A seizure involves a sudden, uncontrolled burst of electrical activity among brain cells, leading to temporary changes in awareness, muscle control, behavior, or sensations. While some seizures might be a one-time event, recurring seizures are characteristic of epilepsy.
Acute Risks During Seizures
Untreated seizures present immediate dangers and can lead to medical emergencies during the event itself. Physical injuries are a common risk, including falls, burns, head trauma, cuts, bruises, or broken bones due to loss of consciousness or uncontrolled movements.
Aspiration, inhaling vomit or saliva, is another serious acute risk, potentially leading to choking or aspiration pneumonia. Untreated seizures also increase the likelihood of status epilepticus, a medical emergency where a seizure lasts over five minutes or multiple seizures occur without regaining consciousness. This prolonged activity can lead to permanent brain damage or death.
A rare but severe complication associated with untreated epilepsy is Sudden Unexpected Death in Epilepsy (SUDEP). SUDEP occurs when a person with epilepsy dies suddenly and unexpectedly, often during or after a seizure, without another clear cause identified. While the exact cause is not fully understood, it is thought to be related to changes in heart rate and breathing during a seizure. The risk of SUDEP is higher in individuals with uncontrolled seizures, particularly tonic-clonic seizures.
Progressive Brain Damage and Cognitive Decline
Recurrent, untreated seizures can have long-term effects on the brain, potentially leading to progressive damage and cognitive decline. Frequent or prolonged seizure activity can cause neuronal damage, leading to the death of brain cells. While single seizures rarely cause lasting harm, prolonged or repetitive seizures, especially those over five minutes, can injure the brain and cause neuronal loss. This damage is particularly noted in vulnerable brain regions like the hippocampus, an area important for memory and learning.
Uncontrolled seizures can lead to cognitive impairment, affecting memory, attention, processing speed, and executive functions. This can manifest as difficulty learning new information, slower thinking, or problems with comprehension and problem-solving.
Living with uncontrolled seizures can also contribute to mood and behavioral changes, increasing the risk of depression and anxiety. This can stem from direct brain changes or the burden of living with an unpredictable condition. Untreated seizures may also lead to epilepsy progression, where seizures become more frequent, severe, or difficult to control over time, potentially further impacting the brain’s ability to recover.
Broader Health System Impacts
Untreated seizures can affect other vital organ systems beyond the brain. The cardiovascular system can experience strain during and after seizures. Seizures often activate the sympathetic nervous system, leading to increases in heart rate and blood pressure. These changes can include arrhythmias like rapid or slow heart rate, or rarely, a temporary cessation of heart activity. Repeated seizure activity may also lead to functional and structural heart changes.
The respiratory system is also susceptible to complications. During a seizure, breathing difficulties and oxygen deprivation to the brain and other organs can occur. Prolonged or severe seizures can lead to postictal depression of autonomic respiratory reflexes, where breathing may be suppressed after a seizure. These respiratory issues, combined with cardiovascular changes, can increase overall health risks.
The musculoskeletal system can suffer direct trauma from uncontrolled movements, leading to chronic muscle pain, fractures, or dislocations. The force of muscle contractions during a tonic-clonic seizure can cause significant injury.
Severe and prolonged seizures can also have implications for kidney function and hydration. Such events may lead to dehydration or electrolyte imbalances, which can put stress on the kidneys. Disruptions caused by severe seizure activity can affect kidney health.
Psychosocial and Quality of Life Ramifications
Untreated seizures profoundly impact daily life, social interactions, and overall well-being. The unpredictability of seizures often leads to social stigma and isolation. Individuals may withdraw from social activities due to embarrassment or fear of public seizures, often facing discrimination. This can lead to loneliness and a reduced sense of belonging.
Uncontrolled seizures also present significant educational and employment challenges. The unpredictable nature of seizures can hinder school performance, attendance, and learning. In the workplace, this unpredictability can restrict job opportunities, lead to job loss, or make stable employment challenging.
Safety concerns and restrictions become a constant consideration for individuals with untreated seizures. Activities like driving, swimming, or operating machinery may be restricted due to seizure risk. These limitations significantly impact independence and autonomy.
Living with an unpredictable and unmanaged condition contributes to a substantial mental health burden. The increased risk of depression, anxiety, and chronic stress is a common consequence. This distress is exacerbated by the fear of future seizures and daily challenges. These factors severely diminish quality of life, independence, and security.