Seizures, sudden and uncontrolled surges of electrical activity in the brain, can affect anyone at any age. Symptoms of a seizure are often very distressing and can include temporary confusion, a loss of consciousness or awareness, and uncontrollable muscle spasms.
Jennifer Norman, a pediatric neurologist with INTEGRIS Pediatric Neurology in Oklahoma City, says the causes and risk factors for seizures vary by a patient’s age.
“For example, newborn babies are going to be at highest risk, due to complications related to birth and the transitions the body goes through immediately after delivery,” she says. “During childhood, seizures often start due to genetic causes. In older adults, seizures are more often related to other medical conditions such as stroke, cancer and substance abuse. At any age, brain injury or brain infection – such as meningitis or encephalitis – can be risk factors for seizure.”
Although there are many types of seizures, they are typically divided into two main categories.
“Generalized onset seizures, which involves misfiring of the entire brain at once, causes the full body jerking and shaking seizures that most of us think of first when imagining what a seizure [looks] like,” says Norman. “Focal onset seizures, also known as partial seizures, involve misfiring starting in just one part of the brain.”
Focal seizures are more common than generalized seizures, but focal seizures can cause a wide range of symptoms, making them more difficult to diagnose. Norman says focal seizures can “present as a simple blank stare with alteration of awareness, like zoning out, an unusual sensation in the body with no clear outward signs, jerking or shaking of just one part of the body, or with full body shaking similar to the generalized onset seizures.”
For those suffering from seizures, there are a variety of treatment options available to help manage symptoms.
“Seizure medications represent one of the mainstays of treatment,” says Bhrugav Raval, a neurologist with OU Medicine in Oklahoma City. “These medications help to prevent the start of abnormal brain activity that culminate into seizures.”
However, he says there are some patients who do not respond well to seizure medications and thus may benefit from additional treatments. These include neurostimulation, epilepsy surgery and dietary therapy.
There are three main types of neurostimulation – vagal nerve stimulation (VNS), deep brain stimulation (DBS), and responsive neurostimulation (RNS). Each type involves using a device to send electrical signals to the brain to help reduce the frequency and severity of seizures or eliminate them altogether.
For individuals with epilepsy, surgical treatments can provide some relief.
“Epilepsy surgery involves removing part of the brain responsible for generating the seizures,” says Raval. “This procedure requires extensive planning and a team of doctors, including epilepsy specialists, neurosurgeons, neuropsychologists [and] neuroradiologists, and is performed at a specialized epilepsy center. In properly chosen patients, this type of procedure often provides a higher chance of seizure freedom than medications alone.”
Used in conjunction with anti-seizure medication, Raval says the classical dietary therapy is a ketogenic diet, which consists of increasing one’s fat and protein intake and minimizing carbohydrates to change body fuel to ketones.
“This therapy requires the assistance of a dietician and often needs to be started in the hospital,” he says. “Other dietary therapies include the modified Atkins diet and low glycemic index treatment, which involve lowering carbohydrates consumed in the diet and may be started at home.”