Seizure Disorders: A Comprehensive Guide to Causes, Types, and Treatments

Epilepsy, or seizure disorder, is one of the most common brain diseases worldwide, with over 50 million people suffering from it globally. 

A seizure is a condition that causes abnormal electrical activity in the brain and can affect your behavior and body movements. Having repeated episodes of seizures that occur more than 24 hours apart is termed epilepsy.

Seizures or epilepsy can occur due to multiple reasons, including brain injury, infections, substance use, toxins, electrolyte imbalance, stress, high fever, and others. Being able to identify the cause of seizures is important so proper treatment can be initiated. 

In this article, we will discuss the complete details of seizure disorders, including their symptoms, types, causes, treatment, and more. Let’s get started.

What Are Seizures? 

A seizure is a neurological condition that occurs when the nerve cells in your brain send improper or incorrect signals. This leads to a burst of sudden, abnormal, or excessive electrical activity in the brain. 

When the nerve cells in the brain send incorrect signals to the body, this can lead to abnormal electrical activity in the brain and affect emotions, movement, sensations, awareness, and muscle control.

Seizures can occur in various forms. It can be a once-in-a-lifetime event or occur multiple times during different stages of your life. Seizures may affect one or both sides of the brain.

Symptoms of Seizure Disorders 

The symptoms of seizure disorders vary from person to person, depending on the type and severity of the attack. 

Common symptoms of seizures may include:

• Uncontrolled body movements or sudden loss of muscle control
• Loss of consciousness 
• Staring spells
• Confusion 
• Stiffness of the body 
• Head nodding
• Loss of control over bowel or bladder
• Mood fluctuations 
• Unusual sensations, such as tingling or dizziness
• Altered sense of smell, taste, sight
• Difficulty speaking or understanding language

What Are the Types of Seizure Disorders? 

Seizures are categorized into types based on where they begin in the brain and their symptoms. 

Focal Seizures 

Focal seizures are when abnormal electrical activity occurs in one specific area of the brain, typically on one side, and commonly affects one side of the body. It is also known as partial seizures. 

Focal seizures are further divided into two types, including:

• Focal-Aware Seizures: Focal-aware seizures don’t affect your consciousness. You are conscious during the seizure attack and are aware of the happenings in your body. Symptoms may include twitching and tingling.
• Focal Impaired-Awareness Seizures: Focal impaired-awareness seizures affect your consciousness. You are unconscious during the seizure attack, don’t know what is happening to your body, and don’t remember the event later. Common symptoms include repetitive movement and confusion.

Generalized Seizures 

Generalized seizures are when abnormal electrical activity occurs on both sides of the brain, typically affecting both sides of the body. 

Generalized seizures are further divided into the following types based on symptoms:

Tonic

Tonic seizures cause stiffening or tightening of the body muscles. This can lead to falls due to sudden stiffness.

Clonic

Clonic seizures result in shaking or abnormal jerky movements of one or both sides of the body. This can last a few seconds to 1 minute.

Tonic-Clonic

Tonic-clonic seizures cause a combination of both tonic and clonic seizure symptoms. Loss of bladder control is also common.

Myoclonic 

Myoclonic seizures cause short and quick muscle spasms or jerky movements that affect one or a group of muscles.

Atonic  

Atonic seizure is also called a drop attack. You may fall suddenly to the ground or experience a loss of muscle control.

Absence 

Absence seizures cause a blank stare or repeated blinking that lasts for a couple of seconds. This is sometimes mistaken for daydreaming.

Unknown Onset Seizures 

Unknown onset seizures are not noticed or witnessed by anyone, commonly because they occur when the person is alone or asleep.  

Unknown onset seizures can also be diagnosed when doctors are unsure about the part of the brain that caused the abnormal electrical activity.

Causes of Seizure Disorders 

The common causes of seizures include: 

• Head injury or trauma
• Brain infection or disease, such as meningitis, brain tumor, or vascular abnormality in the brain
• High fever
• High blood pressure 
• An electric shock
• Stroke
• Substance use or withdrawal
• Electrolyte imbalance 
• Injury to the baby before birth
• Stress
• Dehydration 
• Genetics 

The common risk factors of seizures include:

• Premature birth or low birth weight 
• Developmental disorders such as autism
• Insufficient sleep
• Having a family history of epilepsy 
• Young or advanced age
• Brain damage 
• Developmental disorders 
• Excessive alcohol or drug use
• Intense exercise 
• High fever, especially during childhood
• Exposure to certain medications, particularly those that affect the brain

Diagnosis of Seizures 

The diagnosis of seizures is done through an evaluation of medical and family history, physical exam, and neurological exam through certain brain imaging tests. Diagnosis may involve the following: 

• Magnetic Resonance Imaging (brain MRI)
• CT scan of the brain
• Electroencephalogram (EEG)
• Spinal tap 

The healthcare provider will check your medical history to identify any underlying conditions that may be responsible for causing seizures. Blood tests may be done to evaluate any electrolyte imbalance or the presence of toxins/drug toxicity.

Seizure Treatment 

Seizures are treated according to the type and severity of the disorder and the patient’s condition. The treatment of seizure disorders typically involves anti-seizure medications, specific brain procedures, or surgery, depending on the patient’s needs.

Medications 

Anti-seizure medications help reduce the frequency and severity of seizure attacks and prevent it from occurring in the future. They work by decreasing the excitability of neurons. Medications are often the first-line treatment to control or prevent seizures.

Some of the common anti-seizure medications include: 

• Phenytoin 
• Diazepam 
• Pregabalin
• Lamotrigine
• Carbamazepine
• Valproic acid
• Oxcarbazepine
• Gabapentin
• Levetiracetam
• Clonazepam

Monitoring seizure medication is essential to ensure its effectiveness, minimize side effects, and manage the risk of breakthrough seizures. Regular medical appointments with your doctor are crucial.

Surgery 

Brain surgery is typically done when seizures are severe, occur on a specific part of the brain, and medications have become ineffective in controlling or reducing the attacks. Surgery removes the area of the brain that causes abnormal or excessive electrical activity. 

Common surgical procedures for epilepsy include:  

• Hemispherectomy: This surgical procedure removes the cerebral cortex, the outermost layer of the brain that controls thinking, reasoning, memory, and problem-solving processes.
• Resective surgery: This procedure usually removes the temporal lobes, the area of the brain that controls language, emotions, and visual memory.
• Corpus callosotomy: This procedure removes the part of the brain called the corpus callosum, a bundle of nerve fibers in the brain that connects the two brain hemispheres. It is typically done in patients who experience abnormal electrical activity that spreads from one area of the brain to another.

Nerve Stimulation 

Nerve stimulation is a minimally invasive procedure that involves placing an electrode in the brain and implanting a generator in the chest. The electrode generates mild current, which controls and interferes with the abnormal electrical activity arising from seizures. New neuro-modulation techniques such as vagal nerve stimulation or deep brain stimulation may also hold future promise.