A seizure happens when there are certain types of abnormal electrical activity in the brain. During a seizure, you may: Lose consciousnessStare into spaceHave convulsions—abnormal jerking of the musclesExperience abnormalities of sensation or emotion
If you have two or more seizures that are not due to an illness or other trigger, then it is considered a seizure disorder. This condition is also known as epilepsy.
Seizure disorders may be classified by the part of the brain they affect and the kinds of symptoms they cause. One way to categorize into two important groups is: Generalized seizure disorder—onset is throughout the brain, not from a single focal locationPartial seizure disorder (focal seizure)—begins within certain areas of the brain
Brain Cells (Neurons)
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Seizures are caused by abnormal brain function.
For many people, it is not known what causes the malfunction. Some known causes include:
trauma—common cause (eg,
, bleeding inside of the skull, oxygen deprivation due to
, cerebritis, brain abscess)
In older adults:
Degenerative diseases (eg,
Factors that may increase your chance of developing seizures or a seizure disorder include: Previous brain injury—seizure disorder usually develops within one year of injuryPrevious brain infectionAbnormal blood vessel that has formed in the brainBrain tumorHistory of
strokeHistory of complex febrile seizuresUse of certain medications or recreational drugs
Stopping the use of medications, recreational
Exposure to toxins (eg,
Family history of seizure disordersAlzheimer’s diseaseToxemia during pregnancyChemical abnormalities—decreased or excess blood sodium or glucose, low blood calcium
high blood pressure
Chronic diseases (eg,
sickle cell disease
Cysticercosis—an infection caused by a pork
If you already have a seizure disorder, the following factors can increase your chance of having a
seizure: Sleep deprivationAlcoholHormonal changes, such as those that occur at points during the menstrual cycleStressFlashing lights, especially strobe lightsUse of certain medicationsMissing doses of anti-epileptic medications
There are many kinds of seizure disorders with a variety of symptoms, such as: Aura—a sensation at the start of a seizure, may involve the perception of an odd smell or sound, visual symptoms, or unusual stomach sensationsStaringLoss of consciousnessRepeated jerking of a single limbGeneralized convulsion with uncontrollable jerking of muscles throughout the bodyHand rubbingLip smackingPicking at clothingPerception of an odor, sound, or tasteLoss of bladder or bowel controlPostictal state—a state of drowsiness, alteration in responsiveness, and/or confusion that commonly occurs after a generalized tonic-clonic seizure; may last minutes, hours, or days
Symptoms of generalized seizure disorders include: Generalized tonic-clonic seizures—loss of consciousness, stiffening, uncontrollable jerking of muscles throughout the bodyAbsence seizures—staring, eye blinking, or eye rolling
Symptoms of partial seizure disorder include:
Complex partial or temporal lobe seizures:
May lose contact with reality, stop purposeful activity, and begin a series of automatic gestures (eg, lip smacking, hand-wringing, or picking at clothing)May appear as a brief moment of confusion or loss of attentivenessMay have a perception of unusual sights, sounds, or smells
Simple partial seizures:
Does not involve a loss of contact with reality or a loss of consciousnessSingle area of the body may move uncontrollably (eg, leg or arm shaking)May include the perception of an odor, sound, or taste, or an unrelated emotion
You will be asked about your symptoms and medical history. A physical exam will be done. You may need to see a neurologist. These doctors specialize in the nervous system and brain.
Your bodily fluids may be tested. This can be done with: Blood testsLumbar puncture
Images may be taken of your bodily structures. This can be done with: MRI scanCT scanMagnetoencephalography (MEG)Positron emission tomography
Single photon emission computed tomography (SPECT)
Your brain activity may be evaluated. This can be done with an
The goals of treatment are to: Treat the underlying cause (if known)Prevent seizures—may be done through medications, surgery, or special therapiesAvoid factors that stimulate seizure activity
There are wide varieties of medications that may be used. These drugs may be given alone or in combination. Each drug may have particular side effects and interactions. Talk to your doctor about which medication is right for you.
Talk to your doctor if you are or plan to become pregnant.
If medication does not work or the side effects are too severe, you may need surgery. Surgery involves the removal of the seizure focus. This is the area of the brain that has been identified as starting the seizure. Surgery is only an option for people who have very localized areas of the brain involved.
A device is implanted in the chest. It will provide intermittent electrical stimulation to the vagus nerve. It is not clear how this works. Somehow it prevents or decreases the frequency of seizures. You may still require medication. The dosage may be less.
This is a strict diet. It is high in fat and low in carbohydrates and proteins. This diet keeps the body’s chemical balance in ketosis. Ketosis decreases the frequency of seizures. The reason is unknown. Following a
is most successful in children. It is less successful in adults.
If you have a seizure disorder, you can take the following steps to try to decrease the chance of a seizure: Get enough sleep.Avoid excessive alcohol intake. Alcohol can make seizures more likely.Avoid hyperventilating.Avoid places where flashing or strobe lights are in use.Wear a medical alert bracelet. That way, if you have a seizure, people around you will understand what is happening. They will be able to take appropriate steps to be helpful.Consider keeping a seizure log. Record things that were happening around the time of a seizure. This will help to identify a seizure trigger.Take your seizure medications according to the prescription.
There are no known ways to prevent every type of seizure disorder. You can take steps to prevent brain injuries that could lead to seizures: Always wear a helmet when using bikes, rollerblades, skateboards, or scooters.Wear protective headgear when playing contact sports.Dive in safe depths of water.Always wear a seatbelt.Avoid using street drugs.If your baby or child has a high fever, get treatment right away.
Get prenatal care. If you have
high blood pressure
during pregnancy, get proper treatment.
If you have a chronic condition, get proper care.
If you have a severe seizure disorder, some changes may be needed to prevent serious injuries, such as: Avoid driving, if advised to do so by your doctor.Do not swim or bathe alone.Do not work on ladders or ledges.Avoid or modify athletic activities.
Talk to your doctor about these kinds of issues.
FDA approves new drug to treat severe form of epilepsy. US Food and Drug Administration website. Available at:
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2008/ucm116980.htm. Published November 20, 2008. Accessed November 18, 2014.
FDA approves Potiga to treat seizures in adults. US Food and Drug Administration website. Available at:
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm258834.htm. Published June 13, 2011. Accessed November 18, 2014.
Fisher RS, Van Emde Boas W, Blume W, et al. Epileptic seizures and epilepsy: Definition proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE).
12/20/2007 DynaMed's Systematic Literature Surveillance
http://www.dynamed.com/topics/dmp~AN~T115086/Epilepsy-in-adults: 2007 safety alerts for drugs, biologics, medical devices, and dietary supplements: Carbamazepine (marketed as Carbatrol, Equetro, Tegretol and generics). Medwatch. US Food and Drug Administration website. Available at:
Last reviewed December 2014 by Rimas Lukas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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