Seizure – Symptoms and Causes

Overview

Seizures occur when the brain experiences a sudden surge of electrical activity. These episodes can change behavior, movement, feelings, and consciousness.

When someone has two or more unexplained seizures at least 24 hours apart, doctors diagnose epilepsy. However, not all seizures indicate epilepsy.

Many seizure types exist, each with different symptoms and impacts on daily life. The classification depends on where in the brain they start and how far they spread.

Most seizures last between 30 seconds and two minutes. Any seizure continuing beyond five minutes requires emergency medical attention.

Several factors can trigger seizures:

• Stroke
• Head injury
• Infections like meningitis
• Other illnesses

In many cases, doctors cannot identify the specific cause.

Treatment Options

Medication successfully controls most seizures, though side effects can occur. Patients should work closely with healthcare providers to find the right balance between:

• Effective seizure control
• Manageable side effects

Finding this balance helps people maintain their quality of life while keeping seizures under control.

Signs and Symptoms of Seizures

Types of Focal Seizures

Focal seizures start in one area of the brain. They can happen with or without losing consciousness.

Focal seizures with altered awareness make people feel like they are in a dream. They might stare into space and not respond to others.

Some people make repetitive movements like rubbing their hands, saying the same words over and over, or walking in circles. Many don’t remember having the seizure afterward.

Focal seizures without altered awareness do not result in blackouts, yet they can significantly affect emotions or sensory perceptions. People might suddenly feel happy, sad, or angry. Some experience:

• Unusual smells, tastes, or sounds
• Tingling sensations
• Dizziness
• Flashing lights in vision
• Difficulty speaking
• Jerking movements in an arm or leg
• Nausea or other odd feelings that are hard to describe

These symptoms can sometimes be confused with migraines, mental health conditions, or narcolepsy.

Types of Generalized Seizures

Generalized seizures affect both sides of the brain from the start. There are several types:

• Absence Seizures: These involve brief staring spells lasting 5–10 seconds and are common in children. Individuals might occasionally blink or lightly smack their lips. These seizures can happen hundreds of times daily and cause brief lapses in awareness.
• Tonic Seizures: These cause sudden muscle stiffening, especially in the back, arms, and legs. People often lose consciousness and fall.
• Atonic Seizures: Also called “drop seizures,” these cause sudden muscle weakness, especially in the legs, making a person collapse.
• Clonic Seizures: These involve rhythmic jerking movements, usually affecting the neck, face, and arms on both sides.
• Myoclonic Seizures: These cause brief, sudden jerks or twitches in the arms and legs, usually without causing blackouts.
• Tonic-clonic Seizures: The most common type of generalized seizure, these involve:
  • Loss of consciousness
  • Body stiffening
  • Shaking
  • Possible loss of bladder control
  • Sometimes tongue-biting

These seizures typically last several minutes and may begin as focal seizures before spreading to the whole brain.

Phases of a Seizure

Seizures typically progress through three distinct phases:

Warning phase

Some people experience early warning signs hours or even days before a seizure. This may include:

• A hard-to-explain feeling that a seizure is coming
• Behavior changes
• An “aura” (the first seizure symptom)

Aura symptoms can include:

• Déjà vu (feeling of familiarity)
• Jamais vu (feeling of unfamiliarity)
• Strange sensations
• Fear or panic
• Positive emotions
• Unusual smells, sounds, or tastes
• Blurred vision
• Racing thoughts
• Headache
• Numbness
• Tingling
• Nausea
• Dizziness

Not everyone receives warning signs prior to experiencing a seizure.

Active Phase

This is the seizure itself, starting with the first symptom and lasting until the seizure ends. Symptoms vary based on seizure type.

Recovery Phase

This follows the seizure and can last minutes to hours. During recovery, a person might:

• Respond slowly
• Have memory problems
• Be struggling with speaking or writing
• Feel sleepy or confused
• Experience dizziness
• Feel sad, scared, anxious, or frustrated
• Have nausea, headache, or weakness
• Feel thirsty or need to urinate

Recovery time depends on the seizure type and which brain areas were affected.

When Medical Help Is Needed

Get emergency medical help right away if:

• A seizure lasts longer than five minutes
• Breathing doesn’t resume after the seizure
• Another seizure follows immediately
• The person has a high fever
• The person is overheating
• The person is pregnant
• The person has diabetes
• The seizure causes injury
• The seizure happens in water

Causes

Seizures happen when the brain’s normal communication system gets disrupted. The brain contains nerve cells called neurons that send electrical signals to each other. When something interferes with these signals, a seizure can occur.

While epilepsy is a common reason for seizures, many other factors can trigger them. High fevers, especially in children, can cause febrile seizures. Brain infections like meningitis or encephalitis also increase seizure risk.

Serious illnesses, including severe COVID-19 cases, can trigger seizures in some people. Not getting enough sleep disrupts brain function and may lead to seizures as well.

Some physical conditions, like low blood sodium levels, can cause seizures. This sometimes happens with medications that increase urination.

Medical and substance factors include:

• Certain medications for pain, depression, or smoking cessation
• Recent brain injuries, including head trauma or stroke
• Street drugs such as amphetamines and cocaine
• Alcohol problems (both excessive drinking and withdrawal)

Some people inherit gene changes that affect how their brain cells communicate, making seizures more likely to occur.

Risk Factors

Several factors can raise your chance of having a seizure:

• Brain injuries from accidents or trauma
• Cognitive problems affecting brain function
• Stroke damage to brain tissue
• Alzheimer’s Disease
• Brain Tumors
• Alcohol or drug abuse
• Family History of Seizures or Epilepsy

These conditions affect normal brain activity, potentially triggering seizures in susceptible individuals.

Risks and Dangers

Seizures can lead to several serious complications that may put you or others at risk.

• Seizures can lead to physical injuries. Falling can result in head trauma or broken bones when your body loses control. Always try to create safe spaces if you have frequent seizures.
• Water-related dangers are significant concerns. Having a seizure while swimming, bathing, or near water substantially increases the risk. Never swim alone if you have seizure disorders.
• Driving hazards exist because seizures can cause loss of awareness or loss of control of the vehicle. Most regions have specific laws about driving with seizure conditions.

Seizures during pregnancy can threaten both the mother and baby. Certain seizure medications have been linked to a heightened risk of birth defects. 3

Mental health issues like depression and anxiety occur more frequently in people with seizures. These may develop from the stress of managing the condition or as a medication side effect.

In rare cases, sudden unexpected death can occur following a seizure. While uncommon, this serious risk highlights why proper seizure management is essential.

• Always take medications as prescribed
• Attend regular medical appointments
• Follow safety precautions in daily activities
• Seek support for emotional challenges

Prevention

To reduce the chance of having seizures, people should avoid certain triggers.

• Getting enough sleep is essential. Lack of rest can lead to more seizures
• Avoiding alcohol and drugs is also important for seizure prevention
• Stress management plays a key role in keeping seizures at bay
• People with seizure disorders should also avoid flashing lights