A seizure is a sudden change in movement or awareness due to a change in the electrical function of the brain. Sudden bursts of electrical energy may affect movement, sensation and consciousness.
Seizures are changes in the brain’s electrical activity. These changes can cause dramatic, noticeable symptoms, subtle or mild symptoms, or no symptoms at all.
The symptoms of a major seizure include repetitive jerking and stiffening and a loss of control. Because some seizures can lead to injury or be a sign of an underlying medical condition, it’s important to seek treatment if you experience them.
One way of classifying seizures is based on where they start in the brain. According to this classification method, seizure types include focal onset seizures, generalized onset seizures, and unknown onset seizures.
Focal onset seizures
Focal onset seizures begin in only one area of the brain. Some people may also refer to these as partial seizures.
Focal onset seizures start in small areas of the brain—such as the area that controls leg movement on one side of the body—and can sometimes spread throughout the hemisphere (one side of the brain) or even to the other side of the brain.
Medical professionals typically define focal onset seizures into two types: focal aware seizures and focal awareness-impaired seizures.
Focal aware seizure
During a focal aware seizure, you’ll remain conscious and be aware that something is happening, even if you don’t recognize it as a seizure.
The symptoms of a focal aware seizure will depend on which part of the brain the seizure starts.
Focal aware seizures may occur briefly, but can also spread to cause a focal impaired-awareness seizure or a secondarily generalized seizure. Often, when a focal awareness seizure precedes a more widespread seizure, this early stage is defined as a warning or an aura.
Focal impaired-awareness seizure
This type of seizure affects your consciousness. During a focal impaired-awareness seizure, you may not be able to move, talk, or hear as you did before. You may also not be able to remember the event.
Focal impaired-awareness seizures can last for up to
Generalized onset seizures
These seizures start in both sides of the brain simultaneously. Among the more common types of generalized onset seizures are:
- Tonic: Tonic seizures will result in your muscles stiffening up.
- Clonic: The convulsions in clonic seizures may cause abnormal, jerky movements of your limbs. You will likely lose consciousness during these seizures that can last for a few minutes.
- Tonic-clonic: Tonic-clonic seizures include a combination of both tonic and clonic symptoms.
- Myoclonic: During a myoclonic seizure, you may experience sudden muscle spasms. These are typically too short-lived to affect consciousness and pass quickly. Myoclonic seizures may be of generalized onset as well as focal onset.
- Absence: People may also refer to these as petit mal seizures. Absence seizures last for only a few seconds. They can cause you to blink repeatedly or stare into space. Other people may mistakenly think you’re daydreaming.
- Atonic: During atonic seizures your muscles suddenly go limp. Your head may nod, or your entire body could fall to the ground. Atonic seizures are brief, lasting about 15 seconds. People may refer to these seizures as drop attacks.
Unknown onset seizures
Sometimes no one witnesses the beginning of a seizure. For example, someone may wake up in the middle of the night and observe their partner having a seizure.
It’s possible to have an epilepsy condition that causes both focal and generalized seizures at different times, but not simultaneously.
A focal seizure can progress to become a generalized seizure. Sometimes this happens slowly and sometimes it can happen rapidly.
Sometimes warning symptoms occur before the seizure takes place. These can include:
- a sudden feeling of fear or anxiousness
- a feeling of being sick to your stomach
- dizziness
- a change in vision
- a jerky movement of the arms and legs that may cause you to drop things
- an out-of-body sensation
- a headache
- déjà vu
- mood changes
Signs that indicate a seizure is in progress include:
- losing consciousness, followed by confusion
- having uncontrollable muscle spasms
- drooling or frothing at the mouth
- falling
- having a strange taste in your mouth
- clenching your teeth
- biting your tongue
- having sudden, rapid eye movements
- making unusual noises, such as grunting
- losing control of bladder or bowel function
Seizures can stem from several health conditions. Some examples include:
- alcohol withdrawal
- brain infection, such as meningitis
- brain injury during childbirth
- brain irregularity present at birth
- choking
- illegal drug use
- illegal drug withdrawal
- electrolyte imbalance
- electric shock
- epilepsy
- extremely high blood pressure
- fever
- head trauma
- kidney or liver failure
- low blood glucose levels
- stroke
- brain tumor
- vascular abnormality in the brain
Seizures can run in families. Tell your doctor if you or anyone in your family has a history of seizures. In some instances, especially with young children, the cause of the seizure may be unknown.
