Swallow tongue during seizure

Most epileptic seizures are over so quickly that you don’t really have much time to do anything. After it’s over, you simply make sure that the child wasn’t injured.

Tonic-clonic seizures are the most dramatic and frightening of the seizures, and they usually last longer than other seizures. Here are some suggestions for handling them:

  • Move things out of the way so the child won’t injure him or herself.
  • Loosen any tight clothing around the neck.
  • Put a pillow or something soft under the head.
  • Lay him or her on one side.
  • Time the seizure.

Call an ambulance about a seizure if:

  • The child was injured during the seizure.
  • The child may have inhaled water.
  • The seizure lasted longer than five minutes.
  • There is no known history of seizures.

Things not to do during a seizure:

  • Don’t put anything in the mouth. First of all, despite what you’ve heard, it’s impossible to swallow your tongue and choke. While the child may bite his or her tongue during a seizure, trying to cram something in the mouth probably won’t work to prevent this. You may also get bitten, or you may break some of the child’s teeth or your child may break the object and choke or aspirate.
  • Don’t try to hold the child down. People, even children, have remarkable muscular strength during seizures. Trying to pin a child with a seizure to the ground isn’t easy and it won’t do any good, anyway.
  • Don’t give mouth-to-mouth resuscitation until the seizure is over. After the seizure has ended, give mouth-to-mouth resuscitation if the person is not breathing.
  • Don’t call an ambulance during a typical seizure. For a lot of people, the first response to seeing a seizure is to call 911. But for the vast majority of seizures, that isn’t necessary. It’s also frightening for a child to spend an afternoon in the hospital unnecessarily. Instead, only call for medical help if the child is injured during the seizure, if a seizure lasts more than five minutes, or if it seems like one seizure is immediately following the previous one.

Myth: It is possible to swallow your tongue.

Contrary to popular belief, it is not possible to swallow your tongue. Well, unless of course if you cut it off and then swallowed it… In any event, the tongue is rooted to the floor of the mouth by the lingual frenulum. This makes getting the tongue far enough back in the throat to actually swallow it and get it stuck impossible.

Also contrary to popular belief, one of the worst things a person can try to do for a someone having a seizure is to try to jam something in their mouth to hold their tongue down. They aren’t going to swallow their tongue and someone trying to jam something in their mouth is very likely going to end up injuring them and, depending on what the person used, the seizure victim might just choke on what was jammed in their mouth. The person trying to force the thing in their mouth can also end up getting their fingers bitten severely, if they aren’t careful, and it’s hard to be careful when someone’s jerking about.

Depending on the size of someone’s tongue and where the lingual frenulum is attached, it is possible for a person having a seizure to have temporary blocking of the airway from the tongue; when they are having a seizure, the tongue can fully relax and fall back. However, this isn’t particularly a problem while they are having a seizure as breathing is usually suppressed anyways. It can be a little bit of a problem when the seizure is over and their breathing resumes. However, a more likely choking hazard for someone having a seizure or unconscious is the person’s own bodily fluids, including saliva and vomit, which they may breathe in once their breathing resumes; this can cause them to choke on these fluids, due to a suppressed coughing reflex while they are unconscious.

In these cases though, all you have to do is turn them on their side. The tongue will then naturally fall to the side of their mouth (gravity works!) and their bodily fluids won’t run back down their throat, in both cases, freeing up the airway.

Bonus Facts:

