Seizure, a sudden, uncontrolled disturbance in the electrical pulse pattern of the brain, is caused when your brain cells start moving simultaneously at a faster pace than the accredited normal.
“My two year old Husky [dog] has been getting seizures every 15 minutes since morning…Ohh…every 5-10 minutes now… [while talking on the other line connecting home]. The vet says we might have to put him down… Can you do something…? My dog is my LIFE!!”
Got this query from an upset dog parent in a rushed voice two days ago.
With nothing else to guide in this do-or-die situation, I prescribed simply upon the frequency of fits and thus the graveness of the situation.
“He’s so much better, the frequency has come down to once in every 5-7 hours now. He could finally get some sleep after so many days.”
Yesterday morning’s follow-up from the slightly at-ease parent.
No fit at all the whole day! He could go for a short walk all by himself [needed to be carried earlier since he couldn’t even walk because of the fits].
Today morning’s report with a note of thanks.
Seizures are more common than you might think. They can affect humans and animals alike and can be severe or subtle. Seizures can cause changes in the behavior, movements, feelings, and level of consciousness.
Most seizures last from 30 seconds to two minutes.
Having two or more seizures at least 24 hours apart that aren’t brought on by an identifiable cause – Primary (idiopathic) seizures, come under the diagnosis of Epilepsy. Secondary seizures linked to various other pathologies (a stroke, a closed head injury, an infection such as meningitis, a cyst or tumor etc.) are entirely different and require different approaches based on the treatment of the primary condition.
Status Epilepticus: a medical emergency
The condition occurs if one is in a state of continuous seizure activity lasting more than five minutes or if one has frequent recurrent seizures without regaining full consciousness in between.
An individual in Status Epilepticus has an increased risk of permanent brain damage and death.
Phases of a Seizure
A seizure can have four distinct phases – Prodrome, early ictal (the “aura”), ictal, and post-ictal.
Before the Seizure: Prodromal Phase
This phase is a subjective feeling or sensation that can occur several hours or even days before the actual seizure. The most common symptoms of a prodrome include confusion, anxiety, irritability, headache, tremor, anger or other mood disturbances.
As few as 20% of the sufferers experience this stage, which may serve as a warning sign of seizure onset in them. Prodrome is not a part of the seizure.
During the Seizure: Early Ictal and Ictal Phases
Early Ictal or Aura
For many people, the earliest sign of seizure activity is an aura. Although it has traditionally been thought of as a warning of an oncoming seizure, an aura actually is the earliest sign of seizure-activity and the beginning of the ictal phase.
The specific symptoms vary depending on the seizure type, severity, and affected brain region. Some common symptoms can be:
An aura can remain localized or progress to other areas of the brain with the person’s awareness becoming impaired to varying degrees. It can also spread to both hemispheres [sides] of the brain, becoming a secondarily generalized seizure within seconds to minutes after onset.
Ictal Phase
This stage manifests in different ways for every person. They may experience a variety of symptoms, including but not limited to:
After the Seizure ends: Post-Ictal Phase
The recovery period following a seizure is the post-ictal phase. Some people recover immediately, while others may require minutes (even days) to feel like they’re back at their baseline. The length of the post-ictal phase depends directly on the seizure type, severity, and region of the brain affected. Typical symptoms include:
Medical types of a Seizure
Doctors generally classify seizures as either focal or generalized, based on how and wherein the brain the abnormal activity began and how far it spread.
Focal seizures
Focal seizures occur due to abnormal electrical activity in one area of your brain. They can occur with or without loss of consciousness:
- Focal seizures with impaired awareness involve a change/loss of consciousness or awareness that feels like being in a dream. You may seem awake, but you stare into space and do not respond normally to your environment or you perform repetitive movements. These may include hand rubbing, mouth movements, repeating certain words or walking in circles. You may not remember the seizure or even know that it occurred.
- Focal seizures without loss of consciousness may alter emotions or change the way things look, smell, feel, taste or sound, but you don’t lose consciousness. You may suddenly feel angry, joyful or sad. Some people have nausea or unusual feelings difficult to describe. These seizures may also result in difficulty speaking, involuntary jerking of a body part, such as an arm or a leg, and spontaneous sensory symptoms such as tingling, dizziness and seeing flashing lights.
Symptoms of focal seizures may be confused with other neurological disorders, such as migraine, narcolepsy or a mental illness.
Generalized seizures
Seizures that appear to involve all areas of the brain simultaneously are considered generalized. Different types of generalized seizures include:
- Absence seizures. Previously known as petit mal, these seizures often occur in children and are characterized by staring into space or by subtle body movements, such as eye blinking or lip-smacking. They usually last for 5 to 10 seconds but may happen up to hundreds of times per day. They may occur in clusters and cause a brief loss of awareness.
- Tonic seizures. They cause stiffening of your muscles and usually affect muscles in your back, arms and legs. They may cause you to lose consciousness and fall to the ground.
