Seizures are sudden, uncontrolled changes in the brain’s electrical activity. These disturbances can go unnoticed or cause dramatic changes in your movements, behavior, feelings, and consciousness.
Seizures are common, causing 1 to 2 percent of all visits to the emergency room. Usually, a first seizure happens before age 25. Most last from 30 seconds to two minutes; a seizure lasting longer than five minutes should be treated as a medical emergency.
Because the exact cause of a seizure cannot always be pinpointed, you should be evaluated by a doctor the first time you experience one. This will ease your concern over the episode, and help identify if you have a treatable underlying health condition, such as epilepsy.
There are many types of seizures, which can cause symptoms varying from mild to severe:
- Blank staring spells
- Convulsions, shaking, or tremors
- Loss of awareness or consciousness
- Loss of bladder and/or bowel control
- Repetitive motions, such as smacking your lips
- Sudden anxiety, panic, or sense of deja vu
- Uncontrollable movement of the eyes
The International League Against Epilepsy developed new terms to provide more clarification about each type of seizure1. The following four types now better classify the onset, awareness, and effects experienced during a seizure:
Generalized Onset Seizures
These seizures affect both sides of the brain and body at the same time and can include atonic, absence, and tonic-clonic, to name a few.
Focal Onset Seizures
Previously referred to as partial seizures, focal seizures begin within one side of the brain and one side of the body. These seizures are most common with a diagnosis of epilepsy.
Focal Onset Aware Seizures
Once known as a simple partial seizure, focal aware seizures occur when you are awake and aware during an episode.
Focal Onset-Impaired Awareness
When your awareness is affected in some way during a focal seizure, it’s known as a focal-impaired awareness seizure (previously known as complex partial seizures).
Unknown Onset Seizures
If the start of a seizure is unknown or unwitnessed, it is called an unknown seizure, or unknown onset seizure.
While the most common cause of seizures in epilepsy, anything that disrupts the communication pathways in the brain can cause a seizure, including the following:
- Alcohol abuse or withdrawal
- Brain tumor
- Head trauma with brain bleeds
- Low blood sodium (hyponatremia)
- Medications that decrease seizure thresholds, including smoking cessation therapies, antidepressants, and some pain relievers
- Recreational drug use, such as cocaine
Just because you’ve had one seizure is no reason to believe you’ll have another. If your doctor determines it was an isolated incident, treatment may be delayed until you’ve experienced another seizure. Once your doctor determines the cause of your seizures and the likelihood you’ll have another, they’ll prescribe the best possible therapy to stop them, with the fewest side effects. This may include:
Medication. Your doctor may prescribe medication based on your age, the frequency of your seizures, and other factors to prevent or limit seizures.
Nerve stimulation. Often combined with medication, your doctor may choose to implant a device in your chest to stimulate the vagus nerve in your neck to inhibit seizures.
Surgery. A surgeon may remove any brain abnormalities.
Responsive neurostimulation. When implanted on the surface of your brain or in brain tissue, this device can detect and stop seizure activity.
Deep brain stimulation. Your doctor may choose to implant a pacemaker-style device in your chest to produce electrical impulses that regulate abnormal brain activity.
Diet restrictions. A ketogenic diet, which is high in fat and low in carbohydrates, can improve seizure control.
Alternative medicine. Cannabidiol, or CBD, has garnered significant scientific evidence supporting usefulness in the treatment of seizures.
The most recent study showed that patients taking a 10 mg daily dose of pharmaceutical-grade CBD in the form of Epidiolex experienced a reduction in seizures and fewer side effects compared to other drugs used to treat epilepsy.2
While more research is needed, scientists believe the reason CBD tends to help with seizures is that the endocannabinoid signaling pathways are altered with a seizure disorder—and CBD can potentially help get them back on track.3
1 Fisher RS, et al. Operational classification of seizure types by the International League Against Epilepsy: Position Paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017; ;58(4):522-530. doi: 10.1111/epi.13670.
2 Devinksy O, et al. Trial of Cannabidiol for Drug-Resistant Seizures in the Dravet Syndrome. The New England Journal of Medicine. 2017; 376:2011-2020; doi: 10.1056/NEJMoa1611618
3 Reddy DS, Golub VM. The Pharmacological Basis of Cannabis Therapy for Epilepsy.The Journal of Pharmacology and Experimental Therapeutics. 2016. ;357(1):45-55. doi: 10.1124/jpet.115.230151.