The Best Life Health Diary mobile app by Live Learn Innovate Foundation empowers epileptic patients and others experiencing seizures to manage their condition, learn the triggers, and pursue their best lives within their own means.
What is a seizure?
A seizure is a sudden, uncontrolled electrical disturbance in the brain. It can cause changes in your behavior, movements or feelings, and in levels of consciousness. Having two or more seizures at least 24 hours apart that aren’t brought on by an identifiable cause is generally considered to be epilepsy.
Epilepsy and Seizures
Epilepsy is a disorder of the brain. People are diagnosed with epilepsy when they have had two or more seizures. As there are many types of seizures, a person with epilepsy can have more than one type of seizure.
The main symptom of epilepsy is repeated seizures. These are sudden bursts of electrical activity in the brain that temporarily affect how it works.
Seizures can affect people in different ways, depending on which part of the brain is involved.
Some seizures cause the body to jerk and shake (a “fit”), while others cause problems like loss of awareness or unusual sensations. They typically pass in a few seconds or minutes.
Seizures can occur when you’re awake or asleep. Sometimes they can be triggered by something, such as feeling very tired.
The signs of a seizure depend on the type of seizure.
Sometimes it is hard to tell when a person is having a seizure. A person having a seizure may seem confused or look like they are staring at something that isn’t there. Other seizures can cause a person to fall, shake, and become unaware of what’s going on around them.
Seizures are classified into two groups.
1. Generalized seizures affect both sides of the brain.
- Absence seizures, sometimes called petit mal seizures, can cause rapid blinking or a few seconds of staring into space.
- Tonic-clonic seizures, also called grand mal seizures, can make a person
- Cry out.
- Lose consciousness.
- Fall to the ground.
- Have muscle jerks or spasms.
The person may feel tired after a tonic-clonic seizure.
2. Focal seizures are located in just one area of the brain. These seizures are also called partial seizures.
- Simple focal seizures affect a small part of the brain. These seizures can cause twitching or a change in sensation, such as a strange taste or smell.
- Complex focal seizures can make a person with epilepsy confused or dazed. The person will be unable to respond to questions or direction for up to a few minutes.
- Secondary generalized seizures begin in one part of the brain, but then spread to both sides of the brain. In other words, the person first has a focal seizure, followed by a generalized seizure.
Seizures may last as long as a few minutes.
Types of seizures
Simple partial (focal) seizures or ‘auras’
A simple partial seizure can cause:
- a general strange feeling that’s hard to describe
- a “rising” feeling in your tummy – like the sensation in your stomach when on a fairground ride
- a feeling that events have happened before (déjà vu)
- unusual smells or tastes
- tingling in your arms and legs
- an intense feeling of fear or joy
- stiffness or twitching in part of your body, such as an arm or hand
You remain awake and aware while this happens.
These seizures are sometimes known as “warnings” or “auras” because they can be a sign that another type of seizure is about to happen.
Complex partial (focal) seizures
During a complex partial seizure, you lose your sense of awareness and make random body movements, such as:
- smacking your lips
- rubbing your hands
- making random noises
- moving your arms around
- picking at clothes or fiddling with objects
- chewing or swallowing
You will not be able to respond to anyone else during the seizure and you will not have any memory of it.
Tonic-clonic seizures
A tonic-clonic seizure, previously known as a “grand mal”, is what most people think of as a typical epileptic fit.
They happen in 2 stages – an initial “tonic” stage, shortly followed by a second “clonic” stage:
- tonic stage – you lose consciousness, your body goes stiff, and you may fall to the floor
- clonic stage – your limbs jerk about, you may lose control of your bladder or bowel, you may bite your tongue or the inside of your cheek, and you might have difficulty breathing
The seizure normally stops after a few minutes, but some last longer. Afterwards, you may have a headache or difficulty remembering what happened and feel tired or confused.
Absences
An absence seizure, which used to be called a “petit mal”, is where you lose awareness of your surroundings for a short time. They mainly affect children, but can happen at any age.
During an absence seizure, a person may:
- stare blankly into space
- look like they’re “daydreaming”
- flutter their eyes
- make slight jerking movements of their body or limbs
The seizures usually only last up to 15 seconds and you will not be able to remember them. They can happen several times a day.
Myoclonic seizures
A myoclonic seizure is where some or all of your body suddenly twitches or jerks, like you’ve had an electric shock. They often happen soon after waking up.
