It is possible to have multiple seizures in a row. A seizure is a sudden, uncontrolled electrical disturbance in the brain that temporarily affects movement, consciousness, or behavior. While many seizures are isolated events, experiencing a succession of seizures is a recognized pattern in epilepsy that requires specific medical attention. This occurrence can manifest in different ways, ranging from short bursts of increased activity to a prolonged medical emergency.
Understanding Seizure Clusters
Seizure clusters, also known as acute repetitive seizures, involve multiple seizures occurring within a short timeframe, often hours or a few days. Clinically, this is often defined as two or more seizures within a 24-hour period. The defining characteristic is that the person recovers consciousness or returns to their baseline state between each event, distinguishing clusters from continuous seizure activity. Clusters can involve any seizure type and may increase the risk of injury due to the repeated events and prolonged recovery time. Individuals experiencing clusters often have a prescription for rescue medication, a fast-acting drug administered outside a hospital to interrupt the cluster and prevent a more severe event.
Recognizing Status Epilepticus
The most serious medical condition involving repeated seizures is Status Epilepticus (SE), a life-threatening emergency. SE is defined as a single seizure lasting five minutes or more, or as a series of seizures where the person does not regain full consciousness between episodes. If a seizure continues past five minutes, the brain’s natural mechanisms for stopping the event have likely failed, meaning intervention is required. Status epilepticus is categorized into two main forms: convulsive and non-convulsive. Convulsive SE involves the dramatic, uncontrolled shaking associated with prolonged tonic-clonic seizures. Non-convulsive SE is harder to recognize, involving continuous electrical seizure activity without prominent physical convulsions; the person may appear confused or have an altered mental state. Uncontrolled seizure activity for an extended time is dangerous because it can damage neurons, potentially leading to permanent brain injury or death, particularly if the seizure continues beyond 30 minutes.
Common Reasons Seizures Repeat
Repeated seizures often occur due to an identifiable trigger or change in management. The most common causes include not taking anti-seizure medication as prescribed or a recent change in dosage. A sudden illness or infection, especially one causing a high fever, can also significantly lower the seizure threshold. Lifestyle factors play a substantial role in recurrence. Severe sleep deprivation or chronic stress are well-known triggers that disrupt the brain’s stability. Other factors include significant hormonal changes, such as those experienced during the menstrual cycle in catamenial epilepsy, or metabolic imbalances like low blood sugar. Additionally, the use of or withdrawal from alcohol and certain recreational or prescription drugs can provoke a cascade of seizures.
Emergency Protocol for Repeated Seizures
Immediate action is necessary when a person experiences a prolonged or repeated seizure. If the person is having a convulsive seizure, first ensure safety by moving nearby objects that could cause injury. Gently turn the person onto their side to keep the airway clear and place something soft under their head. The most crucial step is to time the seizure accurately, as this duration dictates the need for emergency services. Call emergency services immediately if a seizure lasts five minutes or longer, which is the defining time point for a medical emergency. Emergency services should also be called if the person has a second seizure without fully regaining consciousness or awareness after the first, or if they are injured during the event. People with known epilepsy should have an individualized seizure action plan that outlines when to administer rescue medication and when to contact emergency services.