Living with epilepsy and experiencing repeated seizures can have both short- and long-term effects. These can range from a drop in quality of life to increased risks of mental health conditions.
Short-term effects
Some seizures can cause you to lose total control of your body. This can lead to falls and other movements that can result in injury.
Epilepsy
Being prone to seizures may also affect your quality of life. For example, you may no longer be able to drive. You may want to avoid situations where a seizure could cause serious harm, such as swimming or traveling alone.
It’s important to wear a medical identification bracelet that tells emergency responders that you have epilepsy.
Long-term effects
If you have epilepsy, treatment is important to prevent future seizures and worsening epilepsy. And a prolonged seizure episode can be dangerous if it’s not treated.
While death as a direct result of seizures is rare, the risk of premature death in people with epilepsy is up to
Living with epilepsy can have an impact on your mental health. People living with epilepsy may become depressed or anxious due to the worry of having a seizure. You may also feel isolated, be worried about getting hurt or experience stigma.
The changes in the brain that can cause epilepsy may be associated with the different brain changes that can cause psychiatric conditions,
Your doctor may recommend specific tests to accurately diagnose a seizure and help ensure that treatments will be effective.
They will consider your complete medical history and the events leading up to the seizure. For example, migraine, headaches, sleep disorders, and extreme psychological stress can cause symptoms that may seem like seizures.
Lab tests may help your doctor rule out other conditions that may be considered during your diagnostic evaluation. The tests may include:
- blood testing to check for electrolyte imbalances
- spinal tap to rule out infection
- toxicology screening to test for drugs, poisons, or toxins
An electroencephalogram (EEG) can help your doctor diagnose a seizure. This test measures your brain waves. Viewing brain waves during a seizure can help a doctor diagnose the type of seizure. An EEG can show evidence of seizure activity even when you aren’t having a seizure.
Treatments for seizures depend on the cause. By treating the cause of the seizures, you may be able to prevent future seizures from occurring. The treatment for seizures due to epilepsy include:
Medications
Antiepileptic drugs are often the first treatment option for people experiencing multiple seizures. They target the signaling activities in specific brain cells and can effectively control seizures in approximately 70% of cases.
There are several types of antiepileptic drugs. You and your doctor may have to work to find out which is the best medication for treating your condition.
Brain surgery
Doctors may recommend surgical options for treating epilepsy and seizures if you have a seizure focus or a growth that needs to be removed.
Surgical procedures to treat epilepsy include:
- resective surgery
- multiple subpial transection
- hemispherectomy
- corpus callosotomy
Brain surgery for epilepsy can improve quality of life but does carry a risk of complications. Consult with your doctor to discuss whether surgery is the right option for you.
Nerve stimulation
In addition to brain surgery, surgeons can insert nerve stimulation devices in the body to treat epilepsy.
Vagus nerve stimulation involves placing electrodes around the vagus nerve in your neck and a generator for these electrodes in the upper chest. These devices then stimulate the nerve with electrical signals, which can help manage seizures.
Responsive neurostimulation systems also work by stimulating the brain to manage seizures. Doctors can program these devices to assess and respond to nerve activity associated with seizures, often stopping them.
These less invasive surgical options can help safely reduce seizure frequency and severity.
Doctors may also suggest deep brain stimulation therapy. This is where a surgeon places electrodes onto the thalamus.
The thalamus is a part of the brain that processes signals from almost every sensory system. It regulates consciousness, alertness, and sleep cycles.
Electrical signals from these electrodes help regulate the excitability of certain parts of the brain. This can help reduce the frequency of seizures.
These techniques only work for certain seizure types, and pre-surgical testing can help determine whether you would benefit from electrical stimulation device implantation.
Diet changes
Following a ketogenic diet may be an alternative to surgery for some people living with epilepsy.