  • For a seizure victim, rolling them on their left side is the preferred position. I was not able to ascertain why this was the case, but it was recommended by the epilepsy foundation.
  • You should also never try to restrain the person having a seizure. Roll them on their left side and then move objects away from them, so that they don’t injure themselves on those objects. But otherwise, you just have to let the seizure run its course.
  • The lingual frenulum is the small mucous membrane that extends from the floor of the mouth to the mid-line of the tongue.
  • In some people, this lingual frenulum can be so restrictive, in terms of restricting the movement of the tongue, that they can have trouble speaking. When this happens, it is known as Ankyloglossia, or “tongue-tie”. Often these people cannot even extend the tip of their tongue beyond their front teeth. This is particularly a problem for babies with this condition as they have trouble breast feeding, thus trouble taking in enough food.
  • The base of the lingual frenlum contains tissue that has a series of saliva glands on it. The two largest of these are called the Wharton’s Ducts and are in the front.
  • The tongue isn’t just one muscle, as many people say, “the strongest muscle… etc.” In fact, it’s made up of many muscles, which allows for the great range of movement most people have with it, with the muscles running in different directions.
  • As you age, the number of taste buds you have tend to diminish. An average child is born with about 10,000 taste buds. An average elderly person only has about 5,000. This is partially why many kids hate vegetables so much. Vegetables can be very bitter to “super tasters” or those close to that. As you age and your taste buds diminish, this bitter flavor goes away somewhat and changes the taste of the vegetables dramatically in the process.
  • The tongue never really gets a rest. Even while you are sleeping it is constantly pushing saliva into the throat, making sure you don’t drool all over your pillows.

Expand for References:

Contents

Here’s how to help someone who is having a seizure

  • According to the Centers for Disease Control and Prevention (CDC), one in 10 people has had a seizure.
  • Movies portray and normalize sometimes very dangerous “first aid” methodologies, such as pushing a towel into someone’s mouth so they won’t bite their tongue off.
  • This can cause very dire consequences, like suffocation.
  • Your focus when someone is having a seizure should be, “How can I keep him safe?” as opposed to, “How can I stop this seizure?”
  • Knowing what to do and not do may help save a life.

Seizures can happen to anyone. According to a study published by researchers at the CDC, almost one in 100 people have active epilepsy, a neurological disorder that can cause seizures. Of course, seizures can also happen to people who do not have this type of neurological disorder.

A seizure is just a symptom of abnormal electrical activity in the brain. This could be triggered by something as seemingly benign as taking asthma medication, staring at flashing lights, or not getting enough sleep, according to WebMD.

In 2011, a month and a half before my 22nd birthday, I had my first grand mal seizure.

I was getting ready for my afternoon class, ready to finish off my junior year as a Special Education major.

One moment, I was putting my contacts in, squinting into the bathroom mirror. The next moment, I was “coming to” through a haze, staring up at strangers crammed into my bathroom, trying to press an oxygen mask onto my face.

Half a dozen different types of brain scans later, I was diagnosed with a rare type of vascular malformation called Arteriovenous Malformation. According to the National Organization of Rare Disorders (NORD), the prevalence of this disorder in the United States is 10 in 100,000. Figures that I’d have a disorder that only has an annual “new-diagnosis” rate of 3,000 cases a year.

Sometimes a seizure really has no diagnosable cause. Other times it may be a symptom of a larger underlying issue such as a stroke or brain tumor. Regardless, keeping calm and knowing what to do may make a great difference in the outcome of the seizure.

Don’t try to “stop” the seizure by hugging or holding a person down.

It won’t stop the seizure and could put you at risk. Warner Bros. Television Distribution

The Catholic University of America’s disability support services advises you let the seizure run its course. You could seriously hurt either or both of you by clutching the person. They might end up punching you in the face, or pull some muscles straining against you.

The seizure won’t stop until the abnormal electrical current finished coursing through, so focus on maintaining a safe space for them until it finishes.

Don’t put anything in their mouth.

You’ve seen people stuff a piece of cloth into a seizing person’s mouth in the movies to keep them from biting their tongue? Don’t. Despite what some might tell you, you cannot swallow your own tongue. They can choke on whatever is pushed into their mouth and suffocate, or bite pieces off and injure themselves.

Some people vomit during seizures, and the fluid needs to come out, not get stuck behind a well-meaning towel. Some people try to stick a solid object — or worse, their finger — into the mouth try to stop the teeth gnashing. At best, your finger is going to get bitten very badly. At worst, they may chip their tooth or slice up their mouth.

Don’t perform CPR until after the seizure stops.

It may not be necessary. Gene Kim

Cardio Pulmonary Respiration (commonly known simply as “CPR”) is an intervention where one breathes for someone who has stopped breathing. Sometimes, people seem to stop breathing while having a seizure. Most people return to breathing normally after the seizure stops.

