A seizure represents a temporary, uncontrolled electrical disturbance within the brain. This sudden surge of activity can lead to a range of physical and mental changes. Understanding how to identify seizure activity is important because early recognition can contribute to better management and outcomes. Seizures can manifest in various ways, from subtle changes in awareness to more dramatic physical movements. Recognizing these different presentations allows individuals to seek appropriate medical attention or provide assistance.
Understanding Seizure Categories
Seizures are broadly classified based on where they begin in the brain. Generalized onset seizures involve abnormal electrical activity that affects both sides of the brain simultaneously. These seizures typically impact awareness from the outset.
Focal onset seizures originate in only one specific area or side of the brain. The symptoms experienced during a focal seizure depend on the brain region affected. Sometimes, a focal seizure can spread to involve both sides of the brain, becoming a focal to bilateral tonic-clonic seizure. There are also unknown onset seizures, where the beginning of the seizure is not observed or cannot be determined.
Recognizing Seizure Symptoms
Recognizing the signs of a seizure involves observing both motor and non-motor changes. Generalized seizures, which affect both sides of the brain, include several types with distinct symptoms. A common generalized seizure is the tonic-clonic seizure, formerly known as a grand mal seizure. This type typically involves an initial stiffening of the body (tonic phase), often causing a fall, followed by rhythmic jerking movements of the limbs (clonic phase). During a tonic-clonic seizure, a person usually loses consciousness and may experience frothing at the mouth or loss of bladder control.
Absence seizures, sometimes called petit mal seizures, are another type of generalized seizure. These are characterized by brief periods of staring or blank spells, often lasting only a few seconds. The person may appear to be daydreaming and will typically be unaware of their surroundings during the episode.
Myoclonic seizures involve sudden, brief, shock-like jerks or twitches of a muscle or group of muscles, which can cause a person to drop an object they are holding or experience a sudden jolt. Atonic seizures, or “drop attacks,” cause a sudden loss of muscle tone, leading the person to suddenly collapse or slump over if seated. This rapid loss of muscle control can result in falls and potential injuries.
Focal onset seizures, originating in one part of the brain, can present with a wide array of symptoms depending on the affected area. Focal motor seizures involve involuntary movements such as jerking, stiffening, or repetitive actions of a limb or one side of the body. For example, a person might experience repetitive movements like lip smacking, chewing, or fumbling with their hands.
Focal non-motor seizures affect senses, emotions, or thinking without prominent physical movements. A person might experience unusual sensations like tingling, numbness, or a strange taste or smell that isn’t actually present. They could also have visual disturbances, such as flashing lights or blurred vision. Emotional changes, like sudden feelings of fear, joy, or déjà vu, can also occur. Awareness may or may not be impaired during a focal seizure; some individuals remain fully conscious, while others might appear confused or unresponsive.
Immediate Steps During and After a Seizure
Knowing how to respond during and after a seizure ensures safety. If you observe someone having a generalized tonic-clonic seizure, keep them safe. Move any nearby objects that could cause injury, such as furniture or sharp items. Gently turn the person onto their side to keep their airway clear and prevent choking. Place something soft, like a jacket or pillow, under their head.
Time the seizure from start to finish. Do not attempt to restrain the person or put anything into their mouth, as this can cause injury. Loosen any tight clothing around their neck to aid breathing. After the seizure ends, the person may be confused, drowsy, or disoriented; remain with them until they fully recover. Call for emergency medical help immediately if the seizure lasts longer than five minutes, if the person has difficulty breathing after the seizure, if a second seizure occurs, or if the person is injured.
Seeking Professional Medical Evaluation
After experiencing or witnessing a potential seizure, seek professional medical evaluation. A definitive diagnosis requires a comprehensive assessment by a healthcare provider. This evaluation typically includes a detailed review of the event, including what happened before, during, and after the suspected seizure. Providing a thorough account of symptoms, duration, and any accompanying observations is helpful for the medical team.
Diagnostic procedures often involve a neurological examination to assess brain and nerve function. An electroencephalogram (EEG) may be performed to record the electrical activity of the brain, which can help identify abnormal patterns. Imaging scans such as magnetic resonance imaging (MRI) or computed tomography (CT) scans of the brain are used to look for structural abnormalities or other underlying causes. Medical consultation is important for proper understanding and management, as self-diagnosis is not sufficient for these complex neurological events.