Types of seizures, symptoms & treatment

What is a seizure?

Generally, a seizure is the result of sudden abnormal electrical activity in the brain. In some cases, this can be traced to a specific cause or trigger. In other cases, a cause can’t be identified, but the seizures can still be treated.

With isolated seizures, symptoms are generally an indicator of another condition, such as a brain injury or disease (like epilepsy or metabolic disease), stroke or certain illnesses.

Epileptic seizures can cause involuntary movements, changes in behavior and sometimes a loss of consciousness.

Other kinds of seizures are called unprovoked seizures because no cause can be identified. A seizure is also called an unprovoked seizure if it happens more than seven days after a head injury, stroke, brain hemorrhage or other brain accident.

Widely regarded as a pediatric disorder, almost one-third of new cases of epilepsy are diagnosed in early childhood. A first seizure requires careful diagnostic evaluation to determine the cause of the event and the most appropriate treatment. Recurrent epileptic seizures can affect neural development in young children and present special challenges to patients and their families.

Types of seizures & symptoms

When some people think of seizure symptoms, they imagine a full-body episode with loss of consciousness and involuntary jerking or twitching of the muscles. This type of seizure – called a tonic-clonic or grand mal seizure can actually involve a wide range of symptoms.

Focal onset seizures

Focal onset seizures, which were previously called partial seizures, start in one side of the brain and may spread to other areas of the brain.

During focal onset seizures, the person may or may not lose awareness of their surroundings. They may begin in an aware state and progress to a state of impaired awareness – previously called a complex partial seizure.

Depending on what area of the brain is affected, focal onset seizure symptoms may include:

• Rhythmic jerking movements confined to a specific body part, such as a hand or arm
• A sudden change in sensory awareness or strange sensations such as tingling or flashing lights, often referred to as an “aura”
• Compulsive hand-rubbing, swallowing, picking at clothing or other repetitive movement with no purpose (called automatisms)

Generalized onset seizures

Generalized onset seizures affect both sides of the brain at the same time. This type of seizure is characterized by a loss of awareness but may or may not involve motor symptoms. Here are the different types of generalized seizures:

• Atonic seizures: Complete loss of muscle control

• Tonic seizures: Stiffening of muscles
• Clonic or myoclonic seizures: Muscle twitching or jerking movements
• Absence seizures: Vacant stare, hand-rubbing, lip-smacking or chewing
• Tonic-clonic seizure: Muscle stiffening and muscle jerking or spasming
• Absence seizures (previously called petit mal seizures): Staring blankly with a momentary loss of awareness

What causes seizures?

Whereas some seizures can’t be traced to a clear cause (called unprovoked or unknown onset seizures), some types of seizures can occur as a result of a wide range of medical conditions including:

• Brain tumors
• Head injuries
• Meningitis or encephalitis

• Low blood sugar associated with diabetes or abnormal electrolytes (blood minerals)
• Brain malformation or lack of oxygen during birth
• High fever or infection (usually in infants and children)
• Alcohol or medication withdrawal
• Illegal drug use
• Extreme intoxication
• Anxiety and depression (in rare cases)
• Stroke

Are you at risk for stroke?

Most strokes are preventable, and many of the risk factors are controllable. Our stroke risk quiz will help you estimate your chances of experiencing one, find ways to minimize your risk and give you an idea of what to do next based on your results.

Take the stroke quiz

What to do if someone is having a seizure

First, don’t panic. Most seizures don't require emergency medical attention. Stay with the person until the seizure is over, moving any hard or sharp objects away from them to minimize the risk of injury, and protect their head by rolling them to one side if possible. Many people will be confused and disoriented after a seizure, so help them get to a safe place to recover.

If you believe someone is having a seizure, ease them to the floor and cushion their head with a pillow or item of clothing. You can also move them onto their side for easier breathing and remove or loosen items like neckties or glasses. Do not attempt to hold the person down, open their mouth, put anything in their mouth or administer CPR.

How to recognize when a seizure is a medical emergency

Seek medical attention right away if the person has never had a seizure before or if they also have another high-risk condition such as a high fever, heat exhaustion, diabetes or pregnancy.

If the seizure lasts more than five minutes or the person has multiple seizures for more than five minutes also call for medical help immediately. This condition is called status epilepticus and it’s a medical emergency. Status epilepticus can cause permanent brain damage or death if it’s not treated right away.

Treatment for seizures

Dietary therapy and stress reduction can help seizure disorders in some people. In other cases, however, doctors will prescribe anti-seizure medication to help limit seizure frequency.

If medications aren’t effective to control seizure disorders, your doctor may recommend a surgical treatment such as vagal nerve stimulation, laser ablation or surgical resection.

• Medications: Medication can be particularly effective in reducing the frequency and severity of seizures, while surgery may be an option for adults or children with a clearly defined focal point responsible for triggering seizures. It’s a successful way to treat seizures in seven out of 10 people. If one medication doesn’t stop your seizures, your doctor can try a variety of others.
• Vagal nerve stimulation:With this treatment, the doctor implants a small device under the skin in the left chest area. An electrode or wire attached to the device is also placed under the skin and attached around the vagus nerve in the neck. The device is programmed to deliver pulses at regular intervals to prevent seizures.
• Laser ablation: Laser ablation is a minimally invasive, robotic laser surgery for treating epilepsy or tumors. Using near-infrared lasers, neurosurgeons can directly target lesions deep in the brain that they believe may be causing seizures.
• Surgical resection: In some cases, surgery is an option for stopping epileptic seizures. Finding the exact site of abnormal electrical activity is essential before surgical treatment can be considered. Abnormalities located in the temporal lobe of the brain can be treated most successfully with surgery. The surgeon removes brain tissue from the area of the brain where seizures occur, which usually contains a tumor, brain injury or malformation.