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    Seizures and Seizure Disorders

    Naghma Mufti, MD Deaconess Clinic Neurologist 07/08/2021
    Seizures are common, and commonly misunderstood. Many people will have a seizure in their lifetime, and 1 in 26 people will be diagnosed with a seizure disorder (epilepsy).  Learn the facts.
    What is a seizure?
    A seizure is an abnormal neuron discharge in the brain, and is an error related to how brain cells interact with each other.

    Many people have an image of what a seizure looks like--they think of an unconscious person convulsing on the floor. But many seizures are quiet and unremarkable. That’s why it’s important to understand the basics of seizure activity and what constitutes an actual seizure disorder.

    There are two basic kinds of seizures, provoked and unprovoked, and a wide variety of treatment options.

    Provoked Seizures
    A provoked seizure happens when something “triggers” problems in an otherwise healthy brain. Diseases and activities known to trigger seizures include:
    • Metabolic abnormalities (high/low blood sugar, or low sodium or calcium)
    • Alcohol withdrawal
    • A sudden brain incident or injury, such as an infection, stroke or traumatic injury.
    • Illicit drug use or withdrawal
    • High fever in children (febrile seizures)

    Unprovoked Seizures
    An unprovoked seizure occurs due to a seizure disorder. Epilepsy is the name of the neurological disorder that causes unprovoked seizures. Generally, a patient must have at least two unprovoked seizures to be diagnosed with epilepsy.

    To clarify, a seizure is a symptom, but epilepsy is a neurological disease.

    Most of the time, there is no clear cause regarding why a patient has epilepsy. However, epilepsy can run in families, occur because of a prenatal or birth injury, be the result of a developmental disorder, or be related to a structural change in the brain, i.e. a brain tumor.
    Generalized Seizures and Absence Seizures
    The severity of the seizure is just as important to note as what caused it to happen. Grand mal and petit mal are the medical words used to describe generalized and absence seizures, respectively.

    Grand mal or generalized seizures involve the entire body. Patients experience loss of consciousness and violent muscle contractions in addition to stiffness, shaking, and injury due to the seizure symptoms. This is the type of seizure most often portrayed in film and television.

    Absence seizures last only a few seconds, cause lapses in awareness, often involve blankly staring into space, body symptoms without loss of consciousness, or some alterations of consciousness but without visible symptoms. These types of seizures are more common in children and can be mistaken for daydreaming or not paying attention.

    How are seizures diagnosed?
    Seizures are diagnosed through a physician evaluation and some testing. Diagnosis depends on an overall history and examination of the patient including how likely they are to have additional seizures. Further testing may include MRI of the brain, and EEG (electroencephalogram) of the brain. Both of these tests look for abnormal brain activity, and also pinpoint what part of the brain is experiencing the seizure.

    It’s very important to identify the type of seizure being experienced because successful treatment depends on an accurate diagnosis.

    How are seizures treated?
    The goal of any type of seizure treatment is to reduce the frequency and severity of the seizures, and improve the patient’s overall quality of life. Seizures and their treatment are unique to each patient and depend on the following:
    • Type of seizure
    • Other conditions, such as migraines, behavioral/psychiatric issues
    • Gender and age of the patient
    • Side effects that the patient experiences
    • Cost to patient
    The most common treatment for seizures and seizure disorders is medication. If a patient continues to have seizures after one year of being on medication or after trying two kinds of medication with no success, then their epilepsy is considered “intractable” and other treatments should be considered. About 30 to 40 percent of patients have intractable epilepsy.
    Vagus Nerve Stimulator
    A vagus nerve stimulator is a device that can be implanted under the skin. It’s a very simple, same-day procedure that can be performed here in Evansville. The device works by stimulating the vagus nerve in your neck and sending signals to the brain that help prevent seizures. It also gives some control to patients because, when they feel a seizure coming on, they can work with the stimulator to prevent the seizure from actually happening.
    Epilepsy surgery works best for patients with seizures that always start in the same place in their brains. Once the origin area is identified, the surgeon operates on that area of the brain to stop future seizures from happening. This is a very specialized area of medicine and is performed in epilepsy centers in large cities.
    Living with seizures and seizure disorders

    Can I drive?
    One of the major concerns for adults with seizures is that someone will take away their right to drive. It’s important to know that every state has a different law related to seizure activity and operating a vehicle. Some have restrictions of 3 months from last seizure, while others have restrictions for 6 months or more. Check with the local motor vehicle or licensing branch to find out the specific rules.
    While seizures can be scary for patients and those who love them, they are often very manageable. Meeting regularly with a neurologist and following instructions about taking medicines can go a long way toward reducing seizures. At Deaconess Clinic, our goal is to get seizures under control so that they aren’t happening, so people can go on living productive, enjoyable lives.


    Learn more about the author

    Naghma Mufti, MD
    Specialty: Neurology
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