What is a seizure?
The brain is the center that controls and regulates all voluntary and involuntary responses in the body. It consists of nerve cells that normally communicate with each other through electrical activity.

A seizure occurs when part(s) of the brain receives a burst of abnormal electrical signals that temporarily interrupts normal electrical brain function.

What are the different types of seizures?
There are several different types of seizures, including:

• Partial seizures
  Partial seizures take place when abnormal electrical brain function occurs in one or more areas of one side of the brain. In about one-third of people with partial seizures, the person may experience an aura before the seizure occurs. An aura is a strange feeling, consisting either of visual changes, hearing abnormalities, or changes in the sense of smell. Two types of partial seizures include the following:
  • Simple partial seizures
    This type of seizure typically lasts less than one minute. The person may show different symptoms depending upon which area of the brain is involved. If the abnormal electrical brain function is in the occipital lobe (the back part of the brain that is involved with vision), sight may be altered, but muscles are more commonly affected. The person’s muscles are typically more commonly affected. The seizure activity is limited to an isolated muscle group, such as the fingers, or to larger muscles in the arms and legs. Consciousness is not lost in this type of seizure. The person may also experience sweating, nausea, or become pale.
  • Complex partial seizures
    This type of seizure commonly occurs in the temporal lobe, which is the area of the brain that controls emotion and memory function, and usually lasts between one to two minutes. Consciousness is usually lost and a variety of behaviors can occur, including gagging, lip smacking, running, screaming, crying, and/or laughing. After regaining consciousness, the person may complain of being tired or sleepy; this is called the postictal period.
    
    
• Generalized seizures
  Generalized seizures involve both sides of the brain and cause a loss of consciousness and a postictal state. Types of generalized seizures include:
  • Absence seizures (formerly known as petit mal seizures)
    These seizures are characterized by an altered state of consciousness and staring episodes. Typically, the person's posture is maintained during the seizure. The mouth or face may move, or the eyes may blink. The seizure usually lasts no longer than 30 seconds. When the seizure is over, the person may not recall what just occurred and may go on with his/her activities, acting as though nothing happened. This type of seizure may occur several times a day and is sometimes mistaken for a learning problem or behavioral problem. Absence seizures are uncommon before the age of 5 and occur more often in girls.
    
    
  • Atonic
    This type of seizure is characterized by a sudden loss of muscle tone, and the person may fall from a standing position or suddenly drop his/her head. During the seizure, the person is limp and unresponsive.
    
    
  • Generalized tonic-clonic seizures (GTC; formerly known as grand mal seizures)
    This type of seizure is characterized by five distinct phases:. The body, arms and legs will flex (contract), extend (straighten out), and tremor (shake), followed by a clonic period (contraction and relaxation of the muscles) and the postictal period, during which the person may be sleepy, have problems with vision or speech, a bad headache, fatigue or body aches.
    
    
  • Myoclonic seizures
    This type of seizure is characterized by quick movements or sudden jerking of a group of muscles. Such seizures tend to occur in clusters, meaning that they may occur several times a day or for several days in a row.
    
    
  • Infantile spasms
    This rare type of seizure disorder occurs in infants younger than six months of age. It most often occurs when the child is awakening, or when he/she is trying to go to sleep. The infant usually experiences brief periods of movement of the neck, trunk, or legs that lasts for a few seconds. Infants may have hundreds of these seizures a day. This can be a serious problem and have long-term complications.
    
    
  • Febrile seizures
    This type of seizure is associated with fever and most commonly occurs in children between six months and six years old of families in which there is a history. Febrile seizures that last less than 15 minutes are called “simple,” and typically do not have long-term neurological effects. Those lasting more than 15 minutes are called “complex”" and may result in long-term neurological changes in the child.

What causes a seizure?
A person may experience one or many seizures. While the exact cause of the seizure may not be known, the more common types are caused by the following:

• In newborns and infants: 
  • Birth trauma 
  • Congenital (present at birth) problems 
  • Fever 
  • Metabolic or chemical imbalances in the body 
• In children, adolescents, and adults: 
  • Alcohol or drugs 
  • Head trauma 
  • Infection 
  • Unknown reasons

Other possible causes of seizures may include the following:

• Brain tumor 
• Neurological problems 
• Drug withdrawal 
• Medications

What are the symptoms of a seizure?
An individidual may show varying degrees of symptoms, depending upon the type of seizure. The following are general symptoms or warning signs of seizures:

• Staring 
• Jerking movements of the arms and legs 
• Stiffening of the body 
• Loss of consciousness 
• Breathing problems or breathing stops 
• Loss of bowel or bladder control 
• Falling suddenly for no apparent reason 
• Not responding to noise or words for brief periods 
• Appearing confused or in a haze 
• Sleepiness and irritability upon waking in the morning 
• Nodding of the head 
• Periods of rapid eye blinking and staring

During the seizure, the person's lips may become bluish and breathing may not be normal. Movements are often followed by a period of sleep or disorientation.

Symptoms of a seizure may resemble those of other medical conditions. For an accurate diagnosis, always consult a physician.

How are seizures diagnosed?
The full extent of the seizure may not be completely understood immediately after onset of symptoms, but may be revealed with a comprehensive medical evaluation and diagnostic testing. The diagnosis of a seizure is made with a physical examination and diagnostic tests. During the examination, the physician obtains a complete medical history of the person and his or her family and asks when the seizures occurred. Seizures may be due to neurological problems and require further medical follow up.