According to Everyday Health, however, you should not try to do CPR while they are having a seizure. However, if they are not breathing normally even after the seizure stops, call an ambulance and perform CPR (if you are comfortable with performing it).

Don’t call the ambulance if and unless one of the following is true, according to the CDC:

  • The person has never had a seizure before.
  • The person has difficulty breathing or waking after the seizure.
  • The seizure lasts longer than five minutes.
  • The person has another seizure soon after the first one.
  • The person is hurt during the seizure.
  • The seizure happens in water.
  • The person has a health condition like diabetes, heart disease, or is pregnant.

If none of the other points are true, but you don’t know if they have a history of seizures, wait until the person is alert, and ask what they would like for you to do.

If they do have seizure disorder or epilepsy, but the seizure continues for more than five minutes, you may need to call the ambulance anyway. This may especially be true if the color of their skin changes. This could mean that oxygen is not getting to the brain and the rest of the body.

Do keep calm, establish a perimeter, and ask people to stand back.

It’s important to remain calm, as the sight of someone having a grand mal seizure is generally a source of great commotion. Ask people to provide space so the person seizing does not bump into anyone. Stay with the person having the seizure until they are fully aware of their surroundings, or otherwise in a safe place.

Don’t give them water, food, or pills until they are fully alert.

It could be dangerous. Getty Images/Matt Cardy

It may go into the lungs instead, causing them to choke. If they seem to be choking or unable to breathe properly, call an ambulance.

Do put them on the floor. Make sure there are no hard or sharp objects nearby.

If they were standing, they probably, unfortunately, ended up there on their own. Try to cushion the fall if possible, taking special precautions to their head.

If they are sitting on a chair, carefully bring them to the floor and lay them on their side. Make sure they are in an open space where they do not have the danger of knocking over or hitting things.

Do turn their head to the side on the floor.

Many people vomit during the seizure, so do not lay them down on their back, or they may choke. Turning their head to the side allows the vomit to come out instead of flowing back down the airways.

Do loosen any collar or tie and anything constricting his or throat if possible.

It could prevent choking. Business Insider Removing or loosening collars and necklaces could prevent choking or muscle straining. However, if the convulsions are too violent, don’t bother. You might end up hurting yourself or them by trying.

Do slide something soft under the person’s head.

A jacket or pillow is best, but anything to cushion their head as they convulse would be helpful. This could help alleviate the damage done by hard floors.

Do keep track of the time length of the seizure, where it started, the color of their skin, and anything else notable.

Keeping track can help with calculating the severity of the seizure. Flickr / Alan Levine Did it start on the left leg or right arm? Was their face turning green or purple? What were they doing right before the seizure started? Is there blood in the corner of their mouth (a potential indication that they have bitten their tongue)?

The length of the seizure will be helpful in knowing whether it is necessary to call an ambulance. A good rule of thumb is that any seizure lasting longer than five minutes may require medical intervention.

What you do when the person having a seizure “wakes up” is very important.

When they regain consciousness, be as calm as possible.

It is very disorienting to wake up from a seizure, and often, the world is very foggy. It takes at least a few minutes to “land back to earth.”

Speak calmly, slowly explain the situation, and don’t lose your patience, even if they stare back at you blankly. They may be bleeding, injured, covered in vomit, or may have had an accident. Speak soothingly and calmly to help them find their bearing.

Ask simple questions like, “Who do you want me to contact?” or “Where is your phone?” Do not overwhelm them with questions or information.

Speak to the doctor or EMT.

Explain the seizure in as much detail as possible. Netflix If an ambulance was called, speak to the medic who comes to the scene to explain the situation. Or follow them to the emergency room so you can speak with the doctor. If you can’t go to the hospital with them, give your phone number to the EMT so the ER doctor can contact you if necessary.

When trying to support a person having a seizure, your focus should be, “How can I keep him safe?” as opposed to, “How can I stop this seizure?”

With statistics like one in 10, it’s important to have the right information in your back pocket. Keeping calm, and creating a safer space that protects their head and other parts of the body from injury could go a very long way to helping a person in need.

