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Seizures
Definition:
A seizure or convulsion can be a sudden, violent, uncontrollable contraction of a group of muscles. A seizure can also be more subtle, consisting of only a brief "loss of contact" or a few moments of what appears to be daydreaming.

Alternative Names:
Convulsions

Considerations:
Any mild or major seizure is caused by sudden abnormal function of the brain.

Some types of seizures are:

Epilepsy (a disorder with chronic seizure) begins anywhere between the ages of 3 and 14 years, and continues indefinitely. It may be a familial condition.

The most common cause of seizures in children are febrile seizures. Often, uncomplicated febrile seizures are benign.

When witnessing a seizure, try to remember what happened such as:

  • Did limbs twitch? If so, which ones and on which side.
  • Did the head twist, neck go rigid, eyes turn or roll?
  • Was there drooling or foaming at the mouth?
  • Was there a chewing motion or smacking of the lips?
  • Was there any change in consciousness?
  • Did the victim bite the inside of the cheek, tongue or lips?
  • Was there loss of bladder or bowel control?
If there was no twitching at all, just a sudden blanking out, as in a faint, then it may have been a faint if the victim recovered promptly after lying down. In an epileptic seizure, it usually takes minutes or hours to recover.
Common Causes:
Home Care:

Follow your health care provider's recommendations. Known epileptics should always wear a medical alert tag.

There is nothing you can do to stop convulsions once they have started. See seizure-first aid. All that can be done is to help protect the victim from injury and get medical help as needed. Clear furniture and sharp objects from the area around the victim.

If vomiting occurs, turn the victim's head so that the vomitus is expelled. If the victim is unconscious, keep the airway open, and be prepared to administer CPR if necessary.

In an infant or child, if the seizure seems to be the result of high fever, cool the child gradually, using a dampened sponge or cool compress and tepid water. An appropriate dose of acetaminophen (Tylenol) may be used if the child is awake. DO NOT, however, immerse the child in a cold bath.

After a convulsion, most victims go into a deep sleep. Don't prevent the victim from sleeping. He or she will probably be disoriented for awhile after awakening.

Stay with the victim until recovery or until you have professional medical help. Meanwhile, monitor their vital signs (pulse, rate of breathing, blood pressure).

DO NOT:

  • DO NOT restrain the victim.
  • DO NOT place anything between the victim's teeth during a seizure (including your fingers).
  • DO NOT move the victim unless he or she is in danger or near something hazardous.
  • DO NOT try to make the victim stop convulsing -- they can't control themselves during a seizure.
  • DO NOT perform rescue breathing on a seizure victim, even if they are turning blue. Most seizures end long before brain damage would begin.
  • DO NOT give the victim anything by mouth until the convulsions have stopped and the victim is fully awake and alert.
Call your health care provider if:

Report any seizures (even a mild one) to the health care provider.

Note: This is not a trivial symptom. If this is the first time the person has had a seizure (there is no previous history of epilepsy), or if this is a new type of seizure for the person, they should be seen right away (go to the emergency room if necessary).
What to expect at your health care provider's office:
The medical history will be obtained and a physical examination performed.

Medical history questions documenting a seizure in detail may include:
  • Location
    • Did it occur on one side only (unilateral)?
    • Did it affect only a part of the body?
  • Quality
    • Was it a major movement (convulsion) seizure?
    • Did it have a known cause (such as known epilepsy or a recent head injury)?
    • Was consciousness maintained during the seizure?
    • Was it a rhythmic contraction and relaxation of the face, arm, or leg muscles?
    • Was it a petit mal seizure (staring episode or similar activity)?
    • Were there prolonged muscle contractions only?
    • Was there a period of prolonged muscle contraction AND a period of muscle contraction alternating with relaxation?
  • Time pattern
    • How long did the seizure last (how many seconds)?
    • Is this the first time the person has had this type of a seizure?
    • Have they ever had a seizure that lasted longer than 2 or 3 minutes?
    • Have they ever had a seizure that involved large muscle movements (convulsion)?
  • Other
The physical examination may include a neurological examination. The occurrence, nature, and duration of the seizures will be assessed.

Diagnostic tests that may be performed include:

Intervention:
Medications are often prescribed. Strict compliance with drug therapy, if appropriate, will be emphasized. Depending on the cause, surgery may be recommended.

Family members should be asked to observe and record seizure activity to ensure proper treatment.

People with uncontrolled seizures should not drive. Each state has a different law with respect to amount of time a person has to be seizure free before resumption of driving. People with seizures should also not swim or bike alone.

After seeing your health care provider:
You may want to add a diagnosis related to seizures to your personal medical record.

Review Date: 2/7/2002
Reviewed By: Victoria Kennedy, RN, A.D.A.M. editorial. (2/7/2002). Previous review: Galit Kleiner-Fisman MD, FRCP(C), Department of Neurology, University of Toronto, Toronto, Ontario, Canada. Review provided by VeriMed Healthcare Network.(7/30/2001).
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