A seizure is a temporary disturbance in the brain’s electrical activity, causing various symptoms such as changes in movement, behavior, or awareness. While many seizures occur as isolated events, some individuals experience a specific pattern known as cluster seizures. This article explains what cluster seizures are, their potential causes, common triggers, and how to respond safely and effectively when they occur.
What Defines Cluster Seizures
Cluster seizures involve multiple seizures occurring within a short, defined period, typically hours to a few days. Individuals generally regain some level of consciousness between these events, distinguishing them from continuous seizure activity known as status epilepticus. The definition of a seizure cluster generally signifies an increase in seizure activity compared to a person’s usual pattern.
For instance, it might involve two or more seizures within a 24-hour period, or a grouping of seizures closer together than is typical for that individual. Any type of seizure can occur in clusters, including generalized tonic-clonic seizures, focal seizures, and absence seizures. Recognizing this pattern is important as it often indicates a need for intervention to prevent progression to more severe conditions.
Understanding the Causes and Triggers
Cluster seizures often occur in individuals with an underlying diagnosis of epilepsy, which can be idiopathic (of unknown cause) or symptomatic (linked to a specific brain condition). Conditions such as brain injuries, infections, and tumors can disrupt normal brain activity and contribute to the development of epilepsy and, subsequently, seizure clusters. In some cases, the exact reason for cluster seizures is not fully understood.
Beyond underlying causes, several triggers can precipitate a cluster of seizures. Common triggers include stress, sleep deprivation, and illness, especially if accompanied by fever. Changes in medication, such as missed doses of anti-seizure drugs, or hormonal fluctuations, particularly in women around menstruation, can also increase the likelihood of a cluster.
Immediate Steps During a Cluster Seizure
When someone is experiencing a seizure, ensuring their safety is the primary concern. Clear the area around the person to remove any hard or sharp objects that could cause injury, and gently ease them to the ground if they are falling. Cushion their head with something soft, like a folded jacket, and loosen any tight clothing around their neck to aid breathing. Avoid restraining the person or putting anything in their mouth, as this can cause harm.
Time the seizure from its start to its end. After the convulsions stop, gently roll the person onto their side into the recovery position to keep their airway clear and prevent choking. Many individuals with cluster seizures are prescribed “rescue medications,” typically fast-acting benzodiazepines, to be administered at home to stop a cluster. These medications, available as nasal sprays or rectal gels, are distinct from daily anti-seizure medications and should only be used as directed by a healthcare provider.
When to Seek Urgent Medical Attention
While many seizures resolve on their own, certain situations involving cluster seizures warrant immediate medical attention. Call for emergency medical help if a single seizure lasts longer than five minutes, or if multiple seizures occur without the person regaining full consciousness between events. This pattern can indicate a progression towards status epilepticus, a medical emergency.
Urgent care is also necessary if the person sustains a significant injury during the seizure, experiences difficulty breathing, or if it is their first-ever seizure cluster. If prescribed rescue medication is ineffective in stopping the cluster, or if the person does not begin to recover within 10 to 15 minutes after seizure activity stops, seek emergency medical assistance. A seizure action plan, developed with a healthcare provider, can provide clear guidelines on when to escalate care.