Epileptic Seizure: What it Is and How to Respond

05 September, 2020
In our society, witnessing an epileptic seizure is somewhat traumatic for many. After all, many of us don't know how to respond or help. Read on to learn more!
 

Believe it or not, 3% of the population will suffer at least one epileptic seizure throughout their lives. Therefore, it’s a fairly common condition. In fact, it’s the second most common neurological cause people to go to the emergency room.

Epilepsy is a chronic and non-communicable brain disease that affects people of all ages. Furthermore, around the world, approximately 50 million people suffer from it, and about 80% of patients live in low- and middle-income countries.

Next, we’ll explain what an epileptic seizure is and how a person can be kept safe until the seizure ends on its own.

What’s an epileptic seizure?

By definition, an epileptic seizure is a set of diverse symptoms, from some that can go unnoticed to manifestations that people popularly call seizures: generalized body contractions with loss of consciousness. Curiously, these symptoms are due to the fact that a group of neurons in the brain decide to activate at the same time and carry out their activity excessively and abnormally.

Overall, there are two types of epileptic seizures:

  • Acute symptomatic seizure (ASS). An injury outside or inside the brain causes this. A brain trauma, cerebrovascular disease, brain infection, fever, intoxication, or an imbalance of blood sodium and sugar levels can cause this type of seizure.
  • Unprovoked seizures, commonly known as epilepsy. Six out of 10 people who have seizures suffer from epilepsy with no identifiable cause.

According to the ILAE (International League Against Epilepsy), epilepsy is a brain disorder characterized by an enduring predisposition to generate epileptic seizures and by its neurobiological, cognitive, psychological, and social consequences. In other words, any of us can have an epileptic seizure, but not all of us will develop epilepsy.

 
An EEG of the brain.
Epileptic seizures are linked to synchronous and uncontrolled neuronal firing.

You might like this article: Epileptic Seizures: What Should You Do?

Types of epileptic seizures: Signs and symptoms

First of all, it’s necessary to know that there are two main types of epileptic seizures: generalized seizures and focal onset seizures.

Generalized seizures

Unfortunately, abnormal activity occurs throughout the brain and often leads to loss of consciousness. There are several reasons for this:

  • Absence seizures. This usually occurs in children and young people. The individual loses consciousness for a few seconds, without any other clinical manifestation. During this interval, they usually don’t respond and are disconnected from the environment. They don’t pass out or have muscle contractions. They just stop what they were doing and stare ahead.
  • Myoclonic seizures. This type of generalized seizure doesn’t cause loss of consciousness. It causes muscle jerks in the extremities, usually in both hands.
  • Tonic seizures. They cause a single sudden tonic contraction. The body becomes stiff or rigid like a board and it also causes loss of consciousness.
  • Tonic-clonic seizure. This is what we normally associate with an “epileptic seizure.” First, there’s a tonic contraction phase, which is followed by clonic muscle jerks. It’s always accompanied by loss of consciousness. Often, the patient bites the lateral part of their tongue and there’s sphincter relaxation. It usually lasts between one and two minutes, followed by a period of several minutes of confusion.
 

Focal onset seizures

In this case, the abnormal activity only occurs in a specific group of neurons. It causes several symptoms depending on the affected region, such as visual and olfactory hallucinations and jerks in one hand.

A man having a seizure.
There are generalized and focal onset seizures.

This article may interest you: Ocular Migraines: How Can They Affect You?

What you should do

If you witness an epileptic seizure, you should do the following:

  • Carefully lay the person down on the ground or in an area where there are no hard or sharp objects around. You should support their head on something smooth and flat.
  • Then, turn the person to one side to improve breathing.
  • Loosen objects that could be around their neck, as they can be dangerous in the middle of movements.
  • Don’t try to hold them down or prevent movement – simply make sure there’s nothing in their environment that can harm them.
  • Stay with the person until the crisis is over.

Most epileptic seizures are not an emergency and end on their own. That’s why it’s important to simply ensure that the person can’t get hurt by external objects during the seizure. However, it’s often recommended that they report their seizure to their doctor afterward.

 

What not to do

Beyond what you should do at this time, it’s important to know what precautions to take to avoid making mistakes that can complicate the patient’s evolution. First and foremost, you shouldn’t try CPR.

Also, you shouldn’t hold the person during the epileptic seizure, insert objects into their mouth, or try to grasp their tongue. It’s best for the crisis to occur with the person turned to the side and to place their tongue in the same position.

Finally, you shouldn’t offer the person food or liquids immediately after the crisis, at least until you confirm that the affected person is alert.

 
  • Centro para el control y la prevención de las enfermedades. Primeros auxilios para las convulsiones | Epilepsia | CDC [Internet]. 2019. [citado 4 de abril de 2020]. Disponible en: https://www.cdc.gov/epilepsy/spanish/primeros-auxilios.html
  • Megiddo I, Colson A, Chisholm D, Dua T, Nandi A, Laxminarayan R. Health and economic benefits of public financing of epilepsy treatment in India: An agent-based simulation model. Epilepsia. 1 de marzo de 2016;57(3):464-74.
  • ILAE. Welcome to the International League Against Epilepsy [Internet]. [citado 4 de abril de 2020]. Disponible en: https://www.ilae.org/
  • Fauser S, Cloppenborg T, Polster T, Specht U, Woermann FG, Bien CG. Genetic generalized epilepsies with frontal lesions mimicking migratory disorders on the epilepsy monitoring unit. Epilepsia Open. 2020;