“I woke up and was around the paramedics; I didn’t remember
what happened…”
Around one percent of the population of the US (around 3.5 Million) have
been diagnosed with a seizure, which is a sudden, uncontrolled electrical
discharge in the brain. This “short-circuit” of the brain
is most commonly associated with convulsive, jerking movements in the
body; however, other types of more subtle seizures can occur including:
Staring off and being unresponsive to stimulus
Lost consciousness, lost awareness
Confusion and loss of knowledge of where one is
Changes in your behavior, movements or feelings
Epilepsy is a neurological condition diagnosed by recurrent unprovoked
seizures. A syndrome of epilepsy can be categorized by several types or
just one type of seizure and by proper interpretation of an EEG. Not all
epilepsy patients have a syndrome and are less likely to occur in adults.
As not all seizures fit the same mold, these spells are much more common
than one may think. Sometimes seizures can be preceded by an “aura”
including:
Bright lights in vision
Odd, unpleasant smells
Sense of “déjà vu”, or the vague sense that you
are repeating some action or have been somewhere you have not before
Sense of “jamais vu”, or the vague sense that you have never
done an action or been a place despite knowledge to the contrary
After a seizure has finished, people report a number of sensations as their
consciousness returns, including:
Feeling a sense of severe fatigue or lethargy
Feeling diffuse muscle aches
Tasting blood in their mouth, from biting the tongue or side of the mouth
during the seizure
A sense of confusion as to what happened, and where they are
Feeling that they have voided urine
While diagnosing a seizure is based largely on clinical evaluation by a
trained neurologist, sometimes due to the variety of seizures additional
information is needed. To aid in identifying and treating seizures, many
tests can be ordered including:
Seizures can happen after a head injury, bleeding in the brain, stroke,
or because of metabolic abnormalities. In some cases, severe infections
in the body or brain can cause seizures. Much less frequently, brain tumors
or cancers can cause seizures to occur. Despite our ability to diagnose
the cause of most seizures, some still remain “idiopathic,”
meaning of unknown cause.
Seeing a seizure happening to a loved one can be very difficult and traumatic,
but fortunately, most seizures last from 30 seconds to two minutes, and
then resolve. These events should prompt presentation to an emergency
department or at a minimum direct discussion at the time of the event
with your primary care physician for further recommendations.
If a seizure lasts longer than five minutes, immediately activate emergency
medical services, as this constitutes a true medical emergency. The EMS
team on arrival can administer medication to stop the seizure activity,
preventing further injury.
In all cases, a thorough workup of a patient with a first-time seizure
is necessary, as removal of the underlying cause of seizure can increase
the likelihood that the patient will have minimal to no other seizures
in the future.
Most seizure disorders can be controlled with medication, but management
of seizures can still have a significant impact on your daily life. As
such, our neurology and epilepsy teams will work with you to ensure prevention
of seizure disorder, while limiting any side effects which could have
an adverse effect on you.
The term “epilepsy” is used to describe a person who has two
or more seizures at least 24 hours apart that aren’t brought on
by an identifiable cause. To learn more about epilepsy click
here.
Temporal lobe epilepsy occurs mostly in focal epilepsy patients and can involve seizures on just
a portion of the temporal lobe or both sides of the temporal lobe.
Symptoms of this type of seizure include:
Auras
Deja-vu or upset stomach
Feelings of fear, panic, anxiety, a rising sensation coming from the stomach
to the chest or throat, or butterflies with nausea are other common auras
Unusual smell, which may raise the question of whether there is a lesion
or tumor in the hippocampus of the temporal lobe
Mesial temporal lobe epilepsy (MTLE) is when epileptic activity will occur in the hippocampus or surrounding
it and is present in 80 percent of all temporal lobe seizures.
Neocortical or lateral temporal lobe epilepsy just involves the lateral potion of the temporal lobe.
