Seizures occur when electrical signals within the brain are disrupted. There are many different possible causes of seizure as well as many different seizure types; here’s a brief overview of seizures and what to do about them.
Causes and conditions
When seizures are mentioned epilepsy is often the first thing that springs to mind. Epilepsy itself is incredibly complicated and can be related to genetics, damage to the tissue of the brain through injury or illness and tumour growth among other factors.
Seizures are not always caused by epilepsy though. Traumatic head injuries can result in seizures, as can diabetes, overheating, imbalances in salt levels and use of, or withdrawal from, some drugs.
Classification of seizure types is complex and complicated by the fact that there is so much variation in how they begin, which functions are affected and how the seizure progresses. The International League Against Epilepsy classifies seizures into a dozen different categories which are divided into numerous further types. A few of the main external signs of seizures are listed here:
A focal seizure begins in and affects one part of the brain. Exactly how this presents depends on which part of the brain is affected as the seizure progresses. Simple focal seizures can come across as a strange taste in the mouth, unusual feelings in the head, hallucinations and twitching among other signs. For some people, a simple focal seizure is a warning sign that a different type of seizure is about to happen (sometimes known as an aura).
Complex focal seizures affect a larger part of the brain and can result in unusual behaviour such as wandering, fiddling with objects and muttering words that don’t make sense. The person experiencing the seizure may be able to hear, but not be fully alert or understand what is happening.
Generalised seizures can follow focal seizures or start without apparent warning. They affect both sides of the brain and result in unconsciousness, even if only briefly. There are a number of different types of generalised seizures:
Once known as Petit Mal seizures, an absence seizure is a temporary loss of consciousness that appears as though somebody has ‘zoned out’ or is daydreaming. Somebody experiencing an absence will not respond when spoken to and there may be some subtle movements such as nodding of the head.
During a tonic seizure the muscles stiffen, often leading to falls with the potential for injury. They are usually brief.
Sometimes known as ‘drop attacks’, the muscles go floppy, again tending to result in falls.
In a clonic seizure the muscles shake, with unusual movements of limbs. Breathing difficulties may be apparent during the seizure.
These begin as tonic seizures, with a collapse and then shortly afterwards become clonic, with generalised shaking. This is the seizure type people often imagine when they think of epilepsy.
After the seizure
Once the seizure has ended, confusion and disorientation are common. Most people recover within a relatively short period, but every individual responds differently. Often, following a major seizure, people will sleep for an extended period.
With seizures, the principles of first aid are the same as for any other injury or illness. The priority is to ensure the safety of yourself and the person experiencing the seizure. With a complex focal seizure this might include attempting to guide the person away from danger if they are wandering whereas with a tonic-clonic seizure it would be sensible to move furniture and other solid objects out of the way in order to prevent injury.
Never put anything in the mouth of somebody having a seizure and don’t attempt to restrain them. Soft padding can be placed behind the head with care to prevent injury.
Once the seizure has ended, anybody who remains unconscious should be placed on their side in the ‘recovery position’ to ensure that their airway can drain of any fluids.
Medical attention is needed in the following cases:
- The first seizure experienced
- A seizure lasting longer than 5 minutes, or 2 minutes longer than is normal for that individual.
- A second seizure begins without recovering from the first.
- Breathing difficulties following the seizure
- Injuries caused during the seizure (depending on the severity of the injury)
There’s a wealth of information and resources available on the Epilepsy Society and Epilepsy Action websites. For more information on our first aid courses click here.