Epilepsy vs Seizures

What are seizures?

A seizure happens when your brain experiences a brief surge of excessive electrical activity. It can cause changes in behaviour, movements, feelings, or levels of consciousness.

Seizures vary widely in severity and manifestation, from brief lapses of attention or muscle jerks to severe and prolonged convulsions. They are commonly associated with epilepsy, but not all seizures mean a person has epilepsy.

Seizures can be categorised into two main types:

Generalised seizures

Affecting both sides of the brain:

Absence seizures (petit mal seizures): Characterised by brief, sudden lapses in attention, these seizures often appear as staring spells.

Tonic-clonic seizures (grand mal seizures): The most recognisable type of seizure that involves a combination of muscle stiffness (tonic phase), followed by rhythmic muscle contractions (clonic phase). The person may lose consciousness, fall to the ground, and have convulsions.

Focal seizures

Affecting only one area of the brain:

Simple partial (focal) seizures: The person remains conscious and aware, and may experience unusual sensations or movements, like a tingling feeling, a strange taste or smell, or involuntary jerking of a body part.

Complex partial (focal) seizures: The person may appear awake but be unresponsive and unaware of their surroundings. They might make repetitive movements, such as hand rubbing, lip-smacking, or walking in circles.

What causes seizures?

Seizures can be caused by various factors, and they do not always indicate epilepsy. There are three main categories:

Epileptic: These occur in individuals with epilepsy, a condition where there is occasional abnormal electrical activity in the brain. Causes can include brain injuries such as trauma, stroke, infections, or tumours. In some cases, epilepsy may be inherited. However, the exact cause of epileptic seizures is often unknown.
Provoked: These are seizures triggered by external factors, like certain drugs, withdrawal from alcohol, or metabolic imbalances, such as low blood sugar. Once the underlying issue is resolved, these seizures typically do not recur. Individuals with provoked seizures are not considered to have epilepsy.
Nonepileptic: Although these seizures resemble epileptic seizures, they are not caused by abnormal brain activity. They may be due to fainting spells, muscle disorders, or psychological issues.

What is epilepsy?

Epilepsy is a neurological disorder characterised by frequent, unprovoked seizures that affect people of all ages. It is one of the most prevalent neurological conditions.

Childhood epilepsy

Absence Epilepsy: Characterised by brief episodes where the child loses awareness for a few seconds. During these episodes, the child may become pale, stare blankly, and unresponsive when spoken to. Eyelid twitching and the rolling back of the eyes or head may also occur. These short absence seizures can happen as frequently as 100 times a day.
Rolandic Epilepsy: One side of the child’s face may twitch, sometimes accompanied by twitching in an arm or leg. The child might also feel tingling and numbness or experience difficulties with speech and swallowing, leading to increased salivation or drooling. They are usually conscious during these seizures, which typically occur while falling asleep or waking up.
Juvenile Myoclonic Epilepsy: Emerges during adolescence and involves muscle twitching and jerking movements, especially in the arms and shoulders. Seizures often occur in the morning after waking up, and sometimes, the knees may suddenly give way.
Infantile Spasms (West Syndrome): A severe form of epilepsy that almost always begins in infancy. During seizures, the child’s body may bend and stretch, with convulsive movements of the neck and torso muscles. These seizures usually happen shortly after waking or while falling asleep. Though each seizure lasts only a few seconds, they can occur in clusters of up to a hundred, with brief pauses in between.

What causes epilepsy?

Epilepsy causes are frequently categorised into structural, genetic, infectious, metabolic, immune and unknown.

Brain damage from prenatal or perinatal causes like a loss of oxygen or trauma during birth, or low birth weight.
Congenital anomalies or genetic conditions linked to brain deformities.
A stroke that limits the brain’s access to oxygen.
Infections of the brain, e.g., meningitis, human immunodeficiency virus (HIV), encephalitis or neurocysticercosis.
Genetic syndromes like autism.
Brain tumours.

What is the difference between epilepsy and seizures?

Seizures are isolated episodes of abnormal electrical activity in the brain. When seizures become a regular problem, this condition is called epilepsy. Typically, an individual with epilepsy is diagnosed following at least two seizures that were not brought on by a known medical condition.

Is seizure always epilepsy?

No, not every seizure is a sign of epilepsy. Having one or a few seizures does not indicate epilepsy.

Epilepsy is diagnosed when two unprovoked seizures occur at least 24 hours apart and do not have a clear cause.

How are epilepsy and seizure diagnosed?

Diagnosis

Evaluation includes a thorough medical history, physical examination, and several diagnostic procedures.

Electroencephalogram (EEG): To check for unusual electrical activity in the brain using electrodes placed on the scalp.
Blood tests: To look for infections, electrolyte imbalances, genetic conditions, or other metabolic issues that could be causing seizures.
Imaging tests like CT scan and MRI: To look for unusual growth, damage, or scarring in the brain.
Lumbar puncture: To analyse the cerebrospinal fluid surrounding the brain and spinal cord if an infection like meningitis is suspected.

Treatment

Treatment options for seizures and epilepsy include:

Anti-epileptic drugs (sodium valproate, carbamazepine, lamotrigine) to control seizures.
Surgery to remove a small area of the brain that is causing seizures.
Vagus nerve stimulation (VNS) whereby a small device is implanted under the skin of the chest and wires from the device are connected to the vagus nerve in the neck.
Avoid seizure triggers, e.g., flickering lights or sleep deprivation.
Eat a well-balanced diet, exercise regularly.
Avoid smoking, excessive alcohol consumption, or other substance abuse.
Manage stress.

What to do when someone is having a seizure?

Follow these general steps to help someone who is experiencing any type of seizure:

Call for an ambulance.
Move them if they are in danger, such as near heavy or sharp objects.
Loosen any tight clothing around their neck to help with breathing.
Turn them onto their side after their convulsions stop.
Keep track of when the seizure begins and ends.
As soon as they are conscious and able to speak, inform them of what occurred.
Speak calmly and offer the person comfort.

Make an appointment at Pantai Hospitals

Get in touch with us to book an appointment today if you have concerns or questions regarding seizures and epilepsy. A dedicated and expert team of neurologists at Pantai Hospitals is available for consultation to provide the best care and assistance. We assure you the best possible care tailored to your specific needs.

Pantai Hospitals have been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.