A seizure is an abrupt electrical discharge in the brain that impairs control over behavior, movements, feelings, and consciousness. Origin, symptoms, and treatments for seizures differ because there are several types of seizures, each having its characteristics. Here is the information on the types of seizures and their commonly used treatments.
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Understanding Seizures
Seizures occur because of an electrical discharge in the brain. They are categorized into many groups, mainly according to how and where the abnormal brain activity starts. Individuals may be subject to various types of seizures according to what their neurological condition is or what it is caused from. There are many triggers for causing seizures, including high fever, low sugar in the blood, head trauma, infections, and genetic disorders.
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Types of Seizures
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Seizures ures are categorized into two groups: **focal seizures** and **generalized seizures**. There are two broad categories of seizures: focal seizures and generalized seizures.
Focal Seizures
Focal seizures, sometimes called partial seizures, start in one area of one hemisphere of the brain. They are divided into:
- **Focal Aware Seizures (Simple Partial Seizures)**: The patient is conscious and alert to the surroundings in such an episode. Affected person may exhibit peculiar sensations like sudden emotions, flash of light, or tingling sensation. Such seizures persist for a very short time, even less than a few seconds to several minutes in many cases.
- **Focal Impaired Awareness Seizures (Complex Partial Seizures)**: There is a partial loss or alteration of consciousness. Such an individual might exhibit repeated behaviors like lip smacking, fidgeting with clothes, or repeated words without memory after the seizure has passed. Sometimes, several minutes pass before the individual returns to full awareness.
2. Generalized Seizures
Generalized seizures arise in both hemispheres of the brain. Consciousness is generally lost during generalized seizures. There are three kinds of generalized seizures:
- **Absence Seizures (Petit Mal)**: Absence seizures are short events with an abrupt loss of consciousness which may be missed. Someone who is attending to a task or someone can stop for several seconds with a "lost in space" look on their face, and others will misunderstand them as daydreaming. Absence is most common in children.
- **Tonic-Clonic Seizures (Grand Mal)**: The presence of a tonic phase, which involves the stiffening of muscles and a clonic phase involving rhythmic jerking. Such seizure usually results in an abrupt loss of consciousness and usually follows with sensations of exhaustion and dizziness.
- **Myoclonic Seizures**: Characterized by rapid, short muscle jerks that may affect one portion of the body or the entire body. Sometimes, they tend to be brief, and generally occur in clusters within seconds.
- **Atonic Seizures (Drop Attacks)**: Caused by an abrupt loss of muscle tone, which will lead to a collapse of the patient. Generally, these can be hazardous because they heighten the possibility of injury.
- **Clonic and Tonic Seizures**: Clonic seizures cause rhythmic muscle jerking, while tonic seizures result in muscle stiffening. They are rare in isolation but often part of a tonic-clonic seizure.
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Epilepsy Treatment
Treatment for epilepsy greatly differs depending on the type of seizure, frequency, and cause. Generally, these therapies are made up of **drugs, dietary therapies, surgery**, and **neuromodulation treatments**.
1. Drugs
The cornerstone in the treatment of anti-seizure medication is the modification of brain chemistry in order to increase its low threshold phase and also decreases the seizure occurrence. Among the most commonly prescribed drugs control seizures are listed below.
**Phenytoin** : It is used with tonic-clonic as well as focal seizures; it decreases neuronal activity by modulating sodium channels. Regular blood tests are warranted to monitor therapeutic levels and avoid untoward side effects.
- Valproate: This is indicated for various types of seizures such as absence, myoclonic, and tonic-clonic. Valproate works by raising the levels of GABA in the brain to stabilize neuronal activity .
- Carbamazepine: It is primarily used for focal seizures and carbamazepine has been known to act similarly to phenytoin. So it acts on sodium channels. It is generally well-tolerated but can cause dizziness and drowsiness.
- **Lamotrigine**: The medication is often prescribed in various types of seizure; thus, it can be applied both for the focal and generalized seizures. It is also well-tolerated, with few side effects usually accompanying it.
- **Levetiracetam**: This drug is also used in both focal and generalized seizures, with a minimal potential for interaction with other drugs, thus often preferred for multiple medication users.
2. Ketogenic Diet
The ketogenic diet is a diet high in fat but low in carbohydrates, widely recognized as helpful for reducing seizures, notably in children suffering from drug-resistant epilepsy. The diet forces the body to draw energy from fat rather than glucose. This causes ketones to be produced, which are useful in reducing seizure frequency. Its mechanism is not well understood; however it has proven effective in controlling seizures where medications fail.
3. Surgery
Surgery is available for those whose seizures are resistant to the antiepileptic drugs and for whom there is a known site in the brain from which seizures emanate. Available is:
- **Resective Surgery**: In this surgery, the section of the brain from where the seizures originate is removed. It is most effective in focal seizures that are temporal lobe related.
- **Corpus Callosotomy**: Surgery that involves removing the corpus callosum, excess tissue which connects the two hemispheres of the brain to prevent the spread of seizures between the hemispheres. It is majorly applied in the case of the most severe forms of generalized seizures.
- **Laser Ablation**: A new, less invasive surgical procedure where laser beams are used for targeting and destruction of seizure-causing areas.
4. Neuromodulation Therapies
Neuromodulation refers to the application of electrical stimulation with a common goal of reducing seizures, and the main therapies include:
This includes the following: **Vagus Nerve Stimulation (VNS)**: An implanted device under the skin delivering electrical impulses through the vagus nerve, thereby possibly reducing the frequency or severity of seizures. It is used in those who have failed to improve with medications and cannot be taken to surgery.
- **Responsive Neurostimulation (RNS)**: Like VNS, but the device is placed immediately in the area of the brain where seizures are initiated. It senses abnormal electrical activity and responds with stimulation to intervene and stop the seizure.
5. Lifestyle and Management Techniques
Adjustments in lifestyle play a crucial role in the management of seizures and improvement of quality of life. This may involve adjustments such as
- **Sleep and Stress Management**: A known trigger for seizures is sleep deprivation and stress, thus management of these can lower the incidence.
- **Avoidance of Triggers**: Triggering factors such as flashing lights, alcohol, or even certain types of foods may incite seizures. Identifying and avoiding these triggers decrease the seizure frequency.
- **Exercise**: General activity can also improve health. There is often an implication that it may improve seizure control, but this remains unclear.
Some will need cautioning regarding the exercise activity in which they are participating.
Seizure management is multimodal, which revolves majorly around the class of seizure, the effects of medications on the body, and lifestyle in general. While medication forms come as the first line of treatment, ketogenic diets, surgery, and neuromodulation give other options to those who have refractory seizures. Close consultation with a healthcare provider for an individually-suited treatment plan is highly important for desired outcomes.
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