Seizures – causes and symptoms. Treatment of convulsions

Proven content

Seizures, or convulsions, are non-voluntary short, rapidly successive contractions of the skeletal muscles or generalized contractions. Convulsions are an expression of the hyperactivity of the brain or spinal cord, most often caused by: hypoxia, the action of toxic venoms, pyrogenic substances, hysteria, organic diseases of the central nervous system.

What are seizures?

Seizures are sudden and transient contractions of the skeletal muscles or generalized spasms. The seizure is usually accompanied by loss of consciousness and a sudden tightening of the muscles of the whole body, and finally the limbs and head muscles become relaxed. Convulsions usually last about three minutes and are associated with disturbance of some or all of the brain due to abnormal bioelectrical discharges in nerve cells. Usually, seizures affect the hands, but can also affect the patient’s arms, head, face, legs, and torso. This ailment can activate in the course of the following diseases: lupus, diabetes, poisoning, epilepsy, and even when we have a high fever (over 40 degrees Celsius). Convulsions may be of a nature clonic or tonic. If the seizures occur repeatedly and the patient does not regain consciousness during the pauses, this may indicate a convulsive state which requires prompt hospitalization.

Types of seizures

Seizures (as already mentioned) can be divided into tonic and clonic.

1. Tonic seizures – they are characterized by continuous muscle tension, which causes the patient to bend the head back, straighten and lift the limbs. Very often this seizure is accompanied by twitching of the eyelids, breathing disorders or nystagmus.

2. Clonic seizures – in other words, contractions of muscles that vary in duration and intensity, and are characterized by being interrupted by relaxation. Then the patient characteristically moves the affected part of the body (“back and forth”). Clonic seizures are limited in nature and may attack the face, fingers, and limbs, and they like to change their location during the course of their lifetime.

3. Tonic-clonic seizures are seizures that we divide into two phases:

— phase one: the person has clenched fists and straightened limbs, the body becomes stiff and begins to twitch without changing position. The jaw clenches during an attack, and contraction of the respiratory muscles causes the patient to have trouble breathing;

— phase two: the face is distorted and the patient’s eyes begin to move very quickly in different directions.

The onset of a tonic-clonic seizure is sudden and is caused by disturbances in the nervous system, and after such a seizure the person falls asleep very often.

Classification of seizures due to the presence of other accompanying symptoms

1. Primary generalized seizures – the first symptom is loss of consciousness, often followed by convulsions in the form of a tonic-clonic seizure. Generalized primary seizures usually occur in people whose cerebral cortex is prone to abnormal discharge. An unconsciousness attack is considered a mild form of this type of seizure, and it attacks for a few seconds during which the person freezes (the seizures appearing are very delicate and are limited only to the facial muscles).

2. Partial seizures – are caused by disturbances in a single focus in the cerebral cortex, in this case there is no sudden loss of consciousness. The initial symptoms of a partial seizure depend on the location of the epileptic focus in the cerebral cortex (if the focus is outside the part of the cortex that is responsible for motor functions – seizures do not occur). Among partial seizures we distinguish: simple – the patient’s awareness is fully preserved during the seizure; complex – consciousness is disturbed. Partial seizures are characterized by the fact that contact with the patient is possible during the seizure, but the patient does not perceive the world in the same way as before (the patient feels alienated, afraid). When the seizure ends – the patient does not remember what happened to them.

Epilepsy

In Poland, about 400 people suffer from epilepsy. This disease has its origins in childhood or early adolescence. Epilepsy is not hereditary, but a small threshold of excitability of brain cells may be inherited – in short: tendency to epilepsy due to various factors. Such people are more likely to have seizures than those who have not inherited this trait. In about 70% of cases, epilepsy occurs before the age of 18, and in 10% in adults.

What can trigger epilepsy?