Myoclonic seizures usually only last a fraction of a second, but several can sometimes occur in a short space of time. You normally remain awake during them.
Clonic seizures
Clonic seizures cause the body to shake and jerk like a tonic-clonic seizure, but you do not go stiff at the start.
They typically last a few minutes and you might lose consciousness.
Tonic seizures
Tonic seizures cause all your muscles to suddenly become stiff, like the first stage of a tonic-clonic seizure.
This might mean you lose balance and fall over.
Atonic seizures
Atonic seizures cause all your muscles to suddenly relax, so you may fall to the ground.
They tend to be very brief and you’ll usually be able to get up again straight away.
Status epilepticus
Status epilepticus is the name for any seizure that lasts a long time, or a series of seizures where the person does not regain consciousness in between.
It’s a medical emergency and needs to be treated as soon as possible.
You can be trained to treat it if you look after someone with epilepsy. If you have not had any training, call 999 for an ambulance immediately if someone has a seizure that has not stopped after 5 minutes.
Seizure triggers
For many people, seizures seem to have little warning. Sometimes they can have a trigger, such as:
- stress
- a lack of sleep
- waking up
- drinking alcohol
- some medicines and illegal drugs
- in women, monthly periods
- flashing lights (this is an uncommon trigger)
Keeping a diary of when you have seizures and what happened before them can help you identify and avoid some possible triggers.
What happens during a seizure?
According to the Epilepsy Foundation, there is typically a beginning, middle, and end to seizures—even if those stages aren’t easily separated or identified.
For some, there is a clear beginning stage of a seizure—they may even be aware of it days or hours before it actually happens. This is known as a prodrome, and it can include changes in feelings, sensations, or behavior. While not everyone experiences a prodrome with a seizure, those who do may be able to identify an oncoming seizure to better manage it.
Another beginning phase of a seizure for some (but not all) people, is known as an aura. It can sometimes be an indescribable feeling, but it can include feelings of déjà vu, racing thoughts, fear or panic, or certain tastes and smells. “The classic thing is smelling burnt toast or having a metallic taste in your mouth,” Derek Chong, MD, MSc, vice chair of neurology at Lenox Hill Hospital in New York City, tells Health.
The middle phase of a seizure—known a the ictal phase—comes next. This phase lines up with the abnormal electrical activity in the brain, and technically ranges from the first symptoms of a seizure (like an aura) to the ending of a seizure. During this middle phase, a person will likely experience the brunt of their symptoms. Those can include the more sensory or emotional changes (loss of awareness, blurry vision, flashing lights, unusual smells or tastes), or physical symptoms (difficulty talking; tremors, twitching, or jerking; lack of movement; loss of bowel control).
The final phase of a seizure—or the postictal phase—is the recovery period that follows a seizure. It can last minutes, hours, or days, depending on the type and severity of the seizure, as well as the person’s age and health. Research published by the International League Against Epilepsy in 2020 shows that almost everyone experiences some degree of unresponsiveness during the postictal phase of a seizure. Other common symptoms include headaches, fatigue, memory loss, and anxiety.
What are common seizure symptoms?
Common Symptoms Before A Seizure:
Awareness, Sensory, Emotional or Thought Changes:
- Déjà vu (a feeling that a person, place or thing is familiar, but you’ve never experienced it before)
- Jamais vu (feeling that a person, place or thing is new or unfamiliar, but it’s not)
- Smells
- Sounds
- Tastes
- Visual loss or blurring
- “Strange” feelings
- Fear/panic (often negative or scary feelings)
- Pleasant feelings
- Racing thoughts
Physical Changes:
- Dizzy or lightheaded
- Headache
- Nausea or other stomach feelings (often a rising feeling from the stomach to the throat)
- Numbness or tingling in part of the body
With a seizure, signs and symptoms can range from mild to severe and vary depending on the type of seizure. Seizure signs and symptoms may include:
- Temporary confusion
- A staring spell
- Uncontrollable jerking movements of the arms and legs
- Loss of consciousness or awareness
- Cognitive or emotional symptoms, such as fear, anxiety or deja vu
Doctors generally classify seizures as either focal or generalized, based on how and where abnormal brain activity begins. Seizures may also be classified as unknown onset, if how the seizure began isn’t known.
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