Seizure Disorder—Adult



Lose consciousness Stare into space Have convulsions—abnormal jerking of the muscles Experience abnormalities of sensation or emotion


Generalized seizure disorder—onset is throughout the brain, not from a single focal location Partial seizure disorder (focal seizure)—begins within certain areas of the brain
Brain Cells (Neurons)
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In newborns: Congenital brain abnormalities (present at birth)Birth injuries that deprive the brain of oxygenMetabolic disordersMaternal drug useInfection In infants and children: Febrile seizure —caused by spike in fever in a baby or very young child Brain tumor Infections ( encephalitis , cerebritis, brain abscess) In children and adults: Congenital conditionsGenetic Head trauma—common cause (eg, concussion , skull fracture , bleeding inside of the skull, oxygen deprivation due to near-drowning ) Infections (eg, encephalitis , cerebritis, brain abscess) StrokeBrain tumor In elderly: StrokeTraumaBrain tumor Degenerative diseases (eg, Alzheimer’s disease )
Risk Factors


Previous brain injury—seizure disorder usually develops within one year of injury Previous brain infection Abnormal blood vessel that has formed in the brain Brain tumor History of stroke History of complex febrile seizures Use of certain medications or recreational drugs Stopping the use of medications, recreational drugs , or alcohol Drug overdose Exposure to toxins (eg, arsenic , lead , or carbon monoxide ) Family history of seizure disorders Alzheimer’s disease Toxemia during pregnancy Chemical abnormalities—decreased or excess blood sodium or glucose, low blood calcium Liver or kidney failure Severe, untreated high blood pressure Chronic diseases (eg, lupus, polyarteritis nodosa , porphyria , sickle cell disease , Whipple’s disease ) Syphilis Cysticercosis—an infection caused by a pork tapeworm


Sleep deprivation Alcohol Hormonal changes, such as those that occur at points during the menstrual cycle Stress Flashing lights, especially strobe lights Use of certain medications Missing doses of anti-epileptic medications


Aura—a sensation at the start of a seizure, may involve the perception of an odd smell or sound, visual symptoms, or unusual stomach sensations Staring Loss of consciousness Repeated jerking of a single limb Generalized convulsion with uncontrollable jerking of muscles throughout the body Hand rubbing Lip smacking Picking at clothing Perception of an odor, sound, or taste Loss of bladder or bowel control Postictal state—a state of drowsiness, alteration in responsiveness, and/or confusion that commonly occurs after a generalized tonic-clonic seizure; may last minutes, hours, or days

Symptoms of generalized seizure disorders include:

Generalized tonic-clonic seizures—loss of consciousness, stiffening, uncontrollable jerking of muscles throughout the body Absence seizures—staring, eye blinking, or eye rolling

Symptoms of partial seizure disorder include:

Complex partial or temporal lobe seizures: May lose contact with reality, stop purposeful activity, and begin a series of automatic gestures (eg, lip smacking, hand-wringing, or picking at clothing)May appear as a brief moment of confusion or loss of attentivenessMay have a perception of unusual sights, sounds, or smells Simple partial seizures: Does not involve a loss of contact with reality or a loss of consciousnessSingle area of the body may move uncontrollably (eg, leg or arm shaking)May include the perception of an odor, sound, or taste, or an unrelated emotion



Blood tests Lumbar puncture


MRI scan CT scan Magnetoencephalography (MEG) Positron emission tomography (PET) Single photon emission computed tomography (SPECT)



The goals of treatment are to:

Treat the underlying cause (if known) Prevent seizures—may be done through medications, surgery, or special therapies Avoid factors that stimulate seizure activity

Anti-epileptic Medication





Vagus Nerve Stimulation (VNS)


Ketogenic Diet


Modification of Activity


Get enough sleep. Avoid excessive alcohol intake. Alcohol can make seizures more likely. Avoid hyperventilating. Avoid places where flashing or strobe lights are in use. Wear a medical alert bracelet. That way, if you have a seizure, people around you will understand what is happening. They will be able to take appropriate steps to be helpful. Consider keeping a seizure log. Record things that were happening around the time of a seizure. This will help to identify a seizure trigger. Take your seizure medications according to the prescription.


Always wear a helmet when using bikes, rollerblades, skateboards, or scooters. Wear protective headgear when playing contact sports. Dive in safe depths of water. Always wear a seatbelt. Avoid using street drugs. If your baby or child has a high fever, get treatment right away. Get prenatal care. If you have high blood pressure during pregnancy, get proper treatment. If you have a chronic condition, get proper care.


Avoid driving, if advised to do so by your doctor. Do not swim or bathe alone. Do not work on ladders or ledges. Avoid or modify athletic activities.

Talk to your doctor about these kinds of issues.

Rimas Lukas, MD 201412 20141220