Seizures are painful


Brief overview

  • What is a seizure? An involuntary event with spasmodic or twitching movements, possibly with loss of consciousness.
  • causes: Mostly epilepsy, although the cause of the seizures is sometimes known (e.g. increased intracranial pressure, hypoglycaemia, encephalitis) and sometimes not. Non-epileptic seizures are less common, e.g. a febrile seizure in children (febrile convulsions) or seizures as a result of a stroke.
  • First aid for seizures: Remove dangerous objects from the vicinity of the person concerned, protect their head, if necessary bring them into a stable position on their side and call the emergency doctor.
  • How dangerous is a seizure? Seizures often go away on their own. It becomes dangerous if the seizure occurs during a dangerous activity (e.g. driving a car, working with a chainsaw) or expresses itself as "status epilepticus" (a persistent epileptic seizure).

Seizure: causes and possible diseases

A seizure is usually one sudden, involuntary event With cramping or twitching movements. The person concerned can also do that lose consciousness. Sometimes a seizure shows all of these three characteristics, and sometimes it doesn't.

Typically, a seizure is caused by a Dysfunction of nerve cells (Neurons) in the cerebral cortex. The normal task of a nerve cell is to generate or receive and transmit electrical signals. This happens millions of times in the brain every second, but in an orderly manner.

In the case of a cerebral seizure (= seizure emanating from the brain), however, all order is lost, so that suddenly certain groups of nerve cells discharge simultaneously and transmit their uncoordinated signals synchronously. They infect downstream nerve cells with it, so to speak. Figuratively speaking, a seizure could also be called "Thunderstorm in the brain" describe.

Seizures occur usually in the context of epilepsy. Non-epileptic seizures are less common.

There are also seizures that are not based on a neurological disorder in the brain, but have psychological reasons (e.g. an extreme stressful situation). This is then a psychogenic seizure.

Epileptic seizures

In those affected, the nerve cells (neurons) in the brain are more susceptible to spontaneous and uncoordinated discharges. Such discharges - and with them epileptic seizures - can occur for no apparent reason. Then one speaks of idiopathic epilepsy. It is to be distinguished from this symptomatic epilepsywhere the epileptic seizures have known triggers. These include:

  • Brain injuries: As a result of such injuries, scar tissue can form in the brain, which in turn can lead to a seizure.
  • Circulatory disorders: Impaired cerebral blood flow (such as a stroke) occasionally leads to epileptic seizures.
  • Tumors or inflammation: Sometimes epileptic seizures are the symptom of a brain tumor or an inflammation of the meninges or meninges (encephalitis, meningitis).
  • increased intracranial pressure: Increased pressure in the brain (e.g. as a result of an injury) can also promote seizures.
  • Metabolic disorders: Sometimes low blood sugar (hypoglycaemia) can be identified as a cause of convulsions.
  • Lack of oxygen: If the hypoxia lasts for a long time, the body will be undersupplied at some point. In the brain, the lack of oxygen can trigger seizures, among other things.
  • optical stimuli: For some people, for example, a strobe light in the disco triggers a seizure.
  • Poisoning: For example, drugs like tricyclic antidepressants can provoke seizures.
  • Drugs like alcohol: For example, if an alcoholic goes into withdrawal, seizures can occur.

A single seizure is not (yet) called epileptic.

Non-epileptic seizures

Some people have seizures, but they do not have epilepsy. Such non-epileptic seizures are not based on an increased susceptibility of the neurons to convulsions - rather they are caused by a reversible disorder in the brain or another condition that irritates the brain, such as:

  • Head injury
  • stroke
  • infection
  • Medication
  • Drugs
  • in children: fever (febrile convulsions)

A distinction must be made between seizures and other diseases and disorders that can lead to cramping of the muscles. For example, a tetanus infection (tetanus) leads to muscle cramps all over the body.

