seizures.
• Substance Withdrawal: Withdrawal from alcohol, recreational drugs, or certain medications, especially after prolonged use, can trigger seizures.
• Metabolic Imbalances: Conditions like hypoglycemia (low blood sugar), hyponatremia (low sodium), or hypocalcemia (low calcium) can disrupt brain function and cause seizures.
• Genetic Disorders: Certain genetic conditions can alter brain electrical activity, increasing seizure risk.

Warning Signs Of A Seizure

The signs and symptoms of seizures vary depending on the seizure type, the brain area affected, and the individual’s response.

Seizures are a common symptom of…

• Temporary Disorientation: During or after a seizure, the person may appear confused, disoriented, or mentally “foggy.” They may be unable to speak, follow instructions, or respond appropriately.
• Brief Loss of Awareness (Staring Spells): Common in absence seizures, particularly in children, the person suddenly stops what they are doing and stares blankly for a few seconds.
• Uncontrollable Jerking Movements: Sudden, involuntary muscle twitches or jerking, typically in the arms or legs, occur in generalized tonic-clonic or myoclonic seizures.
• Loss of Consciousness or Awareness: The person may collapse or become unresponsive to their surroundings. This can last from seconds to minutes, depending on whether the seizure is focal impaired awareness or generalized.
• Sudden Fear or Anxiety: Some individuals experience intense, unexplained fear or panic before or during a seizure, often in focal seizures without an apparent external trigger.
• Changes in Sensation: Unusual sensations, such as tingling, numbness, or burning, may occur. Other sensory changes include unusual tastes, smells, or visual disturbances, typically in focal aware seizures.

Seizures vs Epilepsy

Seizures and epilepsy are related but distinct concepts that should not be confused.

A seizure is a sudden, temporary disruption of normal brain electrical activity, leading to abnormal movements, behaviors, sensations, or loss of consciousness.

Seizures can be triggered by acute conditions such as high fever, low blood sugar, head injuries, infections, or metabolic imbalances.

They often occur as isolated events and do not necessarily indicate a chronic condition.

In contrast, epilepsy is a chronic neurological disorder characterized by recurrent, unprovoked seizures, typically diagnosed after two or more seizures without an identifiable acute cause.

Treating the underlying cause of a seizure (e.g., fever or hypoglycemia) may prevent further episodes, whereas epilepsy often requires long-term management with anti-seizure medications, lifestyle changes, or, in some cases, surgery.

The key difference lies in their nature and origin: seizures may be isolated events with identifiable triggers, while epilepsy involves a predisposition to unprovoked seizures, sometimes without a known cause (idiopathic).

Epilepsy can affect individuals of all ages, and its onset varies.

Distinguishing between a single seizure and epilepsy is critical for determining the appropriate diagnostic and treatment approach.

While both involve abnormal brain activity, their management differs significantly.

Early evaluation by a physician, including neurological tests like EEG or brain imaging, can clarify whether an individual has experienced an isolated seizure or has a chronic condition like epilepsy.

Complications of Seizures

Seizures can lead to serious complications, especially if they are prolonged, frequent, or uncontrolled.

These complications pose physical, emotional, and cognitive risks, including:

• Physical Injuries: Seizures can cause falls, collisions with hard surfaces, or dropping objects, leading to cuts, bruises, fractures, or head injuries.
• Drowning: Seizures during swimming or bathing increase the risk of accidental drowning. Individuals with seizure disorders should be supervised near water.
• Respiratory and Cardiovascular Problems: Some seizures disrupt the brain’s regulation of breathing or heart rate, potentially causing oxygen deprivation. Prolonged seizures may lead to brain damage due to insufficient oxygen.
• Status Epilepticus: A seizure lasting more than 5 minutes or multiple seizures without full recovery between them is a medical emergency. Untreated, it can cause permanent brain injury or death.
• Mental Health Issues: Frequent or unpredictable seizures may contribute to anxiety, depression, shame, or low self-esteem. Fear of seizures in public can lead to social isolation and reduced quality of life.
• Cognitive Impairments: Recurrent seizures, particularly those affecting the temporal lobe, may impair memory, learning, or concentration. Post-seizure (postictal) effects can include temporary confusion or difficulty processing information.
• Medication Side Effects: Long-term use of anti-seizure medications may cause side effects such as drowsiness, dizziness, weight changes, or mood alterations, impacting quality of life and treatment adherence.

Diagnosis of Seizures

Diagnosing seizures requires distinguishing between seizure types and determining whether they are related to epilepsy or other causes.

Accurate diagnosis is essential for effective treatment.

1: Medical History:

The first step involves a detailed medical history.

Physicians inquire about the seizure’s characteristics (e.g., symptoms, duration, frequency), potential triggers (e.g., stress, sleep deprivation), and family history of seizures or neurological disorders.

2: Physical and Neurological Examination:

Tests assess reflexes, coordination, muscle tone, and cognitive function to identify neurological deficits that may indicate an underlying brain condition.

3: Electroencephalogram (EEG):

This test records the brain’s electrical activity.

Abnormal patterns, such as spikes or waves, can indicate seizures or epilepsy.

Sleep-deprived EEG or prolonged monitoring may improve diagnostic accuracy.

4: Brain Imaging (MRI or CT Scan):

These scans detect structural abnormalities, such as tumors, cysts, scar tissue, or vascular malformations.

MRI provides more detailed images, making it preferred for identifying subtle brain changes.

5: Blood Tests:

These help rule out infections, electrolyte imbalances, or metabolic issues (e.g., hypoglycemia, hypocalcemia) and may identify autoimmune or genetic markers associated with seizures.

6: Video-EEG Monitoring:

In complex cases, continuous EEG with video recording in a hospital setting captures seizures in real-time, helping confirm seizure type and brain region of origin.