For more great stories, head to INSIDER’s homepage.

Dos and Don’ts of Seizure First Aid

A seizure can be terrifying to witness, especially if you aren’t prepared to help. Doctors say that it’s a good idea for everyone to know how to react with the right first aid, particularly if a family member, friend, or co-worker has epilepsy.

How to Recognize a Seizure

When 10-year-old Will Bibbo had his first seizure a year ago, his mother, Margaret, was understandably frightened. “It was the middle of the night, and he started making gurgling sounds, like he was choking,” she recalls. “He was foaming at the mouth, and his body was rigid.” Not knowing what else to do, the Atlanta mother called 911.

“With the most intense seizures, a person will make choking sounds, go stiff, lose consciousness, and jerk their arms and legs,” says Joshua Rotenberg, MD, a pediatric neurologist at Memorial Hermann Memorial City Medical Center in Houston. “It can be very dramatic and very hard to miss.”

The most important thing you can do if you witness someone having a seizure, he says, is to stay calm. About 80 percent of seizures are over in three minutes — which makes it all the more important to act quickly and effectively. These basic dos and don’ts can help.

Epilepsy First Aid: Dos

  • Keep a cool head under pressure. Focus on your goal — to keep the person safe until the seizure stops.
  • Move things out of the way. Remove the individual’s eyeglasses, tie, or scarf, if you can. Also look out for any hard or sharp objects nearby that might cause injury. If the person is seated, try to gently pull him onto a flat surface so he does not fall.
  • Place something soft and flat under the head. A pillow, a folded jacket, or a sweater offers protection.
  • Try to turn the person on her side. This clears the airways by allowing saliva to flow out of the mouth.
  • Time the seizure. Note the time when the seizure begins. An epileptic seizure will generally last only two to three minutes.
  • Check for medical identification. Someone with epilepsy should be wearing a medical bracelet or card containing emergency contact information, what medications he takes, and any drug allergies.
  • Call 911 — if you don’t know the person; if it is the person’s first seizure; if the person is pregnant, has diabetes, or is injured; or if the seizure lasts longer than five minutes.
  • Control the crowd. If you are in a public place, clear a path for emergency medical workers and tell onlookers to move along.

Epilepsy First Aid: Don’ts

  • Restrain the person. You could injure the person or get injured yourself.
  • Offer food or drink. Even a sip of water could cause choking.
  • Put anything in the person’s mouth. It is not true that people having an epileptic seizure can swallow their tongue. Attempting to put an object in the individual’s mouth could be dangerous to you and to him.
  • Perform CPR. Don’t attempt cardio pulmonary respiration or artificial respiration unless the person is not breathing when the seizure has stopped.

Epilepsy First Aid: After the Seizure

Most people, like Margaret’s son Will, don’t remember their seizures — but that doesn’t make the experience any less distressing. “A seizure can be traumatic and embarrassing,” Rotenberg says. “People may wake up to find that they have lost control of their urine or vomited. It’s important to respect them.”

The person may also be confused and combative or try to run away, but more likely, he or she will be very tired and want to sleep. Stay as long as you can and offer reassurance.

Epilepsy First Aid: Practice Makes Perfect

If a loved one has epilepsy, it’s a good idea to come up with a “seizure action plan.” Every family member should know — and practice — what to do.

Bibbo’s twin sister has witnessed his seizures and heard his choking sounds in the night. But now she knows how to stay calm and help her brother. “It’s still a shock every time Will has a seizure,” says his mother, “but it gets easier because we are prepared.”

Hollywood Medical Myths Part 3: You should put a bite block in the mouth of someone having a seizure.

Seizures seem to be an ailment that befalls numerous actors in everything from movies to television shows. Whether it’s the condition that leads to their immediate death on screen, or just a reaction to some dramatic situation, the quivering usually leads to the same thing- someone trying to put a bite block, like a wallet or stick, in the mouth of the person who’s having the seizure. This is presumably to keep the person from either “swallowing” their tongue (not possible), or biting it. The truth is that you should never put anything in the mouth of someone who is having a seizure.

