When many individuals envision seizures, they often picture a person collapsing to the floor with intense shaking, similar to the dramatic depictions found in films and television shows. Although these tonic-clonic seizures (formerly referred to as grand mal seizures) do take place, the truth is that numerous seizures resemble nothing like the representations made by Hollywood. They tend to be subtle, easily overlooked, and may be misinterpreted as daydreaming or odd conduct.
Over 3 million Americans are currently living with epilepsy, and around 150,000 new cases are diagnosed in the U.S. annually. This condition can arise in anyone, at any age. It should not be a source of shame, and with appropriate treatment, whether through medication or surgical procedures, many individuals with epilepsy can lead fulfilling and active lives. Recognizing the signs of a seizure is the initial step towards ensuring they receive the necessary assistance.
Seizures are caused by irregular electrical activity in the brain. The appearance of a seizure depends on the origin and spread of this electrical activity. Here are some types of seizures to be aware of.
Absence seizures (staring spells)
These seizures often begin in childhood. The individual suddenly halts their activity, stares blankly, and becomes oblivious to their environment. They may exhibit repetitive actions like chewing or lip smacking. These typically last for mere seconds but can occasionally extend longer. Such seizures are frequently mistaken for daydreaming or lack of attention.
Focal aware seizures
Individuals may encounter strange sensations, feelings, or movements that they cannot control. During these episodes, they stay conscious and remain aware of their surroundings. The repetitive nature of these episodes and the aura that occurs prior to larger seizures often indicate that these are minor seizures (as they do not cause a loss of awareness due to the restricted spread of electrical activity).
Focal impaired awareness seizures
In a manner similar to absence seizures, some individuals might suddenly stop their activities, stare off into space, and become unresponsive. They may perform repetitive movements such as chewing, lip smacking, and hand fidgeting. Others might wander, respond to questions, and even engage in specific tasks but appear confused and have no memory of those events (impaired awareness).
Generalized tonic-clonic seizures
These are the seizures commonly depicted in media; the person loses consciousness, falls, and experiences full-body rigidity and tremors. Prior symptoms of other seizure types may be evident. They might emit a groan or cry out (ictal cry) as their body begins to stiffen. The most critical action is to ensure the individual’s safety and adhere to the steps outlined below.
Atonic seizures (“drop attacks”)
These seizures typically originate in childhood. The individual suddenly loses muscle tone, resulting in a collapse or a head drop. These occur unexpectedly and can lead to injuries from falling.
Myoclonic seizures
These seizures involve brief, shock-like muscle jerks, which can affect any of the limbs. The jerks may lead individuals to drop items and can occasionally cause their legs to buckle.
If you suspect someone is having a seizure, here are some straightforward steps you can follow:
Stay calm & time it: Keep track of the seizure duration, which usually ranges from 30 seconds to 2 minutes. A seizure lasting longer than 5 minutes is classified as a medical emergency (status epilepticus), so if the convulsion exceeds 2-3 minutes, consider calling 911.
Keep them safe: Clear furniture or sharp objects from the vicinity of the individual. If they are standing, gently assist them to a seated or lying posture.
Protect their head: Position something soft under their head.
Turn them on their side: This helps maintain an open airway, preventing saliva or blood from obstructing it.
Stay with them: After a seizure, the person may experience confusion and might attempt to rise and walk away. Speak to them in a calm manner, reassure them, and ensure their continued safety.
Never place anything in their mouth.
James Park, DO is a neurologist, epileptologist, and clinical neurophysiologist.
Hoag is a nonprofit regional healthcare delivery network in Orange County, California, serving more than 30,000 inpatients and 480,000 outpatients each year. Hoag comprises two acute-care hospitals: Hoag Hospital Newport Beach, established in 1952, and Hoag Hospital Irvine, opened in 2010, in addition to nine health centers and 13 urgent care facilities.
In the past five years, Hoag has allocated $261 million towards programs and services to assist the underserved community, covering areas such as mental health, homelessness, senior transportation, education, and support for single mothers. Hoag is recognized as a Magnet® hospital by the American Nurses Credentialing Center (ANCC). Hoag provides a comprehensive array of healthcare services, including five institutes that specialize in cancer, heart and vascular care, neurosciences, women’s health, and orthopedics through its affiliate, Hoag Orth.