Epilepsy Services of Southwest Florida

Epilepsy and Seizure Information

Epilepsy is a neurological disorder that produces sudden, brief changes in how brain cells function. This is often called an electrical disturbance in the brain. These disturbances are called seizures. During a seizure, a person’s consciousness, movements or actions may be altered for a brief time.

Epilepsy is defined as a condition of having one or more unprovoked seizures. It may also be called a seizure disorder. Seizures can begin at any time of life.

Experts divide seizures into two categories; generalized and partial seizures.

Generalized Seizures

The whole brain is involved in the electrical disturbance at once. Consciousness is usually impaired. There are symptoms of motor dysfunction indicating involvement of both cerebral hemispheres

There are several kinds of generalized seizures including, absence, myoclonic, clonic, atonic and generalized tonic clonic.

Generalized Tonic Clonic Seizures (previously called Grand mal)

A Generalized Tonic Clonic seizure happens when the electrical disturbance involves the entire brain. It starts with a cry caused by air being forced out of the lungs. The person falls to the ground, unconscious. The body stiffens and begins to jerk. A frothy saliva may appear around the mouth and the skin may turn a bluish color. Breathing may be very shallow. Bladder or bowel control may be lost. The seizure will end naturally after a few minutes.

Seizure first-aid for Generalized Tonic Clonic seizures (Grand Mal or convulsive)

  • Remain calm
  • Check the time when the seizure begins. If it lasts more than 5 minutes, call 911
  • Turn the person onto their side to help keep the airway clear and prevent choking
  • cushion their head with something soft and flat
  • Remove glasses and loosen tight clothing
  • Do NOT put anything in the mouth (they cannot swallow their tongue)
  • Do NOT give liquids or medication
  • Do NOT restrain or hold down
  • Remain present until the person regains conscious awareness of their surroundings

A convulsive seizure in someone who has epilepsy is not a medical emergency, even though it may look like one. It stops naturally after a few minutes without ill effects. Some people are able to continue about their business after a rest period, and others will be extremely tired and need to sleep and their muscles may be very sore.

Breathing almost always resumes spontaneously after a convulsive seizure. Failure to resume breathing signals a complication of the seizure such as a blocked airway, heart attack or severe head or neck injury. In these unusual circumstances, CPR must start immediately.

If repeated seizures occur, or if a single seizure lasts longer than 5 minutes, the person should be taken to a medical facility immediately. Prolonged or repeated seizures may require emergency medical treatment.

A Seizure in Water

If a seizure occurs in water, the person should be supported in the water with the head tilted so his face and head stay above the surface. He or she should be removed from the water as quickly as possible with the head in this position. Once on dry land, he should be examined and, if he is not breathing, artificial respiration should be begun at once.

Anyone who has a seizure in water should be taken to an emergency room for a careful medical checkup, even if he or she appears to be fully recovered afterwards. Heart or lung damage from ingestion of water is a possible hazard in such cases.

A Seizure in an Airplane

If the plane is not filled, and if the seat arms can be folded up, passengers to the left and/or right of the affected person may be reassigned to other seats, so that the person having the seizure can be helped to lie across two or more seats with head and body turned on one side.
Once consciousness has fully returned, the person can be helped into a resting position in a single reclining seat.

If there are no empty seats, the seat in which the person is sitting can be reclined, and, once the rigidity phase has passed, he can be turned gently while in the seat so that he is leaning towards one side. Pillows or blankets can be arranged so that the head doesn't hit unpadded areas of the plane. However, care should be taken that the angle at which the person is sitting is such that his airway stays clear and breathing is unobstructed.


A Seizure on a Bus

Ease the person across a double or triple seat. Turn him on his side, and follow the same steps as indicated above. If he wishes to do so, there is no reason why a person who has fully recovered from a seizure cannot stay on the bus until he arrives at his destination.

Absence Seizures (previously called Petit mal)

Includes a momentary interruption of consciousness lasting from a few seconds to 30 seconds. These most commonly occur in children. They will stop what they are doing and stare blankly. Their eyes may roll upwards, eyelids may flutter and their head may droop. They may also drop objects.

Generalized Atonic Seizures (Also called Drop Attacks)

A person suddenly collapses and falls. After 10 seconds to a minute, he recovers, regains consciousness and can stand and walk again.

Generalized Myoclonic Seizures

Sudden brief, massive muscle jerks that may involve the whole body or just parts of the body. These seizures may cause a person to drop what they were holding or fall off a chair.

Generalized Infantile Spasms

These are clusters of quick, sudden movements that start between 3 months and 2 years of age. If a child is sitting up, their head will fall forward and their arms will flex forward. If a child is lying down, their knees will be drawn up, with their arms and head flexed forward as if they are reaching for support.

Partial Seizures

This is the most common type of seizure experienced by people whose seizure disorder starts in adult life. It is called a partial seizure when the electrical disturbance begins in just one part of the brain, affecting whatever physical or mental activity that area controls. There are two types of Partial seizures; Simple and Complex

Simple Partial Seizures

During a simple partial seizure, a person does not lose consciousness. They may remain awake and sometimes can talk normally to others. They can usually remember what happened to them. A simple partial seizure can affect movement, emotion, sensations, and feelings.

Movement: Uncontrolled movements can happen in any part of the body. Some simple partial seizures may start out with shaking of a hand or foot which can spread to an arm or leg or even one whole side of the body. Eyes may move from side to side; there may be blinking, unusual movements of the tongue, twitching of the face.

Emotions: The person may feel a sense of fear or that something terrible is going to happen. They may also feel a sense of intense joy or happiness.

Sensations: All five senses are controlled by various areas of the brain. These areas can produce sensations such as a feeling of a breeze on the skin; unusual buzzing or ringing sounds; voices that are not really there. There may be a distortion of the way things look. A feeling of pain in the stomach may occur. Some people report a feeling of nausea, sweating or even an out of body experience.

Complex Partial Seizures (also called Psychomotor or Temporal Lobe)

Complex partial seizures affect consciousness. During a complex partial seizure, a person does not know what they are doing and cannot interact with others. They will also not remember what happened during the seizure. Although the person is able to move about and has their eyes open, they are in an altered state of consciousness. They may be able to speak but the words do not make sense.

The person stares blankly, and may make chewing movements with the mouth. They may pull at clothing, wander aimlessly and appear confused. Sometimes the seizure produces dramatic changes in behavior, including screaming, crying, laughing, disrobing, running, flailing and becoming agitated. They may say the same phrase repeatedly. They cannot respond to directions.

Seizure first-aid for Complex Partial Seizures

  • Watch the person carefully and explain to others what is happening. Often others do not recognize this kind of behavior as a seizure and may assume the person is drunk or on drugs
  • Speak quietly and calmly in a friendly manner
  • Guide or herd (with arms out to your sides) the person away from dangers such as stairs, traffic or a hot stove
  • Do not grab hold of the person unless an immediate danger threatens. Instinct may make them struggle or lash out at the person who is holding them
  • Stay with the person until full consciousness returns and offer to help them return home

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