Seizures

A seizure is a sudden surge of abnormal electrical activity in the brain. It can cause a wide range of temporary changes — from a brief stare to a full generalised convulsion. A single seizure does not always mean epilepsy (see Epilepsy page); but any first seizure deserves proper evaluation.

Types

• Generalised tonic-clonic — loss of consciousness, stiffening then jerking; may bite tongue; loss of bladder control.
• Focal aware — changed sensation, feeling, smell, twitch, with consciousness preserved.
• Focal impaired awareness — staring, automatic behaviours, memory gap.
• Absence — brief staring spells, often in children.
• Myoclonic, atonic — jerks, drop attacks.

First aid — during a convulsion

• Stay calm. Time the seizure.
• Protect the person from injury — move hard/sharp objects away; cushion the head.
• Roll them to one side (recovery position) once the convulsion stops.
• Do NOT put anything in the mouth (no spoon, handkerchief, key, cloth, onion, shoe). Most Indian folklore around seizure first aid is wrong and can injure teeth, jaw, and the helper's fingers.
• Do NOT restrain violent movements.
• Stay with them until they recover fully.

Dial 112 if

• First-ever seizure.
• Seizure lasting more than 5 minutes, or repeated seizures without recovery (status epilepticus) — emergency.
• Injury, breathing difficulty, blueness.
• Pregnancy.
• Seizure after head injury.
• Fever, diabetes, or other serious illness.
• Confusion lasting more than 30 minutes after.

Causes

• Epilepsy — covered on its own page.
• Acute provoking causes — head injury, stroke, meningitis/encephalitis, neurocysticercosis (from pork tapeworm — important in India), tuberculoma, low blood sugar, low sodium, severe alcohol withdrawal, drug overdose.
• Febrile seizures in children 6 months-5 years — usually benign.
• Post-stroke, post-surgery, post-tumour.

What happens at hospital

• Examination, basic bloods, ECG.
• Brain imaging (CT/MRI) — especially for first seizure or red flags.
• EEG.
• Lumbar puncture if infection suspected.
• Starting treatment depends on the cause — may or may not mean starting anti-seizure medicine long-term.