Diseases with this symptom

Find out here about the diseases that can cause the symptom:

First aid for a seizure

If you see someone having a seizure, you should keep Calm - even if such a full-body cramp is often a frightening sight. The attack usually stops on its own after a few minutes. Otherwise, the following recommendations apply:

  • remove dangerous objectsthat are close to the spasmodic so that they do not injure themselves.
  • protect your head (e.g. with pillow)
  • do not hold the victim
  • do not put any objects in the mouth as a bite wedge (e.g. spoon) - there is a risk of injury and the risk that the patient inhales or swallows the object.
  • secure the airwaysby turning the affected person in a prone or stable position on their side.
  • call the ambulanceif the seizure lasts more than five minutes.

If it is known that the patient is already being treated for seizures, you do not need to consult a doctor if the seizure is minor. In the event of a first attack, however, it is always advisable to alert a doctor.

How dangerous is a seizure?

Single seizures are usually not dangerous and go away on their own. However, an epileptic seizure that lasts longer than five minutes (status epilepticus) is life-threatening. Therefore, in such cases, the emergency doctor must be alerted immediately!

In principle, it can also be dangerous if someone has a seizure in a dangerous situation - for example at the wheel of a car or when working on the roof or with a chainsaw. Epileptics should take this to heart, even if the last seizure was a long time ago.

Normally, if an epileptic has not had a seizure for at least a year, he is allowed to drive a car privately again. However, there are exceptions to this, for example in treatment-resistant epilepsy.

Seizure: What Does the Doctor Do?

First, the doctor clarifies whether you actually had a seizure. To do this, he must rule out other causes that can produce similar symptoms. If the patient actually has a seizure, it is important to clarify the cause and, if necessary, initiate treatment.

Diagnosing a seizure

The exact description of the symptoms - either by the patient himself or by relatives - can already be very helpful. In addition, the doctor asks, among other things:

  • How long did the seizure last?
  • What preceded the attack? (Sometimes unusual sensations such as tingling in the stomach or an unusual smell occur shortly beforehand, or the patient has a premonition that a seizure is about to follow)
  • How quickly did you / did the patient recover after the attack?
  • Are there any factors that could trigger the seizure (noises, flashing lights, etc.)?
  • Do you have a pre-existing or underlying disease (e.g. brain infection) or a recent head injury?
  • Do you / does the patient consume dorgen such as alcohol? Is withdrawal currently taking place?

Means Electroencephalography (EEG), the patient's brain waves are then measured and recorded in order to detect any abnormalities. The doctor can also try to provoke a seizure during the measurement - for example by using certain light stimuli or by deliberately hyperventilating the patient.

An EEG can also be recorded over a longer period of time. There is also the option of filming the patient during this (Video EEG monitoring) so that the doctor can see exactly what is happening during a (possible) further seizure.

To find possible causes of seizures, the doctor can also use Computed tomography (CT) or Magnetic resonance imaging (MRI, magnetic resonance imaging) make detailed sectional images of the brain. It may reveal structural changes (such as a stroke) that could cause seizures.

Blood tests can provide clues to metabolic disorders as a trigger for seizures. Urine tests can also be helpful - for example, to detect drugs that the patient has not reported.

If applicable, are further investigations displayed. This includes, for example, taking and analyzing a sample of the cerebral spinal cord fluid (lumbar puncture) if a brain infection is suspected as the cause of seizures.

Treating a seizure

In the case of seizures, attempts are made to treat the cause. If, for example, hypoglycaemia has triggered the attack, the patient is given glucose (e.g. as an infusion). In addition, if possible, the doctor will treat the reason for the low sugar level (e.g. diabetes).

In most cases, seizures are caused by epilepsy. Long-term, individually tailored treatment may then be necessary to prevent further seizures. Such anti-epileptic therapy can include:

  • anticonvulsants (called anticonvulsants or anti-epileptic drugs)
  • Avoiding possible triggers (e.g. excessive alcohol consumption, lack of sleep)
  • possibly surgical intervention on the brain

Important investigations

These examinations help to find out the causes of the symptoms:

Seizure: When should you see a doctor?

Anyone who has ever had a seizure should always consult a doctor - regardless of how severe the attack was. It is important to clarify the cause. The specialist in charge of seizures is a neurologist.

Sometimes those affected do not even notice that they are having or have just had a seizure (for example, when they are absent). Outsiders who notice should then tell the person concerned.

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