Seizure

What is a seizure?

A seizure is a sudden abnormal electrical signal in the brain. A partial seizure can involve part of the brain, and a generalized seizure usually involves all areas of the brain. It can cause strange sensations and behavior, muscle spasms, and a change in or loss of consciousness.

Generalized seizures are further divided into 2 types of seizures based on the pattern of the attack:

  • Grand mal seizure: a generalized seizure that starts with a loss of consciousness and falling down, followed by a brief period of rigid muscles and a 1- to 2-minute period of violent, rhythmic jerking. The seizure ends with a few minutes of deep sleep before you return to consciousness.
  • Absence or petit mal seizure: a short period of staring, fluttering eyelids, or twitching of facial muscles. There is no loss of consciousness.

One seizure right after another or one long seizure is called status epilepticus. The symptoms are usually those of a grand mal seizure. This can be life threatening and is treated as a medical emergency.

Often the cause of the abnormal electrical signals in the brain is not known. If you have repeated seizures, your healthcare provider may diagnose a seizure disorder, which is also called epilepsy.

What can I expect in the hospital?

Generally, new seizures require hospitalization to determine the cause and treat the condition. If you have a history of seizures, you may need to stay in the hospital because:

  • You have a medical condition which is making your seizures worse or happen more often
  • You have seizures that need immediate treatment or an adjustment to your treatment
  • You need surgery to treat seizures

Several things may be done while you are in the hospital to monitor, test, and treat your condition. They include:

Monitoring

  • You will be checked often by the hospital staff.
  • A heart (cardiac) monitor may be used to keep track of your heartbeat.
  • Your strength, range of motion, and ability to feel pain may be checked regularly.
  • Your blood oxygen level may be monitored by a sensor that is attached to your finger or earlobe.
  • Your heart rate, blood pressure, and temperature will be checked regularly.
  • Your fluid intake may be monitored closely by keeping track of everything you eat and drink and any IV fluids you receive.

Testing

Testing may include:

  • Blood tests to check your blood sugar level and oxygen level, or for dehydration, infections, drugs, or alcohol
  • Blood tests to check how anti-seizure medicine is working
  • EEG (electroencephalogram), which uses small wires pasted or taped to your head to measure and record the electrical activity of your brain
  • Magnetic resonance imaging (MRI), which uses a powerful magnetic field and radio waves to take pictures from different angles to show thin cross sections of the brain
  • Computed tomography (CT) scan, which is a series of X-rays taken from different angles and arranged by a computer to show thin cross sections of the brain

Treatment

The treatment for a seizure depends on its cause.

  • You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow medicine to be given directly into your blood and to give you fluids, if needed.
  • You may receive oxygen through a small tube placed under your nose or through a mask placed over your face. In very severe cases, you may need a tube put into your lungs to help you breathe.
  • Depending on the cause of your seizure, your provider may prescribe medicines to:
    • Prevent seizures
    • Treat or prevent an infection
    • Reduce fever
    • Control your blood sugar
    • Decrease swelling in the brain and around the spinal cord
  • Rarely, you may need surgery to treat seizures if all other treatments have failed. Surgery may include:
    • Vagus nerve stimulation (VNS): A procedure in which a very thin wire (electrode) is placed on the vagus nerve in the neck and attached by a wire that runs under the skin to a very small machine (neurostimulator) placed under the skin in your upper chest. The neurostimulator sends small electrical signals to the electrode to block nerve signals that cause seizures.
    • Resection: Surgery to remove the area of the brain that is causing the seizures. Resection surgeries are named based on the part of the brain that is being removed. For example, a temporal lobectomy involves removing the temporal lobe of the brain.
    • Nerve transection: Surgery to cut nerves or brain tissue so that seizure signals cannot be sent to other nerves
  • Your provider may prescribe a special diet, called a ketogenic diet, to help stop seizures.

What can I do to help?

  • You will need to tell your healthcare team if you have new or worsening:
    • Severe headache
    • Trouble breathing
    • Seizure after a head injury
    • Slurred speech
    • Loss of bladder or bowel control
    • Side effects from your medicine, such as nausea, dizziness, and mental changes, such as hallucinations
    • Seizures that are different, such as happening more often or lasting longer
    • Hallucinations, which may be visual or involve other senses such as hearing, touching, tasting or seeing something that is not really there
    • Intense feelings of fear or déjà vu (the feeling that what you are experiencing has happened before even though you know it hasn’t)
    • Loss of consciousness
    • Confusion
  • Ask questions about any medicine or treatment or information that you do not understand.

How long will I be in the hospital?

How long you stay in the hospital depends on many factors. The average amount of time to stay in the hospital after a seizure is 3 to 4 days.

Developed by RelayHealth.
Acute Care Advisor 2015.1 published by RelayHealth.
Last modified: 2014-07-30
Last reviewed: 2014-07-31
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2015 McKesson Corporation and/or one of its subsidiaries. All rights reserved.

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