Diagnostic tests may include:

• Blood tests 
• Electroencephalogram (EEG) - a procedure that records the brain's continuous electrical activity by means of electrodes attached to the scalp. 
• Magnetic resonance imaging (MRI) - a procedure that uses a combination of large magnets, radiofrequencies and a computer to produce detailed images of organs and structures within the body. 
• Computed tomography scan (CT or CAT scan) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays. 
• Lumbar puncture (spinal tap)– procedure in which a special needle is placed into the lower back’s spinal canal, the area around the spinal cord, to measure the pressure in the spinal canal and brain. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problems. CSF is the fluid that bathes the brain and spinal cord.

Treatment of a seizure
Specific treatment for a seizure will be determined by your physician, based on:

• Your age, overall healthand medical history 
• Type of seizure 
• Frequency of seizures 
• Your tolerance for specific medications, procedures or therapies 
• Expectations for the course of the condition 
• Your opinion or preference

The goal of seizure management is to control, stop or decrease the frequency of the seizures without interfering with the normal activities of daily living (ADLs). The major goals of seizure management include the following:

• Proper identification of the type of seizure 
• Using medication specific to the type of seizure 
• Using the least amount of medication to achieve adequate control 
• Maintaining appropriate medication levels

Treatment may include:

• Medications
  There are many types of medications used to treat seizures and epilepsy. Medications are selected based on the type of seizure, age of the patient, side effects, the cost of the medicationand the adherence with the use of the medication.
  
  Medications used at home are usually taken by mouth (as capsules, tablets, sprinkles, or syrup), but some can be given rectally (into the person's rectum). If the person is in the hospital with seizures, medication by injection or intravenous (IV) may be used.
  
  It is important to take your medication on time and as prescribed by your physician. Different people use up the medication in their body differently, so adjustments (schedule and dosage) may need to be made for the most effective seizure control.
  
  All medications can have side effects, although some people may not experience side effects. Discuss your medication's side effects with your physician.
  
  While you are taking medications, different tests may be done to monitor the effectiveness of the medication. These tests may include the following:
  • Blood work
    Frequent blood draws testing is usually required to check the level of the medication in the body. Based on this level, the physician may increase or decrease the dose of the medication to achieve the desired, “therapeutic” level, where the medication works most efficiently. Blood work may also be done to monitor the effects of medications on body organs.
    
    
  • Urine tests
    These tests are performed to see how the person's body is responding to the medication.
    
    
  • Electroencephalogram (EEG)
    An EEG is a procedure that records the brain's continuous, electrical activity by means of electrodes attached to the scalp. This test is done to monitor how the medication is helping the electrical problems in the brain.
    
    
  • Vagus nerve stimulation
    Some people whose seizures are not being well-controlled with seizure medications may benefit from a procedure called vagus nerve stimulation (VNS). VNS is currently only used for persons over the age of 12 who have partial seizures that are not controlled by other methods.
    
    VNS attempts to control seizures by sending small pulses of energy to the brain from the vagus nerve, which is a large nerve in the neck. This is done by surgically placing a small battery into the chest wall. Small wires are then attached to the battery and placed under the skin and around the vagus nerve. The battery is then programmed to send energy impulses every few minutes to the brain. When the person feels a seizure coming on, he/she may activate the impulses by holding a small magnet over the battery. In many cases, this will help to stop the seizure.
    
    There are some side effects that may occur with the use of VNS. These may include, but are not limited to:
    • Hoarseness 
    • Pain or discomfort in the throat 
    • Change in voice 
      
      
• Surgery
  Surgery may be considered in a person who has:
  • Seizures that are unable to be controlled with medications 
  • Seizures that always start in one area of the brain 
  • A seizure in a part of the brain that can be removed without disrupting important behaviors such as speech, memoryor vision
    
    Surgery for epilepsy and seizures is a very complicated surgery performed by a specialized surgical team. The operation may remove the part of the brain where the seizures are occurring, or, sometimes, the surgery helps to stop the spread of the bad electrical currents through the brain.
    
    A person may be awake during the surgery. The brain itself does not feel pain. With the person awake and able to follow commands, the surgeons are better able to make sure that important areas of the brain are not damaged.
    
    Surgery is not an option for everyone with seizures. Discuss this treatment option with your physician for more information.

Additional information

• Make sure you or your child (if age appropriate) understand the type of seizure that is occurring and the type of medication(s) that are needed. 
• Know the proper dose of all medications, the times they are to be taken and their side effects. 
• Consult your physician before taking other medications. Medications for seizures can interact with many other medications, causing them to work improperly and/or side effects. 
• Young women of childbearing age who are on seizure medications need to be informed that seizure medications are harmful to a fetus, and the medication may also decrease the effectiveness of oral contraceptives. 
• Check with your state regarding laws about people with epilepsy or seizures operating a motor vehicle.
• If a person has good control over the seizures, only minimal restrictions usually need to be placed on activities. 
• Your physician will determine specific follow-up. 
• Medications for seizures may not be needed for the person's entire life. Some persons may be taken off their medications if they have been seizure-free for one to two years. Your physician will determine this.

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Online Resources of Nervous System Disorders