SEIZURES

Name and magnitude of the problem:
Seizures are a temporary neurologic event that results from some abnormality in the central nervous system (CNS). Epilepsy describes a condition where there is a tendency in an individual to have recurrent seizures due to a chronic underlying process. 5-10% of all populations are expected to experience at least one seizure. The incidence of epilepsy is 5-10 in 1000.

How one contracts the illness:
There are many causes of seizures; some of these are obvious (eg. Head injury, drug toxicity or withdrawal, high fever, stroke) while others need extensive investigations to diagnose (eg. Electrolyte or metabolic derangements, CNS tumors, genetic predisposition, infective causes, drugs that lower the threshold for seizures …). A lot of the time a specific cause of the ailment cannot be found with any degree of certainty.

Signs and symptoms:
Seizures present with many varied physical presentations. There can be differences in the characteristic features, severity of manifestations, durations and level of consciousness. Some generalized seizures start with a prodrome which may include lethargy, depression, irritability, jerking of limbs, headache etc … The actual seizure may consist of loss of consciousness, partial or full body muscle spasm or contraction, unresponsive staring, apnea or cessation of breathing, a cry or blue coloring of the lips/nose etc… The seizure maybe accompanied or followed by bowel or bladder incontinence, deep coma, confusion or deep sleep.

How it is diagnosed:
A good description or witnessing of the seizure in most cases is enough to make a diagnosis of seizures. EEG can be useful during the seizure if it can be recorded during the episode and sometimes even when taken between seizures. Neuroimaging can be useful to delineate the exact cause of the seizure. Similarly some blood tests may also assist in ascertaining the cause.

How it is treated:
There are many medications that are used to treat seizures. They have to be taken regularly and advice followed diligently when discontinuation is being considered. Uncommonly surgical treatment is also used in specific conditions.

Important considerations:
Seizures can be life threatening or may result in permanent disability due to damage to the brain. Thus all preventive measures possible should be taken in situations or in patients prone to develop seizures.

What can you do?
The most important action to be taken is to ensure that the patient does not suffer an injury during the seizure. There is no need to physically restrain the patient other than to achieve this. Do not try to give any food or drink to the patient during or just after the seizure. Try to bring the patient to medical attention as soon as possible.