A seizure happens when a temporary change in brain activity disrupts regular processing. Seizures can be provoked by certain factors like abnormal blood sugar levels or medication side effects. They may also be unprovoked, meaning they occur without a definitive cause.

“Some seizures may cause symptoms that are very obvious to the person having the seizure or observers. However, some seizures can be subtle and go unrecognized by both the person having the seizure and those witnessing it,” says Cody L. Nathan, MD, an epileptologist at Northwestern Medicine.

Working with your care team to understand your seizure type can help you recognize when a seizure occurs and get the help you need.

2. What is epilepsy?

Epilepsy is a neurological disorder characterized by recurrent seizures and typically warrants treatment with anti-seizure medication to reduce seizure risk.  

3. If I have a seizure, does that mean I have epilepsy?

Not necessarily. Epilepsy is a specific diagnosis that may be given after a person has experienced two or more unprovoked seizures at some point in their life. It can also be diagnosed after a single seizure if medical evaluation indicates that a person is at increased risk for more seizures, such as the discovery of abnormalities on brain imaging or electroencephalogram (EEG).

If you have had a seizure, it is important to work with your physician to identify which tests you need, evaluate your risk for further seizures and determine if you need medication to prevent further seizures.

4. Does age matter with epilepsy and seizures?

Epilepsy and seizures can develop at any point in your lifetime. New cases are most common with younger children, particularly in their first year of life. However, cases also increase after age 55, as you are more likely to develop brain injuries, such as stroke, brain tumors and Alzheimer’s disease. These conditions put you at higher risk of experiencing seizures.

5. Are there different kinds of seizures?

Each person’s seizure is different. Some can last a few seconds while others can last minutes. It’s important to know that some seizures will have different symptoms, such as numbness, impaired speech and sudden confusion.

Although every seizure is different, there are three main types, defined by the location of impact in the brain:

• Focal onset seizures occur in a limited area of the brain. As such, they may cause a single symptom without progression to more complex symptoms, or they may only affect one part of the body. For example, if they happen in the part of the brain that controls your right arm, you may notice a sensation or uncontrollable movements in your right arm.
• During focal aware seizures, you are awake. This used to be called a “simple partial seizure.”
• During focal impaired awareness seizures, you become confused or lose consciousness. This used to be called a “complex partial seizure.”
• Other symptoms can include déjà vu, a panic sensation, nausea, tingling, numbness or unusual mouth or limb movements.
• Sometimes, focal seizures can progress to generalized tonic-clonic seizures, which are described below.
• Generalized onset seizures affect both hemispheres of the brain.
• The generalized tonic-clonic seizure, previously known as a grand mal seizure, is part of this group. In this type of seizure, you will undergo three stages.
• First, you will become unresponsive.
• You will enter a tonic phase, which results in stiffened limbs.
• Then, you will experience the clonic phase, which results in jerking limbs.

Eventually, the jerking will stop, and you will regain consciousness, though you may feel confused. Full recovery after this type of seizure can take minutes to hours. Sometimes, focal onset seizures can progress to generalized tonic-clonic seizures.

• During atonic seizures, your muscles suddenly become limp.
• Absence seizures, previously known as petit mal seizures, cause you to momentarily become unresponsive and appear to be staring ahead. These are the most common seizure in children under 14. These types of seizures only last a few seconds. They may be accompanied by other symptoms such as eyelid flutter.
• Unknown onset seizures. When it is hard to identify which part of the brain the seizure started, physicians classify this type as an unknown onset seizure. Over time and with observation, they may be identified as generalized onset or focal onset. If your loved one exhibits any signs during their seizure, record as much information as you can to help clinicians identify the type.

6. How do I provide first aid to someone experiencing a seizure?

While you cannot stop a seizure, you can protect and help someone. Most seizures stop by themselves within minutes, although there can be a prolonged period of confusion afterwards.

You should call an ambulance if a seizure lasts longer than three minutes or if the person sustains an injury due to the seizure.

First, remember to stay calm. If appropriate, lay the individual on their side or cushion their head with a pillow. Once they are protected, call for help and remain with them until they recover. During the seizure, you should never put anything in the person’s mouth. This could cause serious injury. Some people have medical ID bracelets, or a seizure action plan should a seizure occur. Here are some other things to be mindful of during a seizure.

Things to DO:

• Do call for emergency assistance when seizures last longer than three minutes.
• Do safely cushion the person’s head.
• Do protect the person from any nearby objects.
• Do time the length of the seizure.
• Do stay with the person until they recover.

Things you should NOT DO:

• Don’t put anything in the person’s mouth.
• Don’t try to move the person.
• Don’t try to restrain the person.

7. How can I manage my epilepsy?

Most people with epilepsy can manage seizures with medication. In addition to medication, lifestyle changes can also reduce the risk of seizures. These include:

• Get adequate sleep. Fatigue is a common trigger of seizures. When your sleep suffers, your brain is more susceptible to misfiring, causing seizures. Managing stressors can also help promote good quality sleep.
• Avoid alcohol and other recreational drugs. Alcohol and illicit drug use can trigger seizures.
• Take your medications. Missed doses of anti-seizure medications are a common seizure trigger that can be avoided.
• Take caution with new medications. Some medications, including over-the-counter medications, can increase your risk of seizure. Consult with your clinician if or when you are starting a new medication.
• Avoid your triggers. Keep a diary of any specific triggers that may result in seizures. For some people, this may include flashing lights, stress or dehydration.

8. What if medication and lifestyle modifications aren’t effective?

If medication and lifestyle changes don’t work, surgery may be the best option. Some patients who previously were not considered candidates for surgery may now be helped through minimally invasive techniques. Stereoelectroencephalography (stereo EEG) can pinpoint the onset of the seizures, and laser ablation may be able to eliminate the part of the brain causing the seizures without needing major surgery.

Another promising advancement in epilepsy care is the use of neuromodulation devices. Responsive neurostimulation (RNS) for instance, acts like a defibrillator but in the brain. The RNS battery is attached within the skull and there are electrodes in the brain that can both detect seizures and stimulate to stop seizures. Another device is called a vagus nerve stimulator (VNS), which is implanted in the chest. This device sends electrical impulses to the vagus nerve to prevent or shorten seizures.

9. Can people with epilepsy give birth to healthy babies?

Yes, people with epilepsy can have perfectly healthy pregnancies. It is best to plan your pregnancy in advance so that you can discuss the safest anti-seizure medications and vitamins to take during pregnancy with your care team. Work with your care team before, during and after your pregnancy. Continue taking your medication as prescribed until you consult with your physician. Be sure to discuss all anti-seizure medications with your care team to determine the best care for you. You should also avoid missing medications and any triggers that may increase your risk of seizures.