Seizures are one of the most important neurological conditions that healthcare professionals, caregivers, and patients must understand. They can be frightening, sudden, and potentially life-threatening. Recognizing seizure types, their causes, stages, and appropriate care can make a life-saving difference.
This article provides a comprehensive overview of seizures, covering:
- What seizures and epilepsy are.
- Causes and triggers of seizures.
- The four stages of a seizure.
- Types of seizures: generalized and focal (partial).
- Seizure precautions and care during an episode.
What Is a Seizure?
A seizure is an abnormal and sudden burst of electrical activity in the brain. This electrical disturbance can temporarily affect how a person moves, feels, behaves, or becomes aware of their surroundings.
Seizures may last from a few seconds to several minutes, and while some are subtle, others are dramatic and involve full-body convulsions.
What Is Epilepsy?
Epilepsy is a chronic neurological disorder in which a person experiences recurrent seizures due to an ongoing underlying brain condition. Unlike a one-time seizure caused by fever or hypoglycemia, epilepsy involves repeated and unpredictable episodes.
Causes of Seizures
Seizures can be triggered by a wide variety of factors. Understanding these causes is essential for both prevention and treatment.
Common causes include:
- Fever (Febrile seizures in children)
- CNS infections such as meningitis or encephalitis
- Drug or alcohol withdrawal
- Acid-base or electrolyte imbalance (ABG imbalance)
- Hypoxia (lack of oxygen supply to the brain)
- Brain tumors
- Hypoglycemia (low blood sugar levels)
- Head injuries
- Hypertension (very high blood pressure)
Seizure triggers may also include stress, sleep deprivation, flashing lights, or missed doses of anti-epileptic medications.
Stages of a Seizure
Seizures typically progress through four stages. Not every patient experiences all four, but understanding them helps in identifying and responding appropriately.
1. Prodromal Stage
- Occurs hours or even days before the seizure.
- Symptoms include mood changes, irritability, anxiety, or difficulty concentrating.
2. Aura Stage
- A warning sign immediately before the seizure.
- May involve unusual smells, tastes, visual disturbances, or dizziness.
- Not all patients experience an aura.
3. Ictal Stage (Seizure Itself)
- The active seizure phase, with symptoms depending on the type.
- May include convulsions, altered awareness, or muscle rigidity.
- Status Epilepticus occurs if the seizure lasts longer than 5 minutes—this is a medical emergency.
4. Post-Ictal Stage
- Recovery period after the seizure.
- Symptoms: confusion, fatigue, headache, or temporary weakness.
Types of Seizures
Seizures are broadly divided into generalized seizures (involving the entire brain) and partial or focal seizures (involving one part of the brain).
Generalized Seizures (Affect the Entire Brain)
Tonic-Clonic Seizures
- Previously called “grand mal seizures.”
- Involve stiffening (tonic) followed by jerking (clonic) of muscles.
- Often accompanied by loss of consciousness.
2. Myoclonic Seizures
- Sudden jerking of arms or legs.
- Brief but can occur in clusters.
3. Absence Seizures
- Appear as brief staring spells or “blank stares.”
- Common in children and may go unnoticed.
- Sudden loss of muscle tone.
- May cause sudden falls or dropping objects.
Partial (Focal) Seizures (Affect One Area of the Brain)
1. Simple Partial Seizures
- Person remains aware.
- May have motor or sensory symptoms (tingling, jerking, visual changes).
- Often described as an aura.
- Person has altered awareness and may appear dazed.
- May perform repetitive movements (lip smacking, picking at clothes).
- Can progress to generalized seizures.
Seizure Precautions and Care
Caring for someone during a seizure requires calmness, quick action, and correct knowledge.
What To Do During a Seizure:
- Maintain an open airway – ensure oxygen and suction are available in hospital settings.
- Turn the person to their side – prevents aspiration and keeps airway clear.
- Loosen tight clothing – especially around the neck.
- Provide padding under the head – to prevent injury.
- Lower the bed and use side rails (hospital care).
- Note the time and duration of the seizure – seizures lasting >5 minutes require emergency intervention.
What Not To Do During a Seizure:
- ❌ Do not restrain the person.
- ❌ Do not force their jaw open.
- ❌ Do not place objects or fingers in their mouth.
- ❌ Do not leave the person unattended.
After the seizure, provide privacy, reassurance, and allow the person to rest.
Table: Seizure Types and Key Features
| Type | Key Features | Consciousness |
|---|---|---|
| Tonic-Clonic | Stiffening then jerking, full-body involvement | Lost |
| Myoclonic | Sudden jerks of arms/legs | Preserved |
| Absence | Blank stare, seconds long | Altered |
| Atonic | Sudden loss of tone, falls | Lost |
| Simple Partial | Motor/sensory symptoms, aura | Preserved |
| Complex Partial | Altered behavior, automatisms | Lost/Altered |
FAQs on Seizures
Q1. What is the difference between a seizure and epilepsy?
A seizure is a single episode of abnormal brain activity, while epilepsy is a chronic condition with recurrent seizures.
Q2. When is a seizure considered an emergency?
If a seizure lasts longer than 5 minutes or occurs repeatedly without recovery, it is status epilepticus—a medical emergency.
Q3. Can stress cause seizures?
Stress alone doesn’t usually cause seizures but can trigger episodes in individuals with epilepsy.
Q4. How can seizures be prevented?
Prevention includes adhering to prescribed medications, avoiding triggers like alcohol and sleep deprivation, and managing underlying health conditions.
Q5. Is it safe to hold someone down during a seizure?
No. Restraining a person can cause injury. The safest approach is to protect them from harm and allow the seizure to run its course.
