Seizures

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Topic Overview

The brain controls how the body moves by sending out small electrical signals through the nerves to the muscles. Seizures, or convulsions, occur when abnormal signals from the brain change the way the body functions.

Seizures are different from person to person. Some people have only slight shaking of a hand and do not lose consciousness. Other people may become unconscious and have violent shaking of the entire body.

Shaking of the body, either mild or violent, does not always occur with seizures. Some people who have seizures briefly lose touch with their surroundings and appear to stare into space. Although the person is awake, he or she does not respond normally. Afterwards, the person does not remember the episode.

Not all body shaking is caused by seizures. Many medical conditions can cause a type of body shaking that usually affects the hands and head (tremors).

A small number of people will have only one seizure during their life. A single seizure usually lasts less than 3 minutes and is not followed by a second seizure. Any normally healthy person can have a single seizure under certain conditions. For instance, a sharp blow to the head may cause a seizure. Having one seizure does not always mean that a serious health problem exists. However, if you have a first-time seizure, you should be checked by your doctor. It is important to rule out a serious illness that may have caused the seizure. Fever seizures are the most common cause of a single seizure, especially in children. For more information see the topic Fever Seizures.

Causes of seizures

Epilepsy is a nervous system problem that causes seizures. It can develop at any age. About 2.5 million Americans have epilepsy. For more information, see the topic Epilepsy.

A seizure can be a symptom of another health problem, such as:

• A rapidly increasing fever (fever seizure).
• An extremely low blood sugar level in a person who has diabetes.
• Damage to the brain from a stroke, brain surgery, or a head injury.
• Parasitic infections, such as tapeworm or toxoplasmosis.
• Problems that have been present since birth (congenital problems).
• Withdrawal from alcohol, prescription medicine, or illegal drugs.
• An infection, such as meningitis or encephalitis.
• A brain tumor or structural defect in the brain, such as an aneurysm.

Eclampsia is pregnancy-related seizure activity that is usually caused by high blood pressure. It is a life-threatening condition for both a mother and her baby (fetus) because during a seizure, the fetus's oxygen supply is drastically reduced. Eclampsia is more likely to occur after the 20th week of pregnancy. For more information, see the topic Preeclampsia and High Blood Pressure During Pregnancy.

Nonepileptic seizure (NES), also called pseudoseizure, is a condition that can cause seizure-like activity. NES is characterized by a loss of or change in physical function without a central nervous system problem. The loss or change causes periods of physical activity or inactivity that resemble epileptic seizures. NES is usually related to a mental health problem. The physical symptoms may be caused by emotional conflicts or stress. The symptoms usually appear suddenly and at times of extreme emotional stress.

Protect a person during a seizure

No matter what caused the seizure, you can take steps to protect a person during a seizure and to get help after the seizure.

• During a seizure:
  • Protect the person from injury. If possible, keep the person from falling. Try to move furniture or other objects that might cause injury during the seizure.
  • Do not force anything, including your fingers, into the person's mouth. This may cause injuries such as chipped teeth or a fractured jaw. You also could get bitten.
  • Do not try to hold down or move the person.
  • Try to stay calm.
  • Pay close attention to what the person is doing so that you can describe the seizure to rescue personnel or doctors.
  • Time the length of the seizure, if possible.
• After a seizure:
  • Check the person for injuries.
  • Turn the person onto his or her side when the seizure ends and he or she is more relaxed.
  • If the person is having trouble breathing, use your finger to gently clear the mouth of any vomit or saliva.
  • Loosen tight clothing around the person's neck and waist.
  • Provide a safe area where the person can rest.
  • Do not give the person anything to eat or drink until he or she is fully awake and alert.
  • Stay with the person until he or she is awake and familiar with the surroundings. Most people will be sleepy or confused after a seizure.

Treatment

Treatment of a seizure depends on what has caused the seizure.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a doctor.

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Last updated:	October 14, 2005
Author:	Sydney Youngerman-Cole, RN, BSN, RNC
Reviewed By:	William M. Green, MD - Emergency Medicine, H. Michael O'Connor, MD - Emergency Medicine
Editors:	Susan Van Houten, RN, BSN, MBA, Lisa Shaw