||Bill Levinger, MD
and, head injury survivor
Pentagon bombing Survivor
Colby, 1984 - 2001
Mesa High School,
|| Disclaimer: The
information herein is presented without warranty regarding its accuracy,
completeness, timeliness or correctness for a particular purpose and is
not meant to be a substitute for professional medical advice. The reader
is advised to always seek the advice of a competent physician prior to
changing any treatment or to receive answers to questions regarding a specific
Epilepsy / Seizure Q & A
- Conditions such as auras, altered consciousness, weird reveres, flashing
lights in your head, metallic taste in your mouth, smelling fragrances
that others do not smell, or hearing music that others do not hear, convulsions,
muscle spasms or twitching, feeling separate or disconnectedness from others,
feelings of disembodiment or observing yourself from afar, vague longing
or yearning, raging, crying or laughing for no apparent reason might
signify seizure activity. In such cases you might want to pursue a seizure
assessment. Your doctor and/or the organizations below can refer you to
services in your area where you can obtain such an assessment.
Q. What is a seizure? If someone
has a seizure, does that mean they have epilepsy?
A. Briefly stated, a seizure is
the result of abnormal electrical activity in the brain. Seizures are sometimes
referred to as "electrical storms". Given the right set of circumstances,
or triggers, anyone can experience a seizure. A list of such "triggers"
include: a blow to the head, intoxication, drug toxicity, missed medication
doses, drug abuse, poor nutrition, high fever, colds, infections, illness,
consumption of very large amounts of fluid, blinking or flashing lights,
emotional stress, extreme fatigue, hyperventilation, hormone changes and
imbalances, fear, hyperventilation, anxiety etc. A single seizure does
not equal "epilepsy." In fact, a single seizure caused by the above
triggers does not mean that it will ever happen again. However, when
seizures recur without any obvious triggers or cause, then a person may
be considered to have epilepsy. These triggers or factors do not cause
seizures, rather they are thought to lower the threshold so that seizures
can occur. A person does not cause seizures to occur at will. Nor
can they consciously call up a seizure, nor control one that is already
Q. Is there anything other than medication
that can help prevent seizures?
A. Lifestyle management can go
a long way toward reducing the incidence and frequency of seizures. A healthy
diet, proper water intake, 64 oz. per day, regular rest breaks, avoidance
of alcohol, caffeine, stimulants, street drugs and substances, not
to mention inhalants, extreme body temperatures, sleep deprivation and
a host of metabolic variables (for example: blood sugar, blood oxygen level,
blood minerals, hormones). Remember moderation in all things, when in doubt
check with your doctor.
Q. What happens
during a seizure?
A generalized, convulsive seizure, also known as
Mal, is characterized by sudden loss of consciousness, usually without
warning. At onset there is usually a general stiffening of the body, often
with forceful exhalation, or breathing out, of air from the lungs, and
a peculiar sound as this air passes through the throat. If the person having
the seizure is standing when this happens, there can be a hard fall to
ground or floor. This "tonic" phase of the seizure is generally
very brief but is responsible for a number of things which often frighten
observers. Virtually all muscles in the body are forcefully contracting
at the same time, there may be tongue biting , passage of urine, (rarely)
defecation or vomiting. Sometimes a change in color (purplish-blue) of
skin, lips and fingernails due to involuntary holding of breath. This phase
generally lasts about 30 seconds.
Immediately following the "tonic" phase
of a seizure, convulsing begins as forceful, rhythmic jerking of arms,
legs, head and neck. This phase is variable in both forcefulness and duration,
but it can last a couple of minutes, with increasing intensity and gradually
subsiding. Skin, lip, fingernail color generally returns to normal during
A state of deep sleep usually follows the tonic
phase. During this period, all the muscles that were convulsing are deeply
relaxed. If a person in this state is in a position which makes it hard
for them to breathe, they may NOT change their own position (see following
section). The folklore about people with seizures "swallowing their tongue"
actually relates to the possible airway obstruction which can occur in
a person who is on their back with their head flexed forward during the
very sleep period after a major convulsion.
As the sleepiness lightens, a person recovering
from a seizure may initially be confused or even hard to engage in conversation
beyond a few words. The confusion more often than not passes over minutes,
but the desire for a retreat to bed to sleep for a while sometimes lasts
for quite a while.
If a generalized convulsion
is prolonged (5 minutes or more) or if it is followed by a second seizure
before complete recovery (person is awake and interactive), it is time
to seek medical assistance.
Q. Temporal Lobe Epilepsy - Complex
Partial Seizures (often erroneously labeled 'petit mal')
The second most common form of seizure in adults
is "partial" (i.e. the electrical 'storm' involves some but not all of
the brain) "complex" (i.e. disturbance of consciousness). Usually the area
of brain involved in the seizure activity is the temporal lobe.
But other parts of the brain can give rise to seizures which fall under
this heading. What most of these seizures have in common is:
Some form of warning or "aura" with an awareness
that something is about to happen. This may take the form of a mental picture,
a noxious odor, an unusual sensation in the stomach, an unusual sensation
of movement under the feet, the perception of a voice or music, even a
particular recollection; loss of awareness without collapse unconsciousness
(as if 'auto pilot' takes over).
