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The Preston Robert Tisch Brain Tumor Center at Duke

General Information | All About Seizures

First Aid for Seizures

About 60% of all brain tumor patients will experience a seizure at least once during the course of their illness. For some people, a seizure may have been the first clue that led to the diagnosis of the brain tumor. Having a seizure or observing someone who is having a seizure can be a frightening experience. Understanding what seizures are and how to help can dispel some of the fear.

What is a Seizure?

Normally the nerve cells in the brain communicate with each other by producing carefully controlled electric signals. If something interferes with those signals and they are disrupted or become more intense, a seizure results. Epilepsy is defined as recurrent seizures. There are two main types of seizures: generalized seizures and partial (or focal) seizures. People may experience just one type or more than one. The type you experience depends on which area and how much of the brain has the electrical disturbance that produces seizures. 

A generalized seizure occurs when large amounts of electrical energy flood the whole brain at once. It can cause loss of consciousness, falls, convulsions, or muscle spasms. 

A partial seizure is sometimes called a focal seizure and is limited to one specific area of the brain. The symptoms reflect the physical or mental activity that is controlled by the particular part of the brain affected. Partial seizures may be called simple partial seizures or complex partial seizures. The main difference between them is whether people remain fully aware (simple) or experience a change in consciousness (complex) during the episode.

Seizures are usually sudden and unexpected. However, some people experience warning signals, called auras, in the moments before the seizure happens. These signals may include headache, mood changes, stomachache, nausea, or dizziness.

What Happens During a Seizure?

Seizures can affect movement, emotion, sensations, and feelings in unusual and sometimes frightening ways. Uncontrolled movements can happen in just about any part of the body. Blinking or face twitching, shaking of a hand or foot is common. In rare cases, there may be flailing movements or running. Some people find they can’t move at all or feel limp until the seizure is over. 

When seizures affect the parts of the brain that control emotions, feelings such as anger, joy, sadness, or fear can be triggered. There can be dramatic mood changes or uncontrolled bursts of crying or laughter. 

When seizures affect the parts of the brain that control touch, hearing, taste, smell, and sight, then unusual sensations can be produced. For example, the person may sense a tingling breeze on the skin; hear buzzing or ringing sounds or voices that aren’t really there; imagine tastes and smells, typically unpleasant ones; see things that aren’t there or experience distortions of the way things really look.

If the area of the brain involved with memory is affected, visions of people or places from the past can playback. The sense of time or place may be affected, causing well-known places to seem unfamiliar, or new places or events to seem familiar, as if they have happened before (called déjà vu). Some people have reported out of body experiences.

People who have simple partial seizures remain awake and aware throughout the seizure. Sometimes they can talk normally during the seizure and can usually remember exactly what happened to them while it was going on. Someone having a complex partial seizure is unaware of what is going on around him and will not be able to talk normally, follow instructions, obey commands, or even recognize danger from threatening situations. 

A complex partial seizure typically starts with a blank stare and loss of contact with surroundings. Actions and movements are usually unorganized, confused, and unfocused during a complex partial seizure.

Grand mal seizures are a type of generalized seizure that begin with a sudden outburst and then a loss of consciousness. Muscle contractions— twitching (tonic) and relaxing (clonic)—follow. The person might bite his tongue, lose control of body functions, and take very shallow breaths.

Seizures produce a wide range of changed feelings or behaviors. However, what each person does or feels during a seizure is likely to be the same and occur in the same order each time.

Although seizures are usually brief, their effects can linger for several hours. Effects can include confusion, sleepiness, headache, or sore muscles. Most people are able to return to their normal activities after resting.

How to Help

Most of the time, a person having a seizure requires no assistance other than caring observation. However, if you have never seen someone having a seizure, it can be a disturbing experience. The first aid list following can help you, your family, and friends know what to do. Your reassuring presence during the seizure can be the most helpful thing you can do. Reassure others that any unusual behaviors are brought on by the seizure and that the brain has its own way of bringing the seizure safely to an end after a minute or two. Provide calm reassurance to the person who has had the seizure until s/he has fully recovered.

Treating Seizures

Most seizures associated with brain tumors can be controlled by medications called anticonvulsants or antiepileptic drugs. The type your doctor prescribes for you depends on the type of seizure you are experiencing. Some individuals require a combination of anticonvulsant medications to obtain the best possible control of their seizures.

In order for the seizure medications to be effective, they must be taken exactly as prescribed. The dose and the time of administration are very important since the drug needs to reach and remain at an ideal level in the bloodstream in order to be effective. If there is too little of the drug, you can be at risk for having a seizure, and if there is too much, there could be side effects. Your healthcare team will tell you about the common side effects for the medication you are taking and the circumstances in which you should call your healthcare team. 

Remember two important rules about anticonvulsants: 

  1. Be sure your doctor is aware of all the medications you take. Many medications, both prescription and over-the-counter, can influence the way your anticonvulsant works.
  2. Never stop taking anticonvulsant medications or change the dosage without talking to your doctor.

Tips For Living Safely

If your seizures cause you to fall, lose consciousness, or become unaware of where you are or what you are doing, then remember these safety tips:

  • Don’t drive! 
  • Tell friends what kind of seizures you have, how to recognize them, and what to do if you have one. 
  • Keep water levels in the bathtub low. 
  • When you use the stove, try to use the back burners as much as possible. 
  • Hang bathroom doors so they open outwards instead of inwards. If someone falls against the door, it can still be opened. 
  • Wearing a life vest is a good idea when you are on or close to water. 
  • Use the buddy system—especially if hiking, skiing, or playing in remote areas.

First Aid for Seizures

Generalized Convulsive Seizures:

  • Keep calm. Let the seizure take its course. Do not try to stop the seizure or revive the person.
  • Protect from further injury if possible. Move hard or sharp objects away, but do not interfere with the person’s movements. Place something soft and small such as a sweater under the head. Loosen tight clothing, especially at the neck.
  • Do not force anything in the persons’ mouth. This could cause teeth and jaw damage. The person will not swallow their tongue during a seizure.
  • Roll the person on their side as soon as possible, to allow saliva or other fluids to drain away, helping to clear the airway.
  • On rare occasions, if a seizure goes on longer than 5 minutes, or repeats without recovery, call for medical help.

Partial Non-convulsive Seizures:

  • Stay with the person. Do not try to stop the seizure, but let it take its course. The person may be unaware of his or her actions and may or may not hear you.
  • Gently guide the person away from danger and move dangerous objects out of the way.
  • Observe carefully. Note different movements or behaviors.
  • Partial seizures may spread to other areas of the brain. Do not be alarmed if a convulsive seizure follows.

After All Types of Seizures:

  • Talk gently to the person. Be comforting and reassuring as it may take some time for the person to become reoriented.

Reprinted with permission from Epilepsy Association of Metro Toronto, 1 St. Clair Ave., East, Suite 500, Toronto, ON M4T 2V7, 416-964-9095.

Email: info@epilepsy.toronto.on.ca

Website: http://www.epilepsytoronto.org/.


For More Information:

Check out these resources for more information and support about seizures:

American Brain Tumor Assn.:
1-800-886-2282
http://www.abta.org/

Epilepsy Foundation of America:
1-800-EFA-1000
http://www.efa.org/


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