Causes and symptoms of seizure / epilepsy

Seizure is identified as the effect or activity of sparking brain. 

• Why do these sparks occur in an insulated (covered) brain?

• How does it occur?

• What is the reason?

• Why does it spread?

• Why doesn’t it spread in some focal seizures?

• How does it resume normalcy after a period without any trace?

• Why can’t even MRI or EEG pin point the foci/cause in every case? 

Why???
WHY???WHY????..................

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Still more questions ‘spark’ in our brain… which have not been answered till now. Anyhow, advancement in medicine easily controls (even though it cannot guarantee cure) and maintains it with tablets. It helps the sufferer lead a good challenging life (with some restrictions) and avoid being disabled.

Causes for seizure or epilepsy disorders – More often, causes will be idiopathic (unknown). Sometimes it may be symptomatic, i.e., having base for the suffering - suspected cause/disease. Commonly, seizure or twitching occurs when the brain/nerves lack essentials like oxygen, glucose, sodium, calcium, etc. Medical science has also identified innumerable causative factors for the occurrence of seizure disorders. The most common causes are:

Hereditary – Chromosomal abnormalities, autism, genetic predisposition, etc.
Attained during birth - Asphyxia developed as a complication of delivery, i.e., delay in conduction of delivery or due to cord around the neck or by ingestion of amniotic fluid, etc.
Physiological – Sleeplessness, overtime job, poor nutrition, poor growth, excess alcohol, sexual excesses, heat stroke, etc.
Psychological – Mental trauma/shock, fear, getting upset, anxiety, tension, depression, emotional conflicts, anger, loss, loneliness, etc.
Pathological – High fever, viral or bacterial infections (meningitis or encephalitis), ischaemia, high blood pressure, increased ventricular pressure, heart arrythmias, high sugar levels, metabolic disorders, vascular disorders/tumours, brain tumours, neurofibroma, parasite infections, etc.
Injury/trauma – Head injury from being hit while playing or due to surgical procedures to remove tumours or clots or druing forceps delivery, etc.
Drug induced – Seizures can also arise as a drug reaction during development (pregnancy period) or from drug dependency or from drug withdrawal which was held suddenly after having developed drug dependency (epilepsy or migraine), or from drugs poisoning with toxic doses, etc.

Generally in

• Childhood – genetic predisposition, chromosomal abnormality, high fever, head injury, forceps delivery, asphyxia during delivery, bacterial or viral encephalitis, parasite infection, etc., come as common causes.

• Adult – Alcohol, brain tumours, stroke, sleeplessness, metabolic disorders, head injury, meningitis, encephalitis, high fever, parasite infection, sclerosis, ageing atrophy, degenerative disorders, hypertension, diabetes, renal failure, etc., are common causes.

Triggers – Triggers vary from person to person. Sufferers often correlate innumerous triggers as the precursor of the attack. The most common among them are anxiety, fear, tension, fever, exhaustion, sleeplessness, alcohol, drugs, flashing lights (including flickering of TV/computer monitor), seeing fast moving objects, thunderstorms, violent headache, high bass and treble sounds, oily foods, indigestion, etc.

Symptoms – also usually vary from person to person. It can occur anywhere in the body and can present symptoms as altered sensations or functions or feelings. Seizures/epilepsy can be of different types with different sets of symptom presentation depending upon the root and progress of the disease. Mainly, it is categorised as localised / focal seizures and generalised seizures depending upon the parts and sides of the body involved. Nowadays, seizures are named after the parts involved and activities during the attack.

For example 

Localised seizure (Petitmal)

• Focal seizure - symptom will be restricted to a part / side. This type of seizure is most common (more than 60 per cent). 

• Absence seizure – just a momentary loss of consciousness or staring

• Akinetic seizure – loss of posture (due to loss of muscle tone) to fall down without any jerks or spasms.

These focal, absence and akinetic seizure commonly originates from the pre-central gyrus of the brain. 

• Generalised seizure (Grandmal) – occurs due to involvement of a larger area of the brain. Here the symptom presentation can be noted in most of the parts or all over the body.

Commonly, seizure has the following movements and they are also named accordingly:

• Tonic movements – with high muscle tone – i.e., muscle become rigid

• Clonic movements – oscillatory movements

• Myoclonic movements – jerks/twitching of the parts/body

• Tonic clonic movements – mixture of tonic and clonic movements 

Symptoms of seizure/epilepsy usually vary in intensity and are strange in presentations from simple blackout/stare for a second to total loss of consciousness with or without sudden violent shaking or jerky movements. That is, some persons will just faint, while some others will have twitching alone with or without consciousness and some others would have violent jerky movements with loss of consciousness. Simple seizures have no warning signs whereas chronic seizures (i.e., epilepsy) can have warning or alarm signs i.e. aura. In the case of those suffering from jerky movements, commonly the opposite side of the body suffers for the sparks on one side of the brain.

Aura – It is an altered (subjective/notion) feeling which alerts or alarms or warns the sufferer about the arrival of epilepsy. It can last for a minute to a day. It may be felt as altered sensation in hearing, vision, taste, smell, feeling, sensations, etc. It may also make one uneasy/uncomfortable and be in an irritable mood. Its presentation (feelings) differs from person to person. Aura signals commonly arise in the temporal lobe.

During attack – Presenting complaints commonly differ from person to person. Sufferers can have a few or all the below symptoms

• Staring

• Blinking/twitching of eyelids and other parts

• Imbalance with dizziness and drowsiness/fainting

• Loss of consciousness/memory

• Deviation of mouth angle with movements

• Stiff face/painful facial expression

• Clenched teeth

• Tongue or cheek can get bitten between clenched teeth

• Drooling and frothy saliva due to severe gasping

• Catch in breath, gasping for air/choking felt due to obstruction in larynx due to accumulated sputum/phlegm and spasms of lung muscles

• Rigidity and spasms in the parts involved - commonly arms flexed and legs extended or stretched

• Rythmic jerky movements in parts with alternate tightness (spasm) and relaxation – eyes, mouth, neck, shoulder, arm, forearm, fingers, legs, etc. – which usually lasts from 30 secs to 3 minutes or more.

• In severe cases, violent attack follows without any relaxation status - epilepticus (dangerous) - where there will be sustained contraction in all parts (including lung muscles – which commonly causes death)

• Bladder and bowel can go out of control with leaking or emptying

• Sufferer often gets injured when he faints and falls down against the wall or floor. They also get injured while having violent jerks against nearby objects.

After seizure – mild symptoms will last for a day or two with dullness

After attack – 

• Coma or loss of consciousness continues (or deep sleep follows) for minutes to hours depending upon the intensity of the suffering and exhaution of the sufferer. All muscles become flaccid and weak after the attack

On getting up

• Unaware of activities/happenings during seizure

• Anxiety, fear and tension

• Drowsiness/dizziness/confusion/lack of concentration due to brain fag

• Sleepiness, dullness, headache, giddiness may last for a day to two days

• Nausea and vomiting

• Stomach discomfort with or without irregular bowel movements

• Tiredness/exhaution/severe body pain due to violent jerky activities

• Tremor, numbness of the parts and sleeplessness may follow

(To be continued)