1. hereditary conditions;
2. consuming a lot of alcohol;
3. brain damage (in utero) or during poor delivery;
4. complications related to head injuries, hematomas or a brain tumor;
5. complications of encephalitis and meningitis;

The causes of seizures

Convulsions can occur in virtually any human being, it depends on the strength of the stimulus used. It is obvious that if the structures of our brain are fully healthy, the stimulus strength must be much greater than in people who have a low threshold of convulsive excitability. For convulsions to arise, several factors must act simultaneously. Among these elements, the most important are: general increased convulsive emergency; the existence of changes in the patient leading to the over-excitability of several groups of neurons in the brain; an additional element that favors the triggering of an attack.

Epileptic outbreak – is a group of altered, over-excitable nerve cells. It usually appears in the area of ​​brain lesions in the form of a tumor or a scar.

The causes of seizures include:

1. stroke,
2. hypoglikemię,
3. tetany,
4. in children – fever,
5. head injuries (including: sunburn, electric shock or mechanical injuries),
6. brain abscess,
7. encephalitis,
8. meningitis,
9. drug poisoning,
10. poisoning with chemicals,
11. brain tumor
12. withdrawal from alcohol or drugs
13. bleeding into the central nervous system,
14. epilepsy.

The two most common causes of seizures in adults are: discontinuation of anti-epileptic treatment and withdrawal of alcohol by abusers. On the other hand, in children, fever is considered the main cause of seizures.

Management of convulsions

If you have a seizure, you should:

1. protect the patient against injuries (cut or bruise of the head and torso) – placing him horizontally on something soft;
2. put the patient on their side in the so-called a safe position rather than on the back to prevent the tongue from collapsing;
3. leave the patient alone (do not give fluids or medications!);
4. after the seizures are over, stay with the patient until he or she is stabilized;
5. call the Ambulance Service when a seizure lasts longer than ten minutes;
6. refrain from putting any objects into the patient’s mouth!

Convulsions – diagnosis

The diagnostic tests that are used in the case of the first seizure include:

1. medical interview,
2. blood test,
3. neurological examination,
4. EEG,
5. sometimes computed tomography.

The above-mentioned methods are aimed at finding the cause of convulsions, because the treatment depends on it. The medical history in the diagnosis is very important, information about the patient’s behavior, the length of the seizure, the nature of the seizure and other nervous system symptoms is important (this is useful in determining the type of seizure). Thanks to neurological examinations, a specialist is able to identify many symptoms in the form of paresis or paralysis of the limbs or imbalance. In children, biochemical tests are often performed in order to exclude genetic determinants of metabolic disorders as well as tetany and hypoglycaemia.

EEG is a test that allows us to show abnormal bioelectrical activity in our brain. It is useful for distinguishing between the types of seizures and epilepsy, and to help determine prognosis and treatment. Important: The presence of EEG seizures never clearly indicates epilepsy, and the results of the examination should always be read together with the medical history. It happens that, in addition to the EEG, it is necessary to perform a CT or MRI (to determine the causes of seizures).

Convulsions – treatment

Treatment of convulsions is based on the acute administration of an anticonvulsant. Further management depends on the causes of the seizures, e.g. if the cause of the seizures is a tumor or hematoma – surgical intervention is required.

Treatment is mainly based on inhibiting the occurrence of epileptic seizures, as repeated seizures may consequently damage the central nervous system. The treatment is aimed at the complete elimination of symptoms with the simultaneous absence of side effects that are associated with the chronic intake of the preparations. The type of treatment you choose depends on the type of seizure. In the beginning, you are given the lowest dose of the drug, which will increase over time. If the seizures persist after some time, the drug should be changed (sometimes it is necessary to use two preparations at the same time). The patient has to take medication for several or even several years, sometimes even for the entire life. Thanks to the medications taken, the seizures disappear in about 70% of patients.

Whether the treatment will be effective depends on the regularity of taking medications, but also on factors that provoke seizures, e.g. alcohol, infections, lack of sleep, and inappropriate lifestyle. Mental and physical activity (to a moderate degree) have a good effect on the patient’s body.