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Everything You Should Know About Epilepsy

Updated on January 17, 2019

What you Should Know About Epilepsy

There are more than 200,000 cases of epilepsy each year. In this article, I will tell you all you need to know about epilepsy. Epilepsy is a seizure disorder in which nerve cell activity in the brain is disturbed, which causes a seizure to happen. Seizures can affect a part of the brain or all of it. Believe it or not, some people live their whole lives without being diagnosed with epilepsy! Throughout the article, I will tell you the types of seizures, symptoms, and what you should and shouldn't do if someone is having a seizure.

A person's brain waves with a partial(left) and generalized(right) seizure.
A person's brain waves with a partial(left) and generalized(right) seizure.

Types of Seizures

There are over 40 different kinds of seizures. Some people have seizures that start as one kind, then become another, and some cannot be classified, so they are called unknown-onset seizures.

In this article, we will only discuss the common types of seizures. Seizures are categorized into two main groups: focal and generalized seizures.

Focal seizures, also known as partial seizures, is when only a part of the brain hemisphere is being affected, and about 60% of people with epilepsy have focal seizures. Generalized seizures are when the whole brain is affected.

There are three types of focal seizures:

  • Simple focal seizures: When a small part of the brain is being affected. These seizures tend to cause twitching or a change in sensation, such as a strange taste or smell.
  • Complex focal seizures: This type of seizure, tends to make people dazed or confused. It can cause someone to be unable to respond to questions or direction for up to a few minutes.
  • Secondarily generalized seizures: This seizure starts at one part of the brain before it eventually spreads to both parts of the brain. The person having the seizure will start with a focal seizure, followed by a generalized seizure.

Compared to focal seizures, there are six types of generalized seizures, and these ones could be more serious. Generalized seizures affect the whole brain, and can give the person muscle spasms, blackout, or fall.

  • Absence seizures: This type is also known as petit mal. Absence seizures can make you seem disconnected from others around you. You may look like you're staring into space, and your eyes might roll back. The seizure will only last a few seconds, and most of the time, the person who had the seizure won't remember having it.
  • Tonic-clonic seizures: Tonic-clonic seizures are also known as grand mal seizures. This one is the most noticeable. The person loses consciousness right from the beginning, and the seizure can last one to five minutes. If it lasts longer, you will need medical help. When someone has this seizure, their body stiffens, shakes, and jerks. Sometimes. loss of bowel and bladder control can happen too. People who have this seizure could also make a loud crying sound. When this happens, they are not in pain. The reason why they are making that noise is that since all the muscles keep contracting, the muscles in their chest is forcing air to rush between the vocal chords. As they are having the seizure, they might also bite their tongue, which could cause bleeding. Saliva might froth at the mouth, and there could be irregular breathing throughout the seizure too. After the person finishes having this seizure, they will go into a postictal state. This state could leave them feeling tired, confused, and disoriented. It could last hours to days.
  • Atonic seizures: These seizures are also known as drop seizures. This seizure happens without warning, and the person's muscles might suddenly go limp. When this happens, their head could fall forward, and if they're holding something, they will drop it. Also, if the person is standing, then they will fall. There is no convulsion, but they could hurt their head as they fall. These seizures last seconds, and if they have several of these seizures, they will have to wear a helmet to protect their head.
  • Myoclonic seizures: Myoclonic seizures start in the same part of the brain, and some people could have both myoclonic and atonic seizures. They involve muscle jerks in parts or all of the body. It can occur in a single event, or a series. The person's memory and consciousness are not impaired.
  • Tonic seizures: This type of seizure lasts less than twenty seconds, and as the seizure is happening, the person's arms, legs, or trunk tense up. They could have impaired consciousness, and flexion or extension of the upper and lower extremities as well. Tonic seizures commonly happen when the person is sleeping, but if they are standing and their muscles go stiff, then they could lose their balance and fall.
  • Clonic seizures: Clonic seizures happen in several parts of the person's body. They could also lose control of bodily functions. When they are having this type of seizure, their neck, arm, face, or other areas will jerk rhythmically. During the seizure, they could lose consciousness and feel disoriented after the seizure. They tend to last several minutes, and over time, they could progress into tonic-clonic seizures.

Symptoms

Many seizures are easier to identify than others. Some types of seizures, absence seizures, for example, are not as simple to identify.

