Let's talk about #seizures baby, let's talk about you and me...
It was Salt-N-Pepa who coined the title above, except with a little somethin' something' more scandelous than "seizures" in their lyrics and I was inspired. So, let's talk about seizures baby!
I discussed what a seizure is in my very first Epilepsy True post but haven't had the chance to talk about all the different types of seizures out there... I'll begin by restating some important information from Navigating Life with Epilepsy, by David C. Spencer, MD, FAAN.
“A seizure is an event that begins in the brain. The brain cells, or neurons, normally communicate with each other in a very controlled way using small chemical and electrical signals… Under normal conditions, the activity of these neurons is precise and controlled, allowing each area to carry out its specific function efficiently. During a seizure this tightly controlled process is disrupted. Some think of a seizure as an electrical “storm” in the brain. The neurons involved in a seizure fire rapidly and may recruit their neighbors to do the same-- so the activity is excessive and hypersynchronous (cells that don’t normally fire together are all firing at the same time). Two key points from the International League Against Epilepsy (ILAE) Dr. Spencer references are:
It is a chronic, or relative long-lasting, condition
It involves recurrent seizures
Show of hands, who skimmed that paragraph... yea it's okay I may have too if I was you #guilty that's why I emboldened the key parts for you, but you're definitely gonna wanna read closely on this next part coming up!
Now that our brains are refreshed on what a seizure is lets talk about the different kinds that are out there baby because as you may or may not know, seizures are not all the same! That would be like saying, since the Jets and the Giants are both NY teams I should cheer for the Jets too? Yea no. #GMen
Leave me a comment if you're a Giants fan... don't if you're a Jets fan! #justkidding ;)
When a seizure is beginning there are plenty of things that will happen to you...and none of it will be fun. Although, there was this one time I was having a seizure while... nope, never mind, not fun. I take it back! Besides all those "fun" things, three things that will happen during your glorious seizure are the aura stage, and ictal and postictal period.
According to The University of Chicago Medicine, 2018, Stages of a Seizure, an aura is an unusual feeling, abnormal sensations, forced thinking, deja vu (familiar feelings) or jamais vu (unfamiliar feelings), perceived sounds, tastes, or smells (some people report smelling burning rubber, for example), physical sensations, like dizziness, headache, numbness, and lightheadedness, nausea, distorted emotions, such as panic or fear. Auras happen before the seizure does and alert the person that a seizure is about to begin.
According to Dr. Spencer, the ictal phase is the behavior that happens during the seizure. The postictal period is the immediate after effects of the seizure.
Next, we've got focal and generalized types of seizures. Focal and generalized are the two major groups.
Focal (or partial): begin in a particular part of the brain
Three basic types- simple partial seizures, complex partial seizures, secondarily generalized tonic-clonic seizures
Simple Partial Seizures- the person is fully aware of what is happening and can generally remember the whole event later. Consciousness is not affected. Motor (jerking, twitching), sensory (touch, visual, auditory, taste, smells), autonomic (flushing, sweating, dilated pupils), and psychic (deja vu) are all types of simple partial seizures.
Complex partial seizure- consciousness is impaired, speech and language are often affected, memory impaired, looks normal but cannot respond normally, dazed and dull eyes, seizure has spread to a limited part of the right and left side of the brain. Confusion is the postictal side effect of CPS and can last for seconds or minutes. *Automatisms are common during complex partial seizures. Automatisms are when someone will arrange things on the table or press numbers on a phone in a random order. This doesn't accomplish anything but it's an indicator that a seizure is about to begin and it is very individual to each person.
I get simple and complex partial seizures! Who else does? Leave your comments below!
Secondarily Generalized Tonic-Clonic Seizure (2 GTC)- when a focal seizure spreads to involve the whole brain. Step 1: simple partial seizure (or aura), Step2: confusion (complex partial seizure). Early symptoms often go unnoticed because this seizure can spread quite fast. During the tonic phase muscles become rigid due to contracting. The tonic phase lasts about 10-30 seconds- stiff muscles, no breathing. During the clonic phase of this seizure brief jerking occurs. The movements are small and fast but will begin to slow down and increase in size before they stop. Postictal phase of 2 GTC is more complex than the postictal of other seizures. The individual will seem to be sleeping and even snoring/breathing sounds. Saliva is produced and increased, which can be dangerous if the individual breathes it into their lungs. You must lay the person on their side if this happens so the saliva does not get into their lungs. Confusion, amnesia, disorientation next will occur as well as tongue biting.
Generalized: Start in the whole brain (both halves), can begin as a focal seizure and later spread to become generalized seizures and with no warning sign will cause quick decrease in conscious awareness.
Most common generalized seizures: Absence, atypical absence, generalized tonic-clonic, myoclonic, tonic, atonic seizure.
Let's get into it!
Absence Seizures: These seizures are brief and often seen in children but may carry on into adulthood. They used to be called "petit mal". Those experiencing them will feel disconnected and unaware of their surroundings. There is no postictal confusion and the individual can continue on with their previous activities as if nothing ever happened, unaware they've just had a seizure. These seizures occur repeatedly, many times per day. Children who have absence seizure are considered "inattentive" but this is inaccurate, they are simply missing out on parts of what they are learning due to the seizures. Other signs of absence seizures include: blinking, hand or mouth movements.
Atypical Absence Seizures: These seizures last longer than absence seizures- 20-30+ seconds longer. Individuals experiencing them seem to be responsive when the seizure is occurring. This type of seizure is found in people who have other seizure types and who have an intellectual disability.
Generalized Tonic-Clonic Seizure: You will experience the same effects of 2 GTC but the difference is, the seizure onset. During the seizure onset, it begins suddenly and at the same time in both halves of the brain. With this you will have tonic and clonic phases of a seizure that affect both sides of your body equally.
Myoclonic Seizures: These seizures can set off brief and sudden jerks of your muscles. You may find your arms, legs, trunk, or face twitching. This may last for a fraction of a second or they may occur in clusters for a period of seconds. You will usually be fully awake and aware of what is happening. Injuries are common when a strong myoclonic seizure occurs that effect the legs and trunk. Not all myoclonus is epileptic myoclonus...
You may not realize this but even if you don't have epilepsy you've experienced myoclonus... hiccups! Even the twitches we get when we're falling sleep are considered myoclonus!
Drop Seizures: Tonic and atonic seizures are called drop seizures because they both cause individuals to have sudden falls. During a tonic seizure your muscles will stiffen throughout your body suddenly. During an atonic seizure there is a sudden loss of muscle tone. So you can see how tonic and atonic seizures are called drop seizures, there is such a contrast that can cause an individual to fall due to their muscle weakness. Drop seizures begin during childhood, usually. These individuals will often wear protective gear such as a hockey helmet and use a wheelchair in order to avoid injury.
As you can see, seizures come in all shapes and sizes, just like us! Seizures are often silent and invisible, but you and I can stop the invisibility right now. Let's spread awareness with our knowledge and super strong brains and hearts! Talk about seizures with your friends who don't have epilepsy, talk about seizures to those who do have them even if you don't, and don't be afraid to learn more on your own! :)