Back نوبة (طب) Arabic Epileptički napad BS Atac epilèptic Catalan نۆرەفێ CKB Krampfanfall German Επιληπτική κρίση Greek Convulsión epiléptica Spanish حمله صرع Persian Crise d'épilepsie French פרכוס אפילפטי HE

Seizure

This article is about epileptic seizures. For other types of seizures, see Non-epileptic seizure. For other uses, see Seizure (disambiguation).

Epileptic seizure
Other namesEpileptic fit,[1] seizure, fit, convulsions[2]
Generalized 3 Hz spike and wave discharges in an electroencephalogram (EEG) of a patient with epilepsy
SpecialtyNeurology, emergency medicine
SymptomsVariable[3]
ComplicationsFalling, drowning, car accidents, pregnancy complications, emotional health issues[4]
DurationTypically < 2 minutes[5]
TypesFocal, generalized; Provoked, unprovoked[6]
CausesProvoked: Low blood sugar, alcohol withdrawal, low blood sodium, fever, brain infection, traumatic brain injury[3][6]
Unprovoked: Flashing Lights/Colors Unknown, brain injury, brain tumor, previous stroke[6][7][3]
Diagnostic methodBased on symptoms, blood tests, medical imaging, electroencephalography[7]
Differential diagnosisSyncope, psychogenic non-epileptic seizure, migraine aura, transient ischemic attack[3][8]
TreatmentLess than 5 min: Place person on their side, remove nearby dangerous objects
More than 5 min: Treat as per status epilepticus[3][5][9]
Frequency~10% of people (overall worldwide lifetime risk)[10][11]

A seizure is a sudden change in behavior, movement, and/or consciousness due to abnormal electrical activity in the brain.[3][6] Seizures can look different in different people. It can be uncontrolled shaking of the whole body (tonic-clonic seizures) or a person spacing out for a few seconds (absence seizures).[3][12][8] Most seizures last less than two minutes.[5] They are then followed by confusion/drowsiness before the person returns to normal.[3][8] If a seizure lasts longer than 5 minutes, it is a medical emergency (status epilepticus) and needs immediate treatment.[3][5][9]

Seizures can be classified as provoked or unprovoked.[3][6] Provoked seizures have a cause that can be fixed, such as low blood sugar, alcohol withdrawal, high fever, recent stroke, and recent head trauma.[3][6] Unprovoked seizures have no clear cause or fixable cause.[3][6][7] Examples include past strokes, brain tumors, brain vessel malformations, and genetic disorders.[3] Sometimes, no cause is found, and this is called idiopathic.[5][13] After a first unprovoked seizure, the chance of experiencing a second one is about 40% within 2 years.[5][14] People with repeated unprovoked seizures are diagnosed with epilepsy.[5][6]

Doctors assess a seizure by first ruling out other conditions that look similar to seizures, such as fainting and strokes.[3][8] This includes taking a detailed history and ordering blood tests.[3][13] They may also order an electroencephalogram (EEG) and brain imaging (CT and/or MRI).[3][7] If this is a person's first seizure and it's provoked, treatment of the cause is usually enough to treat the seizure.[3] If the seizure is unprovoked, brain imaging is abnormal, and/or EEG is abnormal, it is recommended to start anti-seizure medications.[3][7][14]

  1. ^ Shorvon S (2009). Epilepsy. OUP Oxford. p. 1. ISBN 9780199560042.
  2. ^ "Epileptic Seizures - National Library of Medicine". PubMed Health. Retrieved 16 October 2018.
  3. ^ a b c d e f g h i j k l m n o p q r Berkowitz, Aaron L. (2022). "Seizures & Epilepsy". Clinical Neurology & Neuroanatomy: A Localization-Based Approach (2nd ed.). McGraw Hill. ISBN 978-1260453362.
  4. ^ Mayo Clinic Staff. "Seizures – Symptoms and causes". Mayo Clinic.
  5. ^ a b c d e f g Abou-Khalil, Bassel W.; Gallagher, Martin J.; Macdonald, Robert L. (2022). "Epilepsies". Bradley and Daroff's Neurology in Clinical Practice (8th ed.). Elsevier. pp. 1614–1663. ISBN 978-0323642613.
  6. ^ a b c d e f g h Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE, et al. (April 2014). "ILAE official report: a practical clinical definition of epilepsy". Epilepsia. 55 (4): 475–482. doi:10.1111/epi.12550. PMID 24730690. S2CID 35958237.
  7. ^ a b c d e Wilden JA, Cohen-Gadol AA (August 2012). "Evaluation of first nonfebrile seizures". American Family Physician. 86 (4): 334–340. PMID 22963022.
  8. ^ a b c d Winkel, Daniel; Cassimatis, Dimitri (2022). "Episodic Impairment of Consciousness". Bradley and Daroff's Neurology in Clinical Practice (8th ed.). Elsevier. pp. 8–16. ISBN 978-0323642613.
  9. ^ a b Cruickshank, Moira; Imamura, Mari; Booth, Corinne; Aucott, Lorna; Counsell, Carl; Manson, Paul; Scotland, Graham; Brazzelli, Miriam (2022). "Pre-hospital and emergency department treatment of convulsive status epilepticus in adults: an evidence synthesis". Health Technology Assessment. 26 (20): 1–76. doi:10.3310/RSVK2062. ISSN 2046-4924. PMC 8977974. PMID 35333156.
  10. ^ Ferri FF (2018). Ferri's Clinical Advisor 2019 E-Book: 5 Books in 1. Elsevier Health Sciences. p. 959. ISBN 9780323550765.
  11. ^ "Epilepsy". World Health Organization. 9 February 2023. Retrieved 4 June 2023.
  12. ^ Misulis KE, Murray EL (2017). Essentials of Hospital Neurology. Oxford University Press. p. Chapter 19. ISBN 9780190259433.
  13. ^ a b Ropper, Allan H.; Samuels, Martin A.; Klein, Joshua P.; PrasadPrasad, Sashank (2023). "Epilepsy and Other Seizure Disorders". Adams and Victor's Principles of Neurology (12th ed.). McGraw-Hill. ISBN 978-1264264520.
  14. ^ a b Cite error: The named reference :0 was invoked but never defined (see the help page).

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