Seizures, in and of themselves, aren’t generally something that cause a person much or even any harm. Usually it’s the reason the person had the seizure, or an injury that results from seizure convulsions that cause a person injury- bite blocks being one cause of potential serious injury.

There are several different types of seizures and they can be caused by numerous things, such as high or low body temperatures (hyper/hypothermia) and blood sugar levels (hyper/hypoglycemia); abnormalities in electrolytes; low oxygen levels (hypoxia); and trauma to name a few. If a person has a seizure from the most common cause, epilepsy, their doctor will usually say it’s not necessary to seek treatment if the seizure lasts less than 5 minutes.

Almost all treatments for a medical problem come with complications and or risks. Whether or not you get treated with something specific, a doctor will weigh the risks vs. benefits to decide if the treatment is appropriate. That very mindset is at the heart of why you should never put any type of bite block in anyone’s mouth that’s having a seizure. To understand why, let’s look at the benefits vs. the risks.

The presumed benefit of a bite block is to keep the victim from swallowing their tongue, or to keep them from biting it.

Like this supposedly good seizure treatment, the first problem is also a myth that occasionally pops up in movies or on TV. It’s impossible for a person to swallow their tongue, at least in the sense meant here. You could, of course, choose to cut it off and eat it, but barring that, your tongue’s not going to get stuck down your throat.

The tongue, like every muscle in your body, is attached. Specifically, it attaches itself to the hyoid bone, mandible, styloid processes, and pharynx. One of these attachments, a handy little mucus membrane known as your frenulum linguae, keeps your tongue from folding backward too far, thus, unable to be swallowed. Yes, even during a seizure. Further, if the person is lying on their back and happens to be one of the exceptionally few individuals where the combination of tongue length and location where the frenulum linguae attaches makes it possible for the tongue to fall back into the airway somewhat, the problem doesn’t require any special tools to fix. Just roll the person onto their side and the tongue will flop over. Gravity works! Even in these cases, the person’s not going to be able to somehow swallow their tongue, getting it stuck in their throat as is often portrayed.

The second problem of the victim biting their tongue is real. Should the person get their tongue or cheeks between their chompers as they clamp down like a crocodile on zebra flesh, it will most definitely cause some damage- damage that’s acceptable considering the risks of trying to prevent it. Let’s talk about those risks.

As stated before, there are many different types of seizures, caused by abnormal electrical activity in the brain. Focal seizures are localized to one specific area of the brain. Depending on what area of the brain is affected, the victim can have a wide range of symptoms. Petite mal seizures usually last only several seconds and can also have a wide range of symptoms. Sometimes during a seizure, there is no abnormal muscle activity at all. The victim will simply “stare” off as if in some sort of trance. The type that usually gets portrayed in the movies is known as a generalized tonic-clonic seizure.

Tonic-clonic seizures usually involve abnormal electrical activity throughout the brain resulting in extreme muscle rigidity and violent contractions. The person may also become incontinent, losing control of their urine and bowel function. As you might imagine, all of this excessive movement is quite taxing on the body. Like a “Cross-fit” workout from the pages of a Navy SEAL handbook, these seizures can sometimes have the victim taking extremely deep breaths, and often leave them extremely tired afterward.

The risks of putting any bite block in the mouth of a person having a tonic-clonic seizure far outweigh the benefit of preventing a bitten tongue or cheek. The first risk is to the rescuer. Try pulling open the person’s mouth to get something between their teeth and you might end up on YouTube with the video going viral because your finger was bitten off.

The second problem is to the person experiencing the seizure. Numerous seizure patients have lost teeth due to “helpful” citizens placing hard objects in their mouths during the seizure. Further, due to how hard some seizure patients can potentially breathe on occasion, those teeth may become aspirated and end up in their lungs. The object that’s placed in the mouth, might itself be bitten in half, also potentially resulting in aspiration. In either case, choking to death on teeth and sticks is far worse than a lacerated tongue. Treatment for any medical ailment shouldn’t result in death. I’m pretty sure that’s against doctors’ “do no harm” oath.

Now that we’ve dispelled the myth of bite blocks, let’s talk about what you should do in case you come across someone seizing in this fashion.

