Understanding epileptic seizures

About 3 million people in the United States are diagnosed with epilepsy, according to the Centers for Disease Control and Prevention (CDC). Epilepsy is a neurological (brain) disorder in which the normal pattern of activity of neurons (brain cells) becomes disturbed. It's marked by having at least two seizures occurring more than 24 hours apart. These seizures must be unprovoked, meaning they aren’t caused by a clear, temporary issue, such as a head injury or acute infection.

Symptoms can range from unusual sensations and emotions to severe convulsions or loss of consciousness. Some people with epilepsy may experience several seizures a day, while others may go months, or even years, without one. And epilepsy is not always a lifelong diagnosis. Some forms are confined to certain stages of childhood.

Types of epileptic seizures

Neurologists have divided seizures into two major categories: focal seizures and generalized seizures.

Focal onset seizures

These are a type of seizure that occurs in just one part of the brain. During focal aware seizures, a person remains conscious but experiences unusual feelings, sensations, or emotions. During focal impaired awareness seizures, a person may experience repetitious behaviors, such as blinks or twitches, or even loss of consciousness.

Generalized onset seizures

These seizures are the result of abnormal neuronal activity on both sides of the brain. They may take many forms. In absence seizures, for example, the person may have twitching muscles and may appear to be staring into space. Tonic seizures cause stiffening of the muscles, generally in the back, legs, and arms. Other types of generalized seizures include the following:

• Clonic seizures are characterized by repeated jerking movements on both sides of the body.
• Atonic seizures involve a temporary loss of normal muscle tone and strength.
• Tonic-clonic seizures are a mix of symptoms including stiffening of the body and repeated jerks of limbs as well as loss of consciousness.

There are also other seizures that don’t fall neatly into these categories. In these cases, the starting point of the seizure is unknown, but the seizure could be focal or general, and may be diagnosed as one or the other at a later time.

How to help someone having an epileptic seizure

As with any medical event, watching someone have a seizure can be a frightening experience. Fortunately, there are steps you can take to help ensure the person’s safety during a seizure. Here are some tips to follow:

• Note the time the seizure begins. If the seizure lasts longer than 5 minutes, you will need to call for help. Make sure someone remains with the person who is having a seizure.
• Do your best to keep the person from falling, by guiding them gently to the floor and making them as comfortable as possible. Place something soft and flat, like a folded blanket or shirt, underneath the person’s head and support the head so it doesn’t hit the floor.
• Remove glasses if the person is wearing glasses.
• If there are any obstructions in the way, such as furniture or other objects, remove them immediately.
• Try to position the person on their side so that any fluid or saliva can safely leave the mouth and the tongue can fall away to the side of the mouth for a clearer airway. It's physically impossible for someone to swallow their tongue, notes the Epilepsy Foundation.
• Do not force anything into the person's mouth, as this could result in injuries such as broken teeth.
• Do not try to restrain the person, as this could result in injuries such as a dislocated shoulder.

When the seizure is over, stay with the person, but make sure they have some space. Being surrounded by a crowd can be embarrassing and confusing. Reassure the person that they are safe and explain to them what happened.

Treating epilepsy

With treatment, seizures can be controlled in 70 percent of patients, according to the National Institute of Neurological Disorders and Stroke (NINDS). Treatment can include medications and surgical procedures.