- Atonic seizures. Also known as drop seizures, cause a loss of muscle control, causing you to suddenly collapse, fall down or drop your head.
- Clonic seizures. Clonic seizures are associated with repeated or rhythmic, jerking muscle movements. These seizures usually affect the neck, face and arms on both sides of the body.
- Myoclonic seizures. Myoclonic seizures usually appear as sudden brief jerks or twitches of your arms and legs. There is often no loss of consciousness.
- Tonic-clonic or convulsive seizures. Previously known as grand mal seizures, these are the most dramatic type of epileptic seizures and can cause an abrupt loss of consciousness, body stiffening and shaking, and sometimes loss of bladder control or biting your tongue. They may last for several minutes.
What can cause a Seizure?
Nerve cells (neurons) in the brain create, send and receive electrical impulses to help them communicate. Anything that disrupts these communication pathways can lead to a seizure.
Some types of seizure disorders may be caused by genetic mutations.
The most common cause of seizures is epilepsy. But sometimes they may be caused or triggered by:
- High fever, generally associated with meningitis, an infection of membranes of the brain
- Lack of sleep/change in sleep habit
- Flickering or flashing light, moving patterns or other visual stimulants
- Low blood sodium [hyponatremia], which can happen with diuretic therapy
- Low blood sugar
- Certain medications – pain relievers, antidepressants or smoking cessation therapies, that can lower the seizure threshold
- Head trauma that causes an area of internal bleeding in the brain
- Abnormalities of the blood vessels in the brain
- Autoimmune disorders such as SLE [systemic lupus erythematosus] and MS [multiple sclerosis]
- A stroke
- Brain tumor/cyst/worm
- Use of illegal or recreational drugs, such as amphetamines or cocaine
- Alcohol – withdrawal/extreme intoxication
- COVID-19 virus infection
How is it Diagnosed?
After thoroughly going through your symptoms and medical history your doctor may advise a couple of tests to determine the cause of your seizure and evaluate how likely you’re going to have another one. These may include:
- A neurological examination to evaluate your behavior, motor abilities and mental function and know if there is an issue with your brain/nervous system.
- Blood tests to check your blood sugar level and look for signs of infection, genetic conditions or electrolyte imbalance.
- Lumbar puncture. You may need to have a sample of your cerebrospinal fluid taken through a lumbar puncture for testing if your doctor suspects an infection as the cause of your seizure.
- An electroencephalogram (EEG) In this test, electrodes are attached to your scalp with a paste-like substance to record the electrical activity of your brain. It shows up as wavy lines on an EEG recording. Your EEG may reveal a pattern that tells doctors whether a seizure is likely to occur again. It may also help exclude other conditions that mimic epilepsy as a reason for your seizure.
- Imaging tests may include an MRI or a CT scan to detect lesions or abnormalities in your brain that could have lead to the seizure, such as a tumor, internal bleeding or a cyst.
- More detailed PET or SPECT scans help visualize the still active areas of the brain and may provide even more detailed results. SPECT is usually done in a hospital with overnight EEG recording.
Seizure complications
Having a seizure can sometimes lead to circumstances that are dangerous for you or others. You might be at risk of:
- Falling. If you fall during a seizure, you can injure your head or break a bone.
- Accidental drowning. If you have a seizure while swimming or bathing in a tub.
- Car accidents. A seizure that causes loss of either awareness or control can be dangerous if you’re driving a car or operating other equipment.
- Pregnancy complications. Seizures during pregnancy pose danger to both mother and baby. Certain anti-epileptic medications increase the risk of birth defects too. If you have epilepsy and plan to become pregnant, work with your doctor so that he or she can adjust your medication and monitor your pregnancy, as per need.
- Emotional health issues. People with seizures are more likely to have psychological problems, such as depression and anxiety, may be, as a result of difficulty dealing with the condition or as a medicinal side effect.
Most seizure disorders can be controlled with medication. Though the conventional approach of anticonvulsant drugs may provide a quick solution, in that, the fits are controlled and the patient is happy. However, such treatment may just be a symptomatic control and short-lived.
For a pet, maybe putting them to sleep to avoid the agony is an available option at the moment, but what about us humans since the law doesn’t permit Euthanasia in most of the countries in the world..
Seizures are the acute manifestation of an underlying chronic dyscrasia, and the latter must be addressed if there has to be a successful long-term cure.
Homoeopathy offers a genuine cure in majority of cases when the remedies are carefully selected on totality, without giving any side effects. It’s not habit-forming and can be given in conjunction with conventional anti-epileptics.
Through my personal experience in handling such cases for the past 30 years, I can vouch for an improvement in the seizure number, intensity, frequency and duration in most cases, as soon as the start of the medication. In a treatment span of few months to a year or two, gradually, the need for conventional antiepileptic medication gets minimized or you may even be completely weaned off them.
For detail on management and treatment, please wait for the next post...
Dr Renu Madan 