CPR First Aid

What is Seizure?

what is seizure

seizureA seizure is a sudden interruption to the brain’s normal function when an abnormal level of the electrical activity of the neurons takes place.

Epilepsy is the term given to describe a condition where someone is predisposed to recurrent, unprovoked seizures. However, anyone can have a seizure given the circumstances, not just people with epileptic seizures.

Tonic-clonic seizures are convulsive seizures where the body stiffens (tonic phase) followed by general muscle jerking (clonic phase) and involve the whole brain. The person loses consciousness, their body stiffens and their limbs jerk. These seizures generally last up to three minutes. There are many other types of seizures.

Different Types of Seizures

Generalized Seizures

Generalized onset seizures are one major type of seizure. This is characterised by the regions of the brain it affects, namely that it affects both sides of the brain.

There are several terms that help describe how generalized seizures affect a person and their body:

  • Tonic SeizuresStiffening of the muscles occurs in the body.
  • Atonic seizures – When the muscles in the body relax.
  • Myoclonic seizures – This is when parts of the body experience short jerking movements during seizures.
  • Clonic seizures – This is characterized as longer periods when body parts shake or jerk around.

Types of Generalized Seizures

  • Absence Seizures – First type of generalized seizure. Also known as petit mal seizure. This type will have the person rapidly blink or stare into space for several seconds. It is mainly due to unusual electric activity in an area of the brain. This could cause a loss of awareness or consciousness.
  • Tonic-clonic Seizures – Also known as grand mal seizures. This type of seizure has people crying out, falling on the ground, jerking around, experiencing muscle spasms, and generally losing consciousness. This is accompanied by fatigue afterwards.

Focal Seizures

Focal onset seizures are another major type of seizure where it is only located in one part of the brain. These are also known as partial seizures. In some cases, people experience a focal aware seizure wherein they can feel it is about to happen. They may also feel things like deja vu and vision changes.

Here are some types of focal seizures:

  • Simple partial seizures – This type of seizure affects a small portion of the brain. People experiencing it twitch and experience things like changes in taste and smell.
  • Complex partial seizures – As opposed to the previous type, this seizure affects one area of the brain and travels to another area. People can feel dazed and confused when they experience this. They will also be unable to answer any questions for several minutes.
    Infographic shows non-epileptic seizure triggers, raising awareness in the community.

Common Causes of Seizures other than Epilepsy:

  • Head Trauma, a head injury or a brain injury
  • Drug or alcohol intoxication
  • Fever (febrile convulsions)
  • Brain tumours or other medical conditions that could be affecting the brain
  • Lack of sleep or sleep deprivation
  • Certain prescribed drugs, such as some anti-depressants
  • Abnormalities in blood sugar
  • Infection
  • Photo-sensitive epilepsy can be triggered by flashing lights in TV shows or video games
  • Seizures during or shortly after pregnancy can be a symptom of eclampsia

an infographic featuring a list of helpful actions to take during a seizure

Seizure first aid: keep safe, time, cushion head, turn on side, stay calm, don't restrain.Management – DO:

  • Most Important is to stay calm
  • Stay with the casualty
  • Look at the time to see how long the seizure lasts for
  • Move any bystanders and any objects out of the way which could injure the casualty, especially the head
  • Once the seizure has stopped, follow DRS ABCD
  • If unconscious and breathing, or if fluid/vomit/food in the mouth, roll the casualty into the recovery position
  • Maintain casualty’s privacy and dignity
  • They will likely be very tired, so let them rest and stay with them for reassurance
  • If the casualty has injured themselves during the seizure, attend to their injuries once it has finished

Seizure infographic: DON'Ts list. Key support guidelines during a seizure episode.

Management – DO NOT:

🗵 Do not put anything into their mouth

🗵 Do not restrain the casualty

🗵 Do not move the casualty unless they are in danger

🗵 Do not give them anything to eat or drink until they have fully recovered

You need to seek medical assistance (Call 000) if:medical assistance

  • The casualty injures themselves badly during a seizure
  • The casualty is having difficulty breathing after the seizure (this should be distinguished from normal laboured breathing because the casualty is puffed out)
  • If a second seizure follows the first seizure
  • If the seizure lasts longer than 5 minutes (if the normal time is not known), or if the seizure lasts longer than usual (the casualty may have a bracelet or card in their wallet which outlines the usual time they last)
  • If the casualty is not known to have epilepsy

febrile convulsionsSeizures (Febrile Convulsions)

A high fever in a child may trigger a convulsion/seizure known as a febrile convulsion or febrile seizures. This may occur in children aged from six months to five years. The convulsion can last a few seconds or up to 15 minutes and is often followed by a brief period of drowsiness.

Infographic: Icons & text show signs & symptoms of seizures for easy recognition & understanding.

Signs and Symptoms:

  • Loss of consciousness
  • Muscles may stiffen, jerk or twitch
  • Face may go pale or blue
  • Difficulty in breathing
  • Moaning, crying
  • Vomiting
  • Foaming at the mouth
  • Staring off and lip smacking

Management – DO:

✓ Most Important is to stay calm and remain with the child
✓ Look at the time to see how long the seizure lasts for
✓ Lay the child onto a soft surface or the floor with a blanket underneath
✓ Remove any object which could injure the child
✓ Move the child only if they are in a dangerous location
✓ Loosen tight clothing and if possible, remove or open clothes from the waist up

Management – DO NOT:

  • Do not put anything into their mouth
  • Do not restrain the child
  • Do not put the child into a bath
  • Do not give them anything to eat or drink

Once convulsion has stopped:

  • Roll the child into the recovery position whilst drowsy
  • Place cool washcloths on the neck and forehead
  • Using tepid water (not cold), sponge the rest of the child’s body
  • Contact professional medical help (Call 000) if:
    o Convulsion lasted more than 5 minutes
    o Child does not wake up
    o Child had more than one convulsion in a short period of time
    o Child has been injured or appears quite ill
  • Contact a local family doctor if:
    o Convulsion lasted less than 5 minutes
    o Child had a previous illness before the convulsion

Diagnosing Seizures

Seizures are tricky for the reason that if a person has experienced one, they may not realize it. If one suspects that it is the case though, make no mistake, it is a medical emergency that needs to be addressed. That is why it is important to monitor and note any possible seizure activity, and seek out a medical diagnosis.

When visiting a professional healthcare facility, a physical and neurology test need to be taken. Taking a brain scan will help record the electrical events happening in the brain. Things like an MRI and an electroencephalogram (EEG) are two procedures that can help with this. Another possible procedure would be blood tests to look for chemical imbalances and immune system problems.

Treatments and Improvements

Specialists can help treat seizure disorders. Anti-seizure medications can be assigned. It is important to speak to the medical professionals and specialists though to understand any potential side effects.

In some cases, other avenues for treatment can also be pursued. Doctors may recommend a ketogenic diet which is characterised as a high fat and low carbohydrate diet. While there are mixed results for this diet, it may be worthwhile asking about.

Epilepsy surgery is also an option. These surgeries are recommended if two or more medications do not work. For improved control during seizures, nerve stimulation devices can also be placed within the body via surgery.

Finally, for those who wish to learn more about epilepsy and seizures, people can reach out to the Epilepsy Foundation for more education and training.

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