7: Psychiatric Evaluation:

Seizures can have emotional or psychological triggers or consequences.

A psychiatric assessment is particularly useful to diagnose psychogenic non-epileptic seizures (PNES), which mimic epileptic seizures but have a psychological origin.

Seizure Treatment

Seizure treatment depends on the cause, type, frequency, and the individual’s overall health.

The main treatment approaches include:

1: Anti-Seizure Medications:

These are typically the first-line treatment for most individuals with seizures.

Anti-seizure medications stabilize abnormal electrical activity in the brain, reducing or preventing seizures.

With regular use and proper dose adjustments, many patients achieve seizure control or experience fewer seizures.

Ongoing monitoring is essential to optimize dosing and manage side effects.

2: Surgery:

For drug-resistant epilepsy, surgery may be considered if seizures originate from a specific brain area that does not control vital functions.

Identifying the seizure focus through advanced imaging and EEG is critical for successful outcomes.

3: Vagus Nerve Stimulation (VNS):

A small pulse generator implanted in the chest delivers mild electrical signals to the vagus nerve, reducing seizure frequency.

VNS is often used when medications or surgery are ineffective or unsuitable.

4: Dietary Therapy:

The ketogenic diet (high-fat, low-carbohydrate) can reduce seizures, particularly in children with drug-resistant epilepsy.

Alternatives like the Modified Atkins Diet or Low Glycemic Index Treatment may also be effective, depending on the patient’s needs.

5: Lifestyle Management:

Identifying and avoiding seizure triggers (e.g., stress, sleep deprivation, or alcohol) can lower seizure risk.

Consistent medication adherence, adequate sleep, proper hydration, and stress management are crucial for maximizing treatment benefits.

Conclusion

Seizures may seem unpredictable and daunting, but they are less frightening with proper diagnosis, treatment, and support.

Effective management is possible with the right approach. Distinguishing between a one-time seizure and epilepsy reduces fear and stigma.

Understanding seizures enhances safety and improves quality of life. If you or someone you know is experiencing seizures, consult a neurologist for guidance.

For expert care, visit or consult Dr. Vivek Pratap Singh, the top neuropsychiatrist in Patna.

Dr. Singh, specializes in treating seizures, epilepsy, and other neurological disorders with over 10 years of experience.

He practices at Pratap Neuro and Child Psychiatry Clinic in Kankarbagh, offering evidence-based care and daycare deaddiction services.

Frequently Asked Questions

1: Are Seizures Dangerous?

Yes, some seizures can be dangerous, though most are not life-threatening.

They can cause injuries from falls or accidents, and prolonged seizures (status epilepticus) are medical emergencies.

The risk depends on the seizure type, setting, and frequency. For example, generalized tonic-clonic seizures pose a higher risk of injury than absence seizures.

2: How Long Can Seizures Last?

Most seizures last from a few seconds to 2 minutes and stop on their own.

A seizure lasting over 5 minutes (status epilepticus) is a medical emergency requiring immediate intervention.

Prolonged seizures can lead to complications like oxygen deprivation or brain damage.

Emergency treatments, such as intranasal midazolam, may be used to stop them.

Always time a seizure and seek help if it exceeds 5 minutes.

3: Can Seizures Cause Brain Damage?

Do seizures cause brain damage? Yes, some seizures cause brain damage.

Particularly frequent or prolonged ones like status epilepticus, can cause brain damage due to oxygen deprivation or neuronal stress.

Short, isolated seizures are unlikely to cause lasting harm.

Recurrent seizures, especially in epilepsy, may affect brain areas like the hippocampus, impacting memory.

4: Can You Live a Long Life with Seizures?

Yes, with proper treatment and management, many individuals with seizures live long, healthy lives.

Anti-seizure medications or other therapies can control seizures in about 60–70% of epilepsy cases.

Lifestyle adjustments, such as avoiding triggers and maintaining regular sleep, support overall health.

5: Are Seizures Painful?

Seizures themselves are typically not painful, but post-seizure muscle soreness, injuries, or confusion (postictal state) can cause discomfort.

For example, tonic-clonic seizures may lead to muscle strain or bites to the tongue. Focal seizures might cause uncomfortable sensations like tingling.

Pain management may be needed after injuries.

6: Do Seizures Affect Memory?

Yes, frequent seizures or those affecting memory-related brain areas, like the temporal lobe, can impair memory or concentration.

Some anti-seizure medications may also cause cognitive side effects, including memory issues.

The postictal phase often involves temporary confusion or memory lapses.

7: Can Stress Cause Seizures?

Yes, stress is a common trigger for seizures, particularly in individuals with epilepsy.

It can disrupt brain electrical activity, increasing seizure risk.

Managing stress through relaxation techniques, exercise, or therapy may reduce seizure frequency.

Sleep deprivation, often linked to stress, is another trigger to avoid.

8: Can Epilepsy Start at Any Age?

Yes, epilepsy can begin at any age, though it is more common in young children and older adults.

Causes vary, from genetic factors in childhood to strokes or injuries in later life.

Certain epilepsy syndromes, like juvenile myoclonic epilepsy, often start in adolescence.

9: Does Epilepsy Affect Sleep?

Yes, epilepsy can disrupt sleep patterns, and some individuals experience nocturnal seizures during sleep.

Sleep deprivation, a common seizure trigger, can worsen epilepsy control.

Certain anti-seizure medications may also affect sleep quality.

10: Is a 7-Minute Seizure Bad?

Yes, a seizure lasting 7 minutes is a medical emergency (status epilepticus) requiring immediate intervention.

Prolonged seizures can cause brain damage or other complications due to oxygen deprivation.

Emergency medications like lorazepam or midazolam are often administered.