While uncommon, seizures can lead to serious outcomes, including death. Most seizures resolve without lasting harm, and individuals with epilepsy often lead fulfilling lives. This article aims to clarify potential risks and offer actionable knowledge for those with seizures and witnesses.
Understanding Potential Fatalities
Death during or after a seizure can happen through several mechanisms. One significant concern is Sudden Unexpected Death in Epilepsy (SUDEP), which refers to the sudden, unexpected death of a person with epilepsy where no other cause is found during a post-mortem examination. It is estimated to affect approximately 1 in 1,000 adults and 1 in 4,500 children with epilepsy each year.
Causes of SUDEP are not fully understood, but involve a combination of factors. A seizure, particularly a generalized tonic-clonic seizure, can disrupt normal breathing patterns, leading to pauses in breathing (apnea) or respiratory suppression. Prolonged breathing difficulties can reduce oxygen levels in the blood and brain.
Seizures can also affect heart function, potentially causing dangerous heart rhythms or a very slow heart rate. Autonomic nervous system dysfunction, which controls involuntary bodily functions like heart rate and breathing, may also play a role. These cardiac and respiratory issues, sometimes combined with genetic predispositions, contribute to SUDEP.
Another serious condition is Status Epilepticus, defined as a seizure lasting five minutes or longer, or multiple seizures occurring without the person fully regaining consciousness between them. This prolonged seizure activity can lead to brain injury if not treated promptly. While not always fatal, Status Epilepticus is a medical emergency requiring immediate intervention to prevent severe complications.
Beyond these direct physiological impacts, seizures can lead to death through accidents or injuries. Individuals may sustain head trauma from falls during a seizure. Drowning is also a risk if a seizure occurs in water, even shallow water. Aspiration pneumonia can occur if a person inhales food, fluid, or vomit into their lungs during a seizure, leading to severe respiratory complications. Underlying medical conditions that contribute to seizures, such as brain tumors, strokes, or infections, may be life-threatening.
Factors Increasing Risk
Certain factors can increase susceptibility to severe seizure-related outcomes. The frequency and type of seizures impact risk, with generalized tonic-clonic seizures (GTCS) associated with a higher risk of death, including SUDEP. More frequent and uncontrolled seizures are also linked to an elevated risk.
Non-adherence to prescribed anti-seizure medication is a risk factor. Missing doses can lead to breakthrough seizures, increasing the likelihood of adverse events. The duration of epilepsy and the age at which seizures began can also influence risk, with seizures starting at a younger age may be associated with a higher chance of sudden death.
A history of Status Epilepticus indicates an increased risk of mortality. Lifestyle factors, such as alcohol problems, can also contribute to a higher risk of death in individuals with epilepsy. Experiencing injuries or being treated for depression are identified as risk factors.
Reducing Risks
Managing seizures effectively involves several proactive strategies aimed at minimizing risks. Consistent adherence to prescribed anti-seizure medication is a primary method for preventing seizures and their associated risks. Taking medication as directed helps maintain stable drug levels, reducing breakthrough seizures.
Identifying and avoiding personal seizure triggers is another preventive step. Common triggers include sleep deprivation, emotional stress, and alcohol consumption. Flashing lights or certain illnesses can also provoke seizures. Maintaining a regular sleep schedule, managing stress through techniques like meditation or exercise, and limiting alcohol intake can help reduce seizure frequency.
Implementing safety measures in daily life can help prevent injuries during a seizure. This includes ensuring a safe environment by moving away from hazards or securing objects that could cause harm. For instance, avoiding swimming alone or taking baths instead of showers can mitigate drowning risks. Regular medical follow-ups with a healthcare provider are important to review medication effectiveness and adjust treatment plans as needed.
Immediate Seizure Response
Knowing how to respond during a seizure can help ensure the person’s safety. When someone has a seizure, remain calm and stay with the individual. Time the seizure, especially the jerking movements, as this information is useful for medical professionals. Most seizures last less than a few minutes.
Protect the person from injury by moving any hard or sharp objects away from their vicinity. If the person has fallen, gently ease them to the floor. Place something soft, like a folded jacket or pillow, under their head to cushion it. Turning the person gently onto one side can help them breathe more easily and prevent saliva from blocking their airway. Loosen any tight clothing around their neck.
There are also actions to avoid during a seizure. Do not attempt to hold the person down or stop their movements, as this can cause injury to both the person having the seizure and the helper. Do not place anything in the person’s mouth, as this can injure their teeth or jaw. It is not possible for a person to swallow their tongue during a seizure. Do not offer water or food until the person is fully alert, to prevent choking.
Call emergency services if the seizure lasts five minutes or longer. Seek immediate help if:
It is the person’s first known seizure.
A second seizure quickly follows without full recovery.
The person has breathing difficulties after the seizure.
They sustained an injury.
The seizure occurs in water.