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Seizures: Safety First

by Mary Gallagher, RN, MSN, CCRN

Oct 1, 2018
Health

A SEIZURE IS THE PHYSICAL changes in behavior after an episode of abnormal electrical activity in the brain. The term “seizure” is often used interchangeably with “convulsion.” During convulsions, a person experiences uncontrollable rapid and rhythmic shaking, with the muscles contracting and relaxing repeatedly. There are many types of seizures. Some have mild symptoms without shaking.

It may be hard to tell if someone is having a seizure. Some seizures only cause staring spells, which may go unnoticed. Specific symptoms depend on which part of the brain is involved. Symptoms occur suddenly and may include a brief blackout followed by a period of confusion, changes in behavior, drooling or frothing at the mouth, eye movements, grunting and snorting noises, and loss of bladder or bowel control. Other signs include mood changes, shaking of the entire body, sudden falling, tasting a bitter or metallic flavor, teeth clenching and a temporary stop in breathing.

Symptoms may stop after a few seconds or minutes, or continue for up to 15 minutes. They rarely continue longer. The person may have warning signs before the attack, such as fear or anxiety, nausea, vertigo and visual symptoms (such as flashing bright lights, spots or wavy lines before the eyes).

Seizures of all types are caused by disorganized and sudden electrical activity in the brain. This may result from abnormal levels of sodium or glucose in the blood; brain infection including meningitis; toxemia of pregnancy; brain injury to the baby during labor or childbirth; phenylketonuria (PKU), causing seizures in infants; brain problems occurring before birth; fever in young children; brain tumor; drug abuse including street drugs; electric shock; epilepsy; head injury; heart disease; heat illness/intolerance; high fever; poisoning; stroke; toxin buildup in the body due to liver or kidney failure; extremely high blood pressure; venomous bites and stings; withdrawal from alcohol or certain medicines after extended use.

When no cause can be found, seizures are called idiopathic. This is usually seen in children and young adults but can occur at any age. There may be a family history of epilepsy or seizures. If seizures continue repeatedly after the underlying problem is treated, the condition is called epilepsy.

Most seizures stop by themselves, but during a seizure, the person can be injured. If you are traveling and a person near you has a seizure, the main goal is to protect the person from injury. Try to prevent a fall. Lay the person on the ground in a safe area. Clear the area of furniture or other sharp objects. Cushion the person’s head. Loosen tight clothing, especially around the neck. Turn the person on the side; if vomiting occurs, this helps prevent the inhalation of vomit into the lungs. Look for a medical ID bracelet with seizure instructions. Stay with the person until he or she recovers, or until medical help arrives. Monitor the victim’s pulse and rate of breathing.

Do not restrain the person. Do not place anything between the person’s teeth, including your fingers. Do not move the victim unless he or she is near something hazardous. You cannot stop a seizure. The individual has no control over it and is not aware of what is happening. Do not give the person anything by mouth until convulsions stop and the individual is fully alert. Do not start CPR unless the seizure has clearly stopped and the victim is not breathing or has no pulse.

If a baby or child has a seizure during a high fever, cool the child slowly with lukewarm water. Do not place the child in a cold bath. Call your child’s health care provider and ask what to do next. Ask if it is safe to give the child acetaminophen once he or she is awake.

Report all seizures to the person’s health care provider. The doctor may adjust or change medications. A person who has a new or severe seizure is usually seen in a hospital emergency room. The health care provider will try to diagnose the type of seizure based on symptoms.

Tests can rule out other medical conditions that caused the seizure or similar symptoms. Other causes may include fainting, transient ischemic attack or stroke, panic attacks, migraine headaches and sleep disturbances. Tests may include blood tests, CT scan or MRI of the head, EEG and lumbar puncture (spinal tap). Further testing is needed if a person has a new seizure without a clear cause or for epilepsy, to make sure the person is taking the right amount of medicine.

CALL 911 IF

  • This is the first time the person has had a seizure
  • A seizure lasts more than two to five minutes
  • The person does not awaken or have normal behavior afterward
  • Another seizure starts soon after a seizure ends
  • The person had a seizure in water
  • The person is pregnant, injured or has diabetes
  • The person does not have a medical ID bracelet with instructions
  • There is anything different about this seizure compared to the person’s usual seizures

The content of this article is for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition.

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