Seizures
Overview
A seizure is usually caused by unusual electrical activity in the brain.
There are many different types of seizures. These can affect different areas of the brain and body.
Seizures may be divided into two categories:
- Generalized seizures – involve the entire brain at once
- Partial (focal) seizures - involve only part of the brain
When these seizures become more frequent or disruptive, the condition is considered epilepsy.
Symptoms
Partial seizures begin in a specific area of the brain. They may affect only one part or side of the body. Symptoms include:
- Jerky or rhythmic movements
- Tingling
- Dizziness
- Feeling full in the stomach
- Repetitive motions
- Staring
- Confusion
- Changes in emotions
- Altered senses
Generalized seizures occur over the entire surface of the brain and may affect all areas of the body.
Symptoms of generalized seizures include:
- Convulsions
- Crying out or making a noise
- Stiffening
- Jerky, rhythmic or twitching motions
- Falling down
- Loss of consciousness
- Not breathing
- Confusion after returning to consciousness
- Loss of bladder control
- Biting the tongue
Causes and Risk Factors
Seizures can be linked to:
- Serious head injury
- Stroke
- Brain tumor
- Brain infection (meningitis or encephalitis)
- Alzheimer's disease
- Loss of oxygen at birth
- Hardening of the brain's arteries
Children are more likely than adults to develop seizures from an unknown cause. A family history of seizures may sometimes be a factor. However, experts are not sure how the condition is passed from parent to child.
Diagnosing the type of seizure is very important.
The doctor will ask you questions about your seizures to determine the type and if they are caused by epilepsy.
A detailed medical history often has the best clues about seizures. It may help rule out other conditions that might have caused the seizures. Patients will also have a neurological exam. During the exam they will be asked to remember what happens just before, during and right after they experience seizure.
The most useful way to diagnose epilepsy is an electroencephalogram (EEG). This records electrical activity in the brain. The EEG can record unusual spikes or waves in electrical activity patterns. Different types of epilepsy can be identified with these patterns.
Magnetic resonance imaging (MRI) and computed tomography (CT) scans may be used to look at the cause and the location within the brain. The scans can show scar tissue, tumors or structural problems in the brain.
Treatment
Partial and generalized seizures are often treated differently. Treatment will depend on:
- The type of seizure
- Frequency and severity of seizures
- The patient's age
- The patient's overall health and medical history
Anti-seizure (or anti-epileptic) medications can be very effective. Finding the right medication and the right dosage sometimes takes a few tries. Your doctor will work with you to watch for side effects and find the best treatment.
In cases where medication cannot control seizures, surgery may be an option.
A vagus nerve stimulator (VNS) is sometimes implanted and used along with anti-epileptic medication to reduce seizures. The VNS is a device placed under the skin of the chest that sends electrical energy through the vagus nerve in the neck to the brain.
Certain types of seizures may be controlled with a ketogenic diet. This is a high-fat, low-carbohydrate diet used most often for children who have not responded to medications.
The staff at the Cedars-Sinai Epilepsy Program will work with each patient to determine the best treatment option.
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