There may be a few minutes during which
there may be automatisms -- repetitive, non purposeful acts e.g..-
lip smacking, swallowing, picking at things, garbled or semi-random speech,
aimless walking or manipulation of objects. After the episode there may
be a period of confusion lasting few minutes, possibly with sleepiness,
but not the deep sleep that generally follows a major convulsion. The person
in this state may walk around, as if with purpose. Sometimes, aggressive
behavior may be apparent during this phase - especially if someone
is attempting to passively restrain or direct movement. Such aggression,
is not well-focused, not 'thought-out' and can often be avoided by leaving
the person alone for a few minutes.
There is total amnesia for the period of the
seizure and possibly some amnesia, or loss of memory for events just preceding
and following it. In some persons, this type of seizure precedes a generalized
convulsion (see above) as the electrical signal spreads out from one part
of the brain to the entire brain.
Q. "Focal Fits" - Simple Partial
Seizures that involve only part of the brain
are known as "partial" seizures. Those that do not involve an alteration
of awareness are known as, "simple seizures." Seizures commonly
follow brain trauma, such as stroke, hemorrhage, malformation, tumor. Most
commonly, they involve rhythmic (2-3 cycles/second) twitching of face,
hand/arm, and/or leg on the side of the body opposite the side of brain
from which the seizure emanates. Generally, this type of seizure
lasts for a few minutes. In some individuals, they signal the onset of
a generalized or convulsive seizure. Occasionally, it can go on
for a very long time hours or days. The longer it lasts, the greater
the resultant fatigue. Extremely prolonged versions of this seizure type
can interfere with sleep, cause muscle pain and lead to exhaustion.
Q. Other Seizure Types
The true "petite mal" seizure type,
also known as "Absence Attacks" or technically, "Primary Generalized
Seizures - Absence Type," occurs almost exclusively in children.
Absence seizures are characterized by
abrupt and brief interruption of consciousness without convulsion. During
the typical, seconds-long episode there is "loss of contact", "spacing
out" rarely with chewing, swallowing, or blinking automatisms. Sometimes
an individual continues doing whatever they were doing at seizure onset,
though in an automatic way. During the episode, interaction is not possible.
can be very brief, subtle and easily missed by a nearby observer. Normally,
whatever activity a child was engaged in before the seizure is continued
following it. Sometimes children with these seizure types are misdiagnosed
with learning or behavioral problems.
There are a host of seizure types which
are seen only in children or infants, for more information on these and
other seizure types visit the following resources:
Epilepsy Facts & Resources
|Epilepsy Foundation Of America
-- 4351 Garden City Drive, Landover MD, 20785-2267. Telephones:
/ 800-332-1000. Provides information and referrals
to patients with epilepsy / seizure disorders, their families, health professionals,
and the general public. URL: http://www.efa.org
-- email: email@example.com
|Epilepsy Queensland Inc
-- PO Box 459, Brisbane, Albert Street 4002, Queensland, Australia --
Telephone: 07 3404 3131; Fax: 07 3404 3125 - email:
- url: http://www.eqi.org.au/
of Neurology 1080 Montreal Ave., St. Paul MN 55116
-- Telephone: 615-695-1940.
Provides information to both medical professionals and to the public. Included
are fact sheets and brochures on a variety of neurological conditions and
procedures, the American Academy of Neurology (ANA) Patient Information
Guide, general Neurology information, membership information, and current
news. URL: http://www.aan.com/
|Charlie Foundation -- 501
10th St.,, Santa Monaco, CA 90402 -- Telephones: 800-367-5386.
Promotes the use of the neurogenic diet through awareness and training.
|The British Epilepsy Association
- New Anstey House, Gate Way Drive, Leeds, Yeadon, England, Leeds
LS19 7XY - Tel: +44 0113 210 8800 -- Free phone information line
(within UK): 0808 800 5050 - Fax: 0113 391 0300 -- url: http://www.epilepsy.org.uk
-- email: firstname.lastname@example.org
. Neurpsurgical Service Mass Gen Hospital. -- url: http://neurosurgery.mgh.harvard.edu/
-- parents with epilepsy
Center for Children and Youth with Disabilities -- Includes disabilities
fact sheets, information for parents, bibliographies, student guides, a
list of children's books about kids with disabilities. url:
|National Society for
Epilepsy - Residential
centre for epilepsy and associated difficulties. Provides information,
support and medical services including epilepsy assessment. Chalfont
St. Peter, Gerrards Cross, Buckinghamshire, SL9 0RJ, UK. Telephone:
|Medic Alert Foundation --
2323 Colorado Ave. Turlock, CA 95382 Telephone: 209-
668-3333 - Offers Medic Alert bracelets/necklaces, which can
inform emergency medical personnel of medical complications.
|Mental Health Net -- Self-help
resources including symptoms and treatments. Many of these resources are
targeted at the lay person, but professionals may find them useful as well.