Seizures: They Aren’t Always Epilepsy

Seizures are usually associated with epilepsy, but not always. There are several reasons why you might have a seizure. Understanding seizures and epilepsy, including the connection between the two, may help you better manage your condition. 

A seizure is an abnormal electrical discharge in the brain that happens when a malfunction in or around a neuron — the brain’s “information messengers” — causes a group of neurons to synchronize and discharge at the same time. 

There are two main types of seizures: focal and generalized. 

• Focal seizures can start in one area on one side of the brain. People generally remain conscious during focal seizures, perhaps appearing to “zone out” or stare off into space for a minute or two before returning to normal. 

• Generalized seizures affect both sides of the brain. During a generalized seizure, people typically lose consciousness and experience full-body shaking. 

Why Seizures Happen 

There are a few circumstances that can cause neurons to malfunction and discharge abnormally. Some of the most common are: 

• Blood sugar levels that are too high or low

• Sleep deprivation

• Sodium levels that are too high or low 

All these things can lead to dysfunction around the neurons in your brain, triggering a seizure. 

Provoked vs. Unprovoked Seizures 

Seizures are categorized further by whether they are provoked or unprovoked. 

A provoked seizure — also called “acute symptomatic seizure” — has a direct cause, including the ones listed above (dehydration, blood sugar levels, etc.) Additionally, provoked seizures can be caused by head trauma or infection. 

An unprovoked seizure does not have an immediate cause. When there is no obvious cause for seizures — no apparent imbalance or dysfunction — the cause is attributed to epilepsy. Epilepsy is a neurological disorder characterized by the occurrence of two or more unprovoked seizures in one year. 

People are often taken to the emergency room when they have a seizure. But because about 90 percent of seizures last for five minutes or less, the seizure is almost always over before arrival at the ER. Tests like an EEG, which measures electrical activity of the brain, usually aren’t helpful in recording the seizure at this point because brain waves are returning to normal. 

This means that to make a diagnosis, healthcare providers most often rely on gathering information from those who witnessed the seizure about what happened. 

Managing Seizures and Epilepsy 

If a person has a seizure not related to epilepsy, treatment is a matter of addressing the cause. Seizures related to epilepsy are usually treated with anti-seizure medications that help prevent them. 

For the 25 percent to 30 percent of people with epilepsy whose seizures can’t be controlled with medication, there are surgical options and neuromodulation treatment, which involves electrical stimulation with electrodes implanted in the brain. 

Lifestyle changes can be useful, too. Following a ketogenic diet has been shown to help manage seizures in some patients with epilepsy. 

What To Do if You See Someone Having a Seizure 

If someone you’re with starts having a seizure, don’t panic. Instead: 

• Try to bring them gently down to the ground so they don’t fall when they lose consciousness.

• Make sure they don’t have anything tight around their neck that could prevent them from breathing easily.

• If possible, time the seizure so you can let a healthcare provider know how long it lasted.

• If the seizure goes on for longer than five minutes, call an ambulance. 

One thing you should not do for someone having a seizure? Put anything in their mouth. A person having a seizure can’t swallow their tongue, and putting something in their mouth could damage their teeth or jaws.