Seizures

Seizures are conditions when there is abnormal functioning of the brain leading to uncontrollable muscle spasms, altered levels of consciousness and behavior. This is usually traced to abnormal electrical discharge within the brain. Seizures may be localized or affect the whole body. Seizures are classified into 3 based on the severity of attack and response:

• Grand Mal - In this type of seizure, the whole body is racked with convulsions. There can be lack of consciousness or coma
  
• Petit Mal - Only a part of the body is affected by this seizure
  
• Absence - A type of seizure where the affected person is in a stupor and cannot be roused.

Seizures can occur due to poisoning, drug overdose, head injury or medical conditions such as hypoglycemia or neurological abnormality. Fever, brain tumor or other vascular problems can also trigger a seizure. If the brain experiences a sudden lack of oxygen, it can lead to a seizure. Febrile seizures are usually noticed when an infant or small child has high fever, greater than 102 degrees F. The child loses consciousness and experiences uncontrolled shaking of the body. Typically this seizure lasts for a minute or two. Seizures of this kind are not to be mistaken for epilepsy. Though they can be terrifying, febrile seizure attacks must be tackled with care. Place the child on the ground or safe place. Do not restrain movements and wait for the seizure to subside. Do not attempt to feed the child immediately after a febrile seizure. Most seizures are self-limiting. What is essential is to ensure that the person does not get injured during a seizure. Seek seizure first aid. Call a doctor at once if you notice labored breathing or bluish pallor. Epilepsy is a medical condition that is characterized by marked pattern of chronic seizures. Various tests such as spinal tap, heat CT scan or MRI and EEG (Electroencephalogram) can help in identifying the cause for the seizures.

Convulsions

Seizures or convulsions are associated with the electrical activity of the brain. They have an impact on major systems of the body and can be fatal if not treated. Seizures are classified predominantly based upon their site of occurrence and the affected organ or system.

Types of Convulsions

General or clonic seizures: In most cases, generalized seizures are also called as tonic-clonic seizures as they involve the entire body. In common parlance, it also referred as epileptic attacks. Patients experience changes in sensations such touch, taste, smell and vision. Hallucinations or auras are also experienced as they begin to influence the emotional balance of a person.

Focal or Partial seizures: These types of seizures are cause because of disturbed electrical activity in the brain which is localized to one part of the brain. It acts on the temporal region of the brain leading loss of memory and balance in extreme conditions.

Petit mal Seizures: These are temporary and their effects are usually limited to 20 seconds. They generate temporary muscle spasms which happen because of electrical imbalances in the brain.

Epilepsy: This type of seizure is closely related to general seizures. The factors associated with the onset of epilepsy may include preexisting conditions such as ischemic heart disease, Alzheimer disease, meningitis and encephalitis.

Fever induced convulsions: These types of seizures predominantly occur in children, infants and toddlers. The initial phase of these convulsions is very intense as they cause much discomfort to the child. They usually subside within a few hours. Most of the fever induced convulsions are caused by viruses and ear infections.

Clinical manifestations

Most convulsions or seizures are characterized by classical muscle spasm symptoms which includes rigorous shaking and frothing with prolonged effects like unconsciousness (blackout). Since the predominant reason associated with convulsions are related to the electrophysiology of the brain, neurological symptoms such as confusion, hallucination, dementia, drooling, lack of bladder control and sudden loss of balance may also be noticed.

Convulsions also have effects on the emotions of a person as many people complain of unprecedented symptoms such as sudden aggression, depression, mood swings, panic, extreme laughter and joy for a temporary period of time. Warning signs often appear before any form of seizure such as dizziness, sensitivity to light, vertigo and nausea.

Seizures can also occur as a result of withdrawal from use of drugs such as barbiturates, valium or benzodiazepines. Drug abuse and alcohol abuse along with preexisting health complications such as end-stage renal disease, renal failure and congenital heart disease can indicate high percentage of seizure onset. Seizures also occur in conditions such as Steven Johnson syndrome, a disease occurring in children. In addition to these clinical manifestations, seizures can occur because of severe brain injury, shock or even during athletic events as result of extreme adrenaline levels in the blood.

Diagnosis and Treatment

Epileptics are diagnosed with a meticulous examination of their history. Various biochemical tests such as sodium levels, SGOT, SGPT and blood glucose levels are analyzed. Electro encephalogram is done to understand the electrophysiology of the brain. In some cases, neurologists recommend MRI and CT scans to understand the presence of any abnormalities or to identify any kind of trauma caused in the brain or the spinal cord.

In most cases seizures are treated with antidepressants as the predominant cause of any form of seizure is depression. Anti epileptic drugs such as sodium channel blockers and GABA transaminase inhibitors are recommended.

Epilepsy

Epileptic seizures are commonly traced to brain injury or family history. About 0.5% to 2% of the population is likely to suffer an epileptic seizure at some point in time. When the delicate balance of electrical activity in the brain is disturbed, a person suffers seizures. When there are more than a couple of episodes of seizures, it is a condition of epilepsy. Status epilepticus refers to continuous or intermittent seizure activity for more than 5 minutes without recovery of consciousness.

In a typical epileptic seizure, the neuronal activity is hampered bringing on convulsions, muscle spasms and possible loss of consciousness. Each person has a different threshold of resistance to seizures. Inherited condition of neurological disorder can lead to electrical instability causing epileptic seizures. Those dependent on alcohol or drugs may experience seizures during withdrawal. Rarely is a brain tumor the cause of epilepsy. Brain injury is a possible cause of epilepsy. This can be due to a birth defect or head injury or infection such as meningitis. Sometimes a person may experience idiopathic epilepsy where there is no clear cause for the seizures.

Diagnosis of epilepsy can be made with investigative tests such as EEG, CT scan or MRI scan. Anti-epilepsy drugs (AEDs) can control the seizures though there is no cure. These medications help the patient in leading a better quality of life. AEDs are prescribed after studying the person's nature of seizures, general health, age and gender. These medications must be taken in prescribed doses to maintain desired level in the body to prevent further seizures. When some possible triggers have been identified for epileptic seizures, the patient must try and avoid them. These triggers could range from emotional disturbance to lack of sleep. The Vagus Nerve Stimulator (VNS) has been approved by the FDA for the treatment of epilepsy. The VNS is surgically implanted into the chest, near the collarbone. It is a small device, much like a pacemaker that sends weak electrical impulses to the brain through the vagus nerve. These electrical signals are helpful in preventing sudden electrical bursts in the brain that trigger off an epileptic attack.