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Patient education: Seizures (The Basics)

Patient education: Seizures (The Basics)

What are seizures? — Seizures are waves of abnormal electrical activity in the brain. Seizures can make you pass out, or move or behave strangely. Most seizures last only a few seconds or minutes.

Epilepsy is a condition that causes people to have repeated seizures. But not everyone who has had a seizure has epilepsy. Problems such as low blood sugar or infection can also cause seizures. Other problems such as anxiety or fainting spells can cause events that look like seizures.

What are the symptoms of a seizure? — There are different kinds of seizures. Each causes a different set of symptoms:

"Tonic clonic" or "grand mal" seizures – This type of seizure causes people to pass out and have muscle stiffness followed by jerking movements.

Other types – People who have other types of seizures have less dramatic changes. For instance, some people have shaking movements in just 1 arm or in a part of their face. Other people suddenly stop responding and stare for a few seconds.

Should I see a doctor or nurse if I have a seizure? — If you have never had a seizure before and you have one, someone should call for an ambulance (in the US and Canada, call 9-1-1). Having a seizure is a sign that something is wrong with your brain.

How are seizures treated? — The right treatment for seizures depends on what is causing them. If you have seizures because of an infection, you will probably need treatment to get rid of the infection. But if you have repeated seizures because of epilepsy, you will probably need anti-seizure medicines. These are also called "anti-convulsants."

People sometimes need to try different medicines before they find a treatment that works well. Some seizures can be hard to control. But if you work with your doctor, chances are good that you will find a treatment that works.

Do anti-seizure medicines cause side effects? — Yes. Anti-seizure medicines can cause side effects. They can make you feel tired or clumsy, or cause other problems. If you are bothered by side effects, tell your doctor. They can work with you to find the medicine or dose that causes the fewest problems. Most of the side effects from these medicines are mild. But there are 2 side effects that are very serious but rare:

Anti-seizure medicines can cause a rare but serious skin rash. Tell your doctor or nurse right away if you notice a new rash while taking an anti-seizure medicine.

Anti-seizure medicines might increase the risk of becoming suicidal (wanting to kill yourself). The increased risk is very low. But it's very important to tell your doctor or nurse if you start to feel depressed.

Get help right away if you are thinking of hurting or killing yourself! — If you ever feel like you might hurt yourself, help is available:

In the US, contact the 988 Suicide & Crisis Lifeline:

To speak to someone, call or text 988.

To talk to someone online, go to www.988lifeline.org/chat.

Call your doctor or nurse, and tell them that it is an emergency.

Call for an ambulance (in the US and Canada, call 9-1-1).

Go to the emergency department at your local hospital.

If you are worried that a loved one might hurt themselves, get them help right away.

What if anti-seizure medicines do not work for me? — If you keep having seizures even after trying different medicines, you might have other options. For example:

Surgery – Some people can have surgery to remove the small part of their brain that is causing seizures.

Neurostimulation – This is a treatment that can help control seizures in some people who cannot have surgery. Different devices can be used for this. One is called a "vagus nerve stimulator," which is placed under the skin. Others include "responsive cortical stimulation" and "deep brain stimulation."

A special diet – This is called the "ketogenic diet." It might be helpful for some people. This diet involves eating foods that are high in fat but avoiding carbohydrates. If you are interested in trying this diet, your doctor or nurse can talk to you about how to do this safely.

What can I do to keep myself safe? — Until you have your seizures under control, do not drive. The laws about when a person with seizures can drive are different depending on where you live. Ask your doctor if you can safely drive and about the laws where you live.

Also, if your seizures are not under control, take other safety steps. For example, do not swim without someone else nearby who could help you if you start having a seizure. Avoid activities that could result in you falling from a height.

How can I lower my chances of having more seizures? — You can:

Take your medicines exactly as directed, at the right times, and at the right doses.

Tell your doctor about any side effects you have – That way, you can work together to find the best medicine for you.

Avoid letting your prescription run out – Stopping anti-seizure medicine suddenly can put you at risk of seizures.

Check with your doctor before starting any new medicines – Anti-seizure medicines can interact with prescription and non-prescription medicines, and with herbal drugs. Mixing them can increase side effects or make them not work as well.

Avoid alcohol – Alcohol can increase the risk of seizures, affect the way seizure medicines work, and increase side effects from anti-seizure medicines.

What if I want to get pregnant? — If you take anti-seizure medicines, speak to your doctor or nurse before you start trying to get pregnant. Some anti-seizure medicines are not safe to take during pregnancy. You might need to switch medicines before you get pregnant.

What should other people do if they see me having a seizure? — Ask your doctor what your family members, friends, or coworkers should do if you have a seizure. Some people will have seizures from time to time, and they might not need to see a doctor every time. But if you have a seizure that lasts longer than 5 minutes or if you do not wake up after a seizure, someone should call for an ambulance (in the US and Canada, call 9-1-1).

Other people should not try to put anything in your mouth while you are having a seizure. But they should make sure that you do not bang against any hard surfaces.

More on this topic

Patient education: EEG (The Basics)
Patient education: Epilepsy in adults (The Basics)
Patient education: Epilepsy in children (The Basics)
Patient education: Epilepsy and pregnancy (The Basics)

Patient education: Seizures in adults (Beyond the Basics)
Patient education: Seizures in children (Beyond the Basics)
Patient education: Febrile seizures (Beyond the Basics)
Patient education: Treatment of seizures in children (Beyond the Basics)

This topic retrieved from UpToDate on: Feb 02, 2024.
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