First, remove any dangerous objects that might injure them- glasses on their face, sharp objects in their pockets, guns on their hips, that sort of thing. Second, pad around the person to keep them from striking any hard objects nearby. If you can, place a pillow or folded soft jacket under their head to help protect them from hitting it against the ground. Third, place the person on their side. This could be difficult during the seizure, so you might have to wait until they’re done convulsing.

By placing them on their side, this will allow any vomit or other fluids to drain out on the ground, while simultaneously keeping their airway open. Lastly, after the seizure, most people have an altered mental state and can do unpredictable things. Try and keep them from doing anything that might hurt themselves, like running into traffic!

In the end, this Hollywood myth is one you should never try. Unless of course you want to explain to the paramedics why the seizure patient is now choking on part of the pen you placed in their mouth. If you think no one would be that dumb, think again. I have personally seen that on calls I’ve gone on. 🙂

If you liked this article, you might also enjoy our new popular podcast, The BrainFood Show (iTunes, Spotify, Google Play Music, Feed), as well as:

  • Hollywood Medical Myth Part 1: Shocking Someone Who Has Flatlined Can Get Their Heart Going Again
  • Hollywood Medical Myth Part 2: Injecting Medication Straight Into the Heart is Beneficial
  • Fingers Don’t Contain Muscles
  • How Much Caffeine Would it Take to Kill You
  • Top 5 Life Saving First Aid Tricks Everyone Should Know

Bonus Facts:

  • Unlike afflictions such as HIV, seizures have been around since the beginning of recorded history. The first person to correctly identify seizures as an abnormal process within the brain was Hippocrates in 400BC. Seizures were also well known in the time of Jesus. In the Bible, specifically Mark 9:17 a man asks Jesus to heal his son of the affliction which he attributed to an evil spirit. “Teacher, I brought you my son, who is possessed by a spirit that has robbed him of speech. Whenever it seizes him, it throws him to the ground. He foams at the mouth, gnashes his teeth and becomes rigid….” Considering the Epilepsy Foundation of America wasn’t formed until 1968, I suppose divine intervention was the only option a parent had to help their seizure stricken children.
  • If you were a woman in 1487, you would have hoped you weren’t afflicted with seizures. That’s the year the book Malleus Maleficarum, a book attempting to prove witches were real, was first published. Written by a Catholic priest, Heinrich Kramer, the book also helped identify witches, with one of the tell-tale signs a woman was a witch being if she had seizures. Three years after its publication, the Catholic church condemned it, though it was still widely published. Later, even the Spanish Inquisition recommended against giving credence to anything in Malleus Maleficarum.

Expand for References

  • The over-caffeinated brain of a bored paramedic
  • Seizures
  • Seizure Statistics
  • History Of Seizures
  • Tongue Anatomy

Seizures

Overview

A seizure (also called a fit, spell, convulsion, or attack) is the visible sign of a problem in the electrical system of the brain. A single seizure can have many causes, such as a high fever, lack of oxygen, poisoning, trauma, a tumor, infection, or after brain surgery. Most seizures are controlled with medication. If your seizures occur repeatedly, then you may have the chronic disorder called epilepsy.

What is a seizure?

Your seizure results from an abnormal electrical discharge in your brain. This abnormal “short circuit” can cause a change in behavior without you being aware of what is happening. During a seizure you may fall down, stare into space, make jerking movements, or have a funny feeling in your stomach. You cannot control what’s happening while you are having a seizure. Your only memory of a seizure may be waking up with people asking questions such as “What is your name?” “Where are you?” and “What day is it?”

Some seizures have “triggers” such as flashing lights, lack of sleep, stress, medications, or low blood sugar.

What to do during a seizure

Most of the time a seizure lasts less than 3 minutes, so by the time an emergency medication is ready to be given, the seizure is over. The most important thing during a seizure is for you to stay calm and protect the person having a seizure.

The following guidelines apply to tonic-clonic seizures (convulsions, grand mal) or complex partial seizures.

