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What Is Epilepsy? What Triggers A Seizure?

1 February 2021 | 8 mins read | What Is Epilepsy? What Triggers A Seizure?

Did you know that you might have seen someone having an epileptic seizure and not recognized it?

Epilepsy, a disorder in which a person is prone to having seizures, currently affects 65 million people around the world. Relatively few experience the convulsive seizures you may have seen on TV. The type of seizure someone has depends on exactly what is happening in the brain.

epileptic seizure electrical brain impulse halza digital health app management
What Happens in The Brain?

Normally, cells in our brain use electrical impulses to communicate with each other and with the rest of our bodies. These electrical impulses allow the brain to act as the control center for virtually everything we do. Something as simple as drinking a glass of water requires the brain to:

  • tell us that we need water
  • receive information from the eyes, allowing us to see the glass of water
  • interpret what we see so that we know what the glass of water is and what to do with it
  • send signals to our hand and arm so we can bring the glass to our lips
  • ensure that when we swallow the water it goes into our stomach and not into our lungs
  • tell us we are no longer thirsty and should stop drinking

Each of these processes begins in a specific, different place in the brain, yet the whole process takes only a split second as electrical impulses direct signals to the appropriate areas.

epileptic seizure electrical brain impulse halza digital health app management
What Happens in The Brain During A Seizure?

During a seizure there is a sudden, uncontrolled burst of electrical activity in an area in the brain, sometimes described as an “electrical storm”. The effect on the body depends on exactly where in the brain the ‘storm’ happens.

Some seizures originate from only one side of the brain. These are called focal seizures. Typically, during a focal seizure, the person is aware of the seizure and their surroundings. If they are unaware, they may also seem dazed or confused.

signs of a focal seizure halza digital health app

Examples of signs of a focal seizure are:

  • twitching
  • jerking
  • rubbing hands
  • stiffening
  • running
  • inability to speak
  • memory impairment
  • eye-blinking
  • pelvic thrusting
  • nodding the head
  • distorted special awareness
  • smelling or tasting an odor or substance that is not present

Since the brain also regulates emotion, focal seizures can have emotional components. These might be:

  • laughing
  • crying
  • anxiety
  • anger
  • paranoia

Focal seizures typically last for less than two minutes.

epilepsy types of seizures symptoms signs fainting collapsing what to do halza digital health app management
What Is the Kind of Seizure You See on TV?

Some seizures begin on both sides of the brain or start on one side and extend to both.

These are called “generalized” seizures. In generalized seizures, the person is not aware of what is happening. The type of generalized seizure which is most likely to require assistance, and which is the type usually seen on TV, is called a tonic-clonic seizure.

Tonic-clonic seizures follow a typical sequence:

  • first, loss of consciousness and stiffening, causing a standing person to fall
  • tightly contracted muscles
  • stiff, rhythmic jerking, shuddering, or full-blown convulsions
  • regaining consciousness
  • sleeping
  • waking from sleep, often in confusion or without any memory of the seizure
  • re-orientation to their surroundings

During the seizure, the person might make gasping, snuffling, or other sounds. As the seizure subsides, they might lose bladder control.

Other Types of Seizures

There are numerous types of generalized seizures.

Most last for less than 30 seconds and involve some combination of muscle stiffness, spasms, twitches, or weakness. “Absence” seizures, which are more common in children, appear as though the person has stopped their activity and ‘zoned out’.

Are All Seizures Epilepsy?

No. Seizures happen for many reasons – low blood sugar, dehydration, drug withdrawal, and infection, for example. When the acute condition is corrected, the seizures will end.

In epilepsy, the seizures are not attributable to a temporary, reversible condition. Rather, they are from chronic conditions that can affect how the brain cells “fire”. These conditions include:

  • chronic inflammation or infection – such as HIV, tuberculosis (TB), or malaria
  • trauma or stroke
  • a genetic or metabolic condition
  • a neurodegenerative disorder such as Alzheimer’s disease or multiple sclerosis
  • a structural abnormality, which can be congenital or can arise from a stroke or trauma

In many cases, the cause of seizures is unknown.

Related reading:

who gets epilepsy over 65 under age 2 halza digital health app management
Who Gets Epilepsy?

The largest number of new cases is in adults over age 65, as the brain sustains damage from conditions such as strokes or neurodegenerative disorders.

The second-largest number of new cases is in children under two years old. The cause is usually congenital. A common cause of epilepsy in adolescents and teens develop epilepsy is trauma, although epilepsy can develop later as a result of scar tissue from the injury.

What Triggers Epileptic Seizures?

In popular culture, epileptic seizures are often triggered by flashing lights or flickering shadows or patterns, but in reality, these “photosensitive” seizures affect only around 5% of people with epilepsy.

Most epileptic seizures have no obvious trigger; however, seizure activity is very sensitive to overall health and wellness.

epileptic seizure trigger prevention how to prevent halza digital health app management

To help in preventing seizures, people with epilepsy should:

  • have a regular sleep schedule and get enough sleep
  • avoid getting overheated or dehydrated, especially when exercising
  • eating nutritious meals on a regular schedule
  • develop a good support system for coping with stress
  • take medication as prescribed
  • manage other illnesses that they might have

Related reading:

A breakdown in any of these areas can lead to a seizure.

Other “triggers” include:

  • illness, especially with a fever
  • hormonal fluctuations
  • taking a medicine that interferes with anti-epileptic medicine
  • alcohol, which can trigger a seizure up to a day after drinking
  • recreational drugs

treating epilepsy seizures medication surgery nerve stimulation halza digital health app management
Can Epilepsy Be Treated?

Epileptic seizures are usually preventable with one of several different medications. Side effects vary, and it can take some time to find the most effective and tolerable option. Having a health management app like Halza to help you keep track of your medication is useful in adhering to a prescription. Simply enter the medication details for record-keeping and to easily share the information with any attending doctor, and set a reminder for when you have to take them. Learn more about Halza here.

If medicine does not work, second-line treatments are surgery, a ketogenic diet (an exacting low-carb diet, which can be very difficult to follow), and nerve stimulation (available in various forms).

People who have repeated seizures have a significantly higher risk of sudden death, so it is important that they avoid triggers and take their medication consistently. It is also important to recognize that no one can live their life “perfectly”.

Historically, people with epilepsy have been stigmatized by a disease over which they have no control, which at times is very visible, and which can be embarrassing to them. Your support and understanding that epilepsy is a medical condition that someone has but does not define who they are as a person, can be very helpful in eliminating the stigma.

Sources: UpToDateEpilepsy Foundation, 2, 3, 4

Jill Garner
Jill GarnerRegistered Nurse and Diabetes Educator

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