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seizure

Alternative Names 
convulsion, fit, epilepsy

Definition
A seizure is the sudden, uncontrollable discharge of excessive electrical activity in the brain.

What are the signs and symptoms of the injury? 
Symptoms can be different for each person. Symptoms may include:
  • confusion and odd behaviour
  • black outs
  • drooling
  • frothing at the mouth
  • grunting
  • snorting
  • twitching
  • loss of bladder or bowel control
  • loss of consciousness
  • decreased breathing
  • muscle spasms which can be sustained or rhythmical jerking
What are the causes and risks of the injury? 
Seizures are usually caused by injury to the brain, certain drugs, diseases, infections or poisonings, including:
  • withdrawal from a certain medication
  • withdrawal from alcohol
  • poisonous bites or stings
  • kidney failure
  • pregnancy and problems associated with pregnancy
  • stroke, which involves a blood clot that goes to the brain
  • meningitis, or infection of the membrane covering the brain and the spinal cord
  • high blood pressure
  • high fever, especially in young children
  • overheating
  • electric shock
  • drug abuse
  • choking
  • brain tumour
  • epilepsy, or a disease of the nervous system
What can be done to prevent the injury? 
It is not easy to prevent seizures. But, whenever possible, a person should follow these tips:

By reducing excessive alcohol use, a person decreases his or her risk of seizures. But, if he or she suddenly stops drinking alcohol altogether, the risk of withdrawal seizures increases. Anyone trying to give up alcohol should talk to his or her doctor first.

A sudden withdrawal from certain drugs such as phenobarbital and tranquillisers such as chlordiazepoxide or diazepam can cause seizures. Always follow directions on how to decrease or stop using a medication.

By keeping his or her blood pressure and heart disease under control, a person helps prevent seizures. This also helps prevent stroke, which can lead to seizures.

People with an on going seizure disorder can prevent seizures by taking the right medication.

Everyone should avoid areas with high power lines.

Everyone should stay away from poisonous snakes and insects that sting.

Anyone with brain injuries, illnesses like meningitis, and tumours, who also has a seizure, should get medical care right away. Afterward, he or she should talk to his or her doctor.

How is the injury recognised? 
Seizures can cause:
  • a big change in behaviour
  • confusion
  • muscle spasms that cause twitching or jerking of the arms and/or legs
  • an absence of breathing
  • unconsciousness
  • loss of bowel and bladder control
All of these are signs that can be used to diagnose a seizure. Anyone who has these symptoms should see his or her doctor for a definitive diagnosis. A doctor will do a test called an electroencephalogram (EEG) to check brain waves. This will detect areas of the brain with unusual activity that causes the symptoms.

What are the treatments for the injury? 
When a seizure occurs, the first treatment is to keep the person safe. At a later time, a doctor will try other ways to prevent the seizure by treating what caused it. Sometimes seizures are not preventable and can only be controlled by medication. Also, some forms of seizures only occur once and are related to single events. By avoiding those single events, seizures can be prevented.

Anyone giving first aid to a person having a seizure should follow these steps:

Try to prevent the victim from hurting him or herself or someone around them. Protect the person from falling, from hitting his or her head, and from hitting furniture or other sharp objects. Also try to prevent the victim from hitting other people. Do not try to hold the person down, simply keep them away from objects that can hurt them.

If the victim starts to vomit while lying on the ground or a flat surface, roll him or her on his or her side. This way, vomit flows out of the mouth and is not breathed into the airway or the lungs.

Do not:
  • restrain the victim
  • place fingers in the victim's mouth because he or she may bite you
  • move the patient, if possible
  • slap the victim or try to stop him or her from convulsing
  • try to give rescue breaths or CPR during a seizure, even if the victim is turning blue
If an infant or a child is having a seizure that seems to be caused by a high fever, it is important to cool the body slowly. Do not immerse the child in a cold bath. Instead, use a sponge or cool compress with lukewarm water.

Stay with the victim and get help from his or her doctor.

After a seizure is over, the victim will probably want to sleep. This is okay. He or she will also be somewhat disoriented. The time right after a seizure is called the post-ictal phase.

Get emergency help right away if:
  • the victim is having many seizures
  • seizures are lasting longer than two minutes
  • the victim is not able to be awakened between seizures
  • the victim has other health problems such as diabetes or high blood pressure
  • the victim had a seizure while in water
  • the victim is ill, has a fever, seems very weak or is drunk
  • the victim has never had a seizure before

What are the side effects of the treatments? 
Seizures can injure the person and anyone giving first aid. The person can end up with head injuries, injured limbs, cuts, abrasions and scratches. The person's flailing arms or other body parts can hurt anyone helping. Sometimes seizures last so long that the person loses consciousness. And rarely, the person can have brain damage.

What happens after treatment for the injury? 
A doctor may prescribe medication to prevent future seizures, especially if he or she thinks the cause is epilepsy or alcohol. Anyone with epilepsy and anyone whose seizure is caused by alcohol, needs to avoid alcohol. People prone to seizures need to avoid certain medications, including some medications used to stop people smoking. It is also important to control high blood pressure or heart disease. Children should be observed for signs of increased fever. Finally, pregnant women should follow their doctor's advice regarding treatment of high blood pressure, swelling, liver disease or blood clots.

Author: James Broomfield, MD
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne

Last Updated: 6/09/2004
Contributors
Potential conflict of interest information for reviewers available on request
 


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