  1. Cushion the head. Banging the head against a hard surface during a seizure may lead to head trauma. Use any available soft object, and, if needed, use your foot.
  2. Loosen tight neckwear to ease breathing.
  3. Turn the person onto his/her side. This position helps the tongue fall to the side of the mouth, leaving the airway clear for normal breathing.
  4. Do not insert any object into the person’s mouth. An object in the mouth will not prevent tongue biting, nor will a person swallow his/her tongue, as some people think. In fact, if an object is placed into the mouth, you may cause more harm by breaking teeth or losing the object in the throat, causing choking.
  5. Do not restrain a person during a seizure unless there is a danger. They may become aggressive if you do so. Allow them to do what they want to do. Talk to them in a soft voice to reassure them.

Afterward, tell the person that he/she has had a seizure and make sure they’re breathing normally. Check the person’s awareness by asking a few questions, such as, “Where are you?” or “What is the day today?” If a tonic-clonic seizure has occurred, inform the doctor.

When to call 911

The seizure lasts longer than 5-10 minutes (status epilepticus). Timing the seizure with a watch is helpful because a brief seizure may seem longer than it really is.

Two or more seizures occur together.

There are injuries from the seizure.

It is the first seizure the person has ever had.

The person is pregnant.

If you have any suspicion that something is wrong, CALL. It is better to call too frequently than to avoid calling.

What causes seizures?

Approximately 70% of seizures have unknown causes. One in 10 people will have a seizure during their lifetime. Known causes include:

Neurological
lack of oxygen to the brain
poisoning (lead, carbon monoxide)
head injury
genetic defect in the brain
brain tumor
arteriovenous malformation (AVM)
following brain surgery
infection (meningitis, encephalitis, abscess)

Cardiovascular
stroke
irregular blood pressure
irregular heart beat (arrhythmia)

Other
kidney or liver failure
metabolism disorders
low blood sugar (diabetes), hypoglycemia
pregnancy
withdrawal from drugs or alcohol
high fever (febrile seizure) usually in children

Psychological (non epileptic attack)
hysteria or panic attacks
hyperventilation
mental illness

Often confused with seizures is a condition called syncope, which is a fainting spell caused by a lack of blood flow to the brain. Syncope can be caused by treatable cardiovascular disease.

Types of seizures

Seizures are classified as either generalized, focal, or unknown onset. Focal seizures arise from one part of the brain and include focal aware and focal impaired awareness. Generalized seizures involve the entire brain and include generalized tonic-clonic, absence, myoclonic, as well as tonic, clonic, and atonic seizures.

Generalized onset seizures
If you have this type of seizure, the whole brain is involved and you lose consciousness. The seizure may then take one of the following six forms:

  • Tonic-Clonic Seizure (“grand mal”): you become rigid, and may fall if standing. Your muscles switch between periods of spasm (tonic) and relaxation with jerking motions (clonic). You may bite your tongue. Your breathing is labored and you may urinate or defecate involuntarily.
  • Tonic Seizure: your muscles generally stiffen without rhythmical jerking. This stiffening or rigidity also involves the breathing muscles and you may cry out or moan.
  • Clonic Seizure: your muscles jerk rhythmically without stiffening.
  • Atonic Seizure (drop attack): your muscle control is suddenly lost, causing you to fall if you are standing.
  • Myoclonic Seizure: your arms and legs jerk abruptly. These seizures often occur soon after you wake up, either on their own or with other forms of a generalized seizure.
  • Absence Seizure (“petit mal”): your consciousness is briefly interrupted, with no other signs, except perhaps for a fluttering of your eyelids. These seizures happen most often in children.