Symptoms of focal seizures are:

  • Simple focal seizures:
  1. Being inattentive, but still capable of following commands.
  2. Changes in the vision.(One eye is only affected)
  3. Unusual head or eye movements.
  4. Numbness, tingling, or a feeling of something crawling on you.
  5. Difficulty speaking.
  6. Rapid heart rate or pulse.
  7. Sweating or feeling anxious.
  8. Flushed face.
  • Complex focal seizures:
  1. They might "freeze."
  2. Little to no communication.
  3. Suddenly started making a chewing noise.
  4. Lip smacking noise.
  5. Mumbling
  6. Stiff movements
  7. Crying
  8. Laughing
  9. Repetitive movements or speech.
  10. Screaming
  11. Fumbling
  12. Picking at clothing
  • Secondary generalized seizure:
  1. This seizure starts with simple complex seizure symptoms and then progresses into tonic-clonic seizure symptoms.

Symptoms of generalized seizures are:

  • Absence seizures:
  1. Begins abruptly
  2. Has a "daydreaming" appearance.
  3. The person stops what they are doing.
  4. Eyes flutter
  5. Lip smacking
  6. Rubbing fingers or other hand movements.
  7. Unconcious(No memory of it happening)
  • Tonic-clonic seizures:
  1. Strange feeling or sensation before the seizure starts(Aura).
  2. Some people might cry or scream as the seizure begins.
  3. They will fall to the ground.
  4. Loss of bowel and bladder control.
  5. Convulsion
  6. A severe headache and fatigue may occur after the seizure.
  7. Skin turning blue from lack of circulation.
  8. The person could drool or bite their tongue.
  • Atonic seizures:
  1. Having a brief loss of consciousness.
  2. Loss of muscle tone.
  3. Going limp and falling to the ground.
  4. Jerking
  5. Head nods.
  6. Eyelids droop.
  • Myoclonic seizures:
  1. Sudden jerks.
  2. No loss of consciousness.
  • Tonic seizures:
  1. Loss of consciousness.
  2. Confusion before or after the seizure.
  3. Stiff muscles
  4. Possible loss of bladder or bowels.
  • Clonic seizure:
  1. Muscle spasms.
  2. Could possibly lose consciousness.

What You Should Do While Someone Has a Seizure

Some seizures need to be treated differently compared to other seizures. Some do not need much attention, absence seizures, for example, and others need your full attention, such as tonic-clonic. Sadly, there is no possible way to prevent a seizure forever, but this article can help prepare you if someone who has epilepsy has a seizure while you are around.

What You Should Do:

If the person is having a focal seizure, then guide them to a safe area. Once you do that, wait for the seizure to pass, and make sure that they don't feel too disoriented before continuing with their day.

If the person is having a generalized seizure, they might need more attention depending on the type of seizure. If it is an absence, atonic, tonic, clonic, or myoclonic seizure, then all you can do is make sure the person is okay. You should also talk to them in a non-threatening way before and after the seizure.

If someone with epilepsy is having a tonic-clonic seizure, then you need to be with them throughout the whole seizure. What you should do when the person has a tonic-clonic seizure, is to get everyone out of the way. You should also make sure you have them in an open area, so they won't get hurt by any objects. The next thing you should do is to make sure you never hold the person down. Holding them down will not help because you are preventing them from moving around while the seizure is happening. You should make sure you put the person gently on their side, so they can get a clear airway. Also, loosen everything around their neck to help them breathe too. Doing this can also help prevent them from choking on saliva or vomit.

After, you put them on their side, cushion their head with a jacket, or your hand. When you do that, that can help make sure that they will not hurt their head if their jerking is too erratic. Most importantly, never put anything in their mouth, because that can cause them to choke, or hurt their teeth.

While all of this is going on, make sure to stay calm, and to time the seizure. If the seizure is longer than usual, this is their first seizure, or it surpasses five minutes, call your medical emergency number right away. You should also call them if they are having a cluster of seizures nonstop.

What You Should Do After the Seizure:

Once the seizure ends, they will go through a postictal state. The postictal state is the stage of recovery from the tonic-clonic seizure. The person is unconscious and could be like that for five minutes to a half hour.

When they are at this stage, if you have not already, make sure they are on their side, and in the recovery position. The recovery position is the image below. What you do to put them in that position, is to put them slowly on their left side, and to cross the leg on top over the other leg.After that, the arm they are laying on needs to be bent straight. The arm they are not laying on needs to cross over, and put under their cheek.

After you put them in the recovery position, stay near them until they wake up. Once they wake up calmly tell them what happened, and make sure you don't give them anything to eat or drink until they are more aware of their surroundings.

The Recovery Position
The Recovery Position

© 2018 Amy Tailor

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