However, the ketogenic diet and its variants can feel restrictive. Following the diet long term may be challenging for some.
Be sure to check with your doctor before starting a new diet, especially as a mode of treatment.
It can be challenging to live with epilepsy. But if you have the right support, it’s possible to live a full and healthy life.
Take prescribed medications
It’s important to continue taking antiepileptic drugs if your doctor prescribes them.
It’s important to regularly check in with your doctor and tell them whether you’re experiencing any side effects of your medications. If you have your seizures under control for long periods, your doctor may recommend a gradual reduction in dosage.
Avoid triggers
Some people may be able to identify specific triggers for their seizures. These can include:
- stress
- drinking alcohol
- lack of sleep
Avoiding these triggers may help you
Educate friends and family
Teach your friends and family more about epilepsy and how to care for you while a seizure occurs.
This includes taking steps to reduce the risk of injury like cushioning your head, loosening tight clothing, and turning you on your side if vomiting occurs.
Find ways to maintain your current lifestyle
Continue your usual activities if possible, and find ways to work around your epilepsy so you can maintain your lifestyle.
For instance, if you’re no longer allowed to drive because you have seizures, you may decide to move to an area that’s walkable or has good public transportation, or use ride-share services so you can still get around.
Making safety modifications to your place of residence can reduce the risk of injury. This can include covering the corners of low objects, not locking the bathroom door when using it, and using guards on radiators and heaters.
Other tips
- Find a doctor who makes you feel comfortable.
- Try relaxation techniques, such as yoga, meditation, tai chi, or deep breathing.
- Find an epilepsy support group. You can find a local one by looking online or asking your doctor for recommendations.
In many instances, a seizure isn’t preventable. But maintaining a healthy lifestyle can give you the best chance at reducing your risk. You can try:
- getting plenty of sleep
- eating a balanced diet and drinking plenty of fluids
- exercising regularly
- engage in stress-reducing techniques
- avoiding illegal drugs
If you’re on medication for epilepsy or other medical conditions, take them as your doctor prescribes.
If you live with someone with epilepsy, there are some things you can do to help them:
- learning about their condition.
- making a list of their medications, doctors’ appointments, and other important medical information
- speaking with the person about their condition and what role they would like you to play in helping
If you need help, reach out to their doctor or an epilepsy support group. The Epilepsy Foundation is a helpful resource. However, it’s important to note that the foundation is an advocacy group, and may maintain bias on specific topics.
What to do during a seizure
If someone near you is having a seizure, there are a number of things you can do to help them.
Clear the area around a person who’s having a seizure to prevent possible injury. If possible, place them on their side and provide cushioning for their head.
Stay with the person. Call 911 or local emergency services as soon as possible if the person is pregnant or has never had a seizure before, or if they experience any of the following:
- a seizure that lasts longer than 5 minutes
- doesn’t wake up after the seizure
- repeat seizures
It’s important to remain calm. While there’s no way to stop a seizure once it’s begun, you can provide help. The
- stay with the person having the seizure until it ends, or until they’re fully awake
- checking to see whether the person is wearing a medical bracelet
- removing their glasses or anything around their neck
- holding them in a hug or gently guiding them to the floor if they are standing
- positioning them on their side if they are on the ground so that saliva or vomit leaks out of their mouth instead of down their windpipe
- placing something soft under their head
- not holding the person down while they’re having a seizure
- not putting anything in the person’s mouth
After the seizure
Once a seizure is over, you should:
- check the person for injuries
- turn the person on their side, if not already
- stay with them until they’re fully awake and alert
- provide them with a safe area to rest
- not offer them anything to eat or drink until they’re fully conscious
Typically, a seizure doesn’t require emergency medical attention.
However, there are some circumstances when you should
- This is the first time the person has ever had a seizure.
- The seizure continues for more than 5 minutes.
- The person is having difficulty with breathing.
- The person is having trouble waking following the seizure.
- The person is injured during the seizure.
- The seizure occurs in water.
- The person is pregnant, has diabetes or heart disease.
- A second seizure happens soon after the first.