Focal onset seizures
If you are having a focal seizure, the disturbance in brain activity begins in a distinct area of your brain. The nature of these seizures is usually determined by the function of the brain area involved. For example, if the motor cortex area is affected, then your arm or leg may jerk uncontrollably. Focal seizures were previously called “partial.” There are three types of focal seizures:

  • Focal Aware Seizure: you do not lose consciousness and are aware, but may be unable to respond. Your arm or leg may rhythmically twitch or you may experience unusual tastes or sensations, such as a feeling of “pins and needles,” in a distinct part of your body. If a focal seizure develops into another type of seizure, it is often called a “warning” or “aura.” Focal aware seizures (previously called simple partial seizure) are brief and the person goes on with their activity when it is over.
  • Focal Impaired Awareness Seizure: the seizure usually begins with a blank or empty stare, and your awareness changes, even though the seizure does not involve convulsions. You may fiddle with clothes, smack your lips, wander around, and generally be confused. This type of seizure usually lasts 2-4 minutes and involves the temporal lobes of the brain, but may also affect the frontal and parietal lobes. The person has no memory of the seizure and may feel tired or confused afterwards. It is often preceded by an aura or warning. (Previously called complex partial seizures.)
  • Focal to Bilateral Tonic-Clonic Seizure: is a focal seizure that starts in one area and then spreads to involve the whole brain, causing body stiffness (tonic) and jerking movements (clonic). The old term for this type is secondarily generalized seizure.

What treatments are available?

Medication
Your doctor may prescribe a drug called an antiepileptic drug, or anticonvulsant, used to treat seizures. These drugs are taken every day, sometimes several times a day, for as long as needed. The drugs help control the seizures. There are over two dozen medications for seizures. Common anticonvulsants include Dilantin (phenytoin), Tegretol (carbamazepine), Depakote (valproic acid), and phenobarbital. Several recent medications, such as Lamictal (lamotrigine), Neurontin (gabapentin), Cerebyx (fosphenytoin), Keppra (levetiracetam), and Felbatol (felbamate), have been approved since 1993 for the treatment of seizure disorders. These drugs may be used alone or in combination with each other when seizures are difficult to control.

Your doctor may prescribe anticonvulsants briefly after you have had brain surgery, head trauma, or a cerebral hemorrhage. If you have no seizures, the dosage of the drug is usually tapered until it is stopped within a short time. However, that time period may vary, based on your condition and specific problem.

As with all drugs there are side effects and drug interactions. Most common side effects include fatigue, drowsiness, nausea, and blurred vision. Also, these drugs may reduce the effectiveness of birth control pills.

Surgery
If medications do not control your seizures, then surgery in the portion of the brain responsible for your seizures (e.g., brain resection, disconnection, or stimulation) may treat the condition. If this is the case, you should discuss this option with your doctor (see Epilepsy Surgery).

Clinical trials

Clinical trials are research studies in which new treatments—drugs, diagnostics, procedures, vaccines, and other therapies—are tested in people to see if they are safe and effective. Research is always being conducted to improve the standard of medical care and explore new drug and surgical treatments. You can find information about current clinical investigations, including their eligibility, protocol, and participating locations on the web: the National Institutes of Health (NIH), www.clinicaltrials.gov, sponsors many trials; private industry and pharmaceutical companies also sponsor trials. www.centerwatch.com

Sources & links

If you have more questions, please contact Mayfield Brain & Spine at 800-325-7787 or 513-221-1100.

Links
Epilepsy Foundation www.epilepsy.com

Glossary

anticonvulsant: a drug that prevents or stops convulsions.

arteriovenous malformation (AVM): a congenital disorder in which there is an abnormal connection between arteries and veins without an intervening capillary bed.

epilepsy: a chronic disorder marked by repeated seizures causing a sudden loss or change of consciousness and convulsions or muscle spasms.

generalized seizure: a seizure involving the entire brain.

partial seizure: a seizure involving only a portion of the brain.
seizure: uncontrollable convulsion, spasm, or series of jerking movements of the face, trunk, arms, or legs.

status epilepticus: a seizure that lasts more than 5 minutes and requires immediate medical attention due to lack of oxygen to the brain.

syncope: a fainting spell caused by an abrupt reduction of blood flow to the brain.

tumor: an abnormal tissue that grows more rapidly than normal tissue; a tumor may be either benign (non-cancer) or malignant (cancer).

updated > 7.2018
reviewed by > George Mandybur, MD, Mayfield Clinic, Cincinnati, Ohio

Mayfield Certified Health Info materials are written and developed by the Mayfield Clinic. We comply with the HONcode standard for trustworthy health information. This information is not intended to replace the medical advice of your health care provider.

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