Evaluation of First-Time Seizure
Seizures can be a sign of epilepsy, but they can happen for other reasons as well. Although the exact cause of a seizure can't always be pinpointed, you should always be evaluated by a doctor the first time you have a seizure. It’s important to know if you have an underlying health condition, such as epilepsy, that needs to be treated to prevent future seizures.
Facts about seizures
When your brain's electrical system doesn't work properly, a seizure occurs. Usually, your brain cells shoot off electrical impulses in a particular way. Certain factors can make those electrical impulses fire erratically, essentially resulting in a "short circuit" in your brain that causes a seizure.
Seizures are classified by type and each has different symptoms. You may have a seizure that lasts for under a minute and causes no lasting effects, or a seizure that lasts for a few minutes and causes symptoms that last for a short time. Why the brain suddenly misfires and causes a seizure is not usually identified, except when it occurs in infants and older adults. Sometimes, health conditions, such as a tumor, a brain infection, or developmental problems, may be responsible for seizures.
About 1 to 2 percent of all visits to the emergency room are because of seizures. Usually, a first seizure happens before age 25.
Types of seizures
Seizures are often grouped by the amount of brain tissue that's involved. These are the major types of seizures:
Spasms in infants
Absence seizures, or petit mal seizures
Generalized tonic-clonic or grand mal seizures
Symptoms can vary widely based on the type and severity of the seizure. These are common symptoms:
Repetitive motions, such as smacking your lips
Uncontrollable movement of the eyes
Loss of consciousness
Loss of bladder and/or bowel control
Convulsions and jerking
Tremors or twitching
Diagnosing the seizure
Your doctor will first make sure that you're getting enough oxygen, that all of your vital signs are normal and healthy, and that there are no signs that the seizure is still happening. The primary goal of the medical evaluation is to figure out if your symptoms were actually caused by a seizure and, if so, why the seizure occurred.
To make a diagnosis, your doctor may perform or order:
Complete neurological exam
Blood work and other lab tests to look for abnormalities in blood glucose and other factors
Imaging tests of the brain, such as an MRI or CT scan
Electroencephalogram, to test your brain's electrical activity
Your doctor will also ask a series of questions to find out if any of these factors may be responsible for the seizure:
Drug or alcohol use
Injury to the head
High fever or infection
Seizures can be treated in several ways. These are common treatments:
A special high-fat, low-carbohydrate diet called the ketogenic diet (often suggested for children)
Medications to control electrical activity in the brain
Surgery to repair abnormalities in the brain
Vagus nerve stimulation, which delivers electrical impulses to the brain
Calling the doctor
Any time a child or an adult has a seizure, call your doctor immediately for an evaluation. Your doctor may be able to find a health problem or abnormality that caused the seizure and recommend appropriate treatment.
Seizures can happen at any time. If you're driving, operating a dangerous machine, or standing at the top of a staircase, you could be seriously injured during your seizure.
Key points to remember
Although seizures usually aren't serious, that doesn't mean that they don't need to be evaluated by a doctor. Seizures can often be successfully treated so that they don't interfere with your life.