What are "Seizures", Exactly?

A friend of mine just started taking a medication, the monograph for which states that there is a small risk of “seizures”. He didn’t like the sound of that, so he asked me what that meant. I had to admit that I didn’t know.

Are they talking about an epilectic episode? If so, that’s a pretty scary side effect, even if the likelihood isn’t high.

Your friend should talk to his/her/it’s doctor about the benefit of taking the medicine vs. the risk of the medicine causing a seizure.

There are several different kinds of seizures. Most result in a temporary “unresponsiveness”; that is, a person having a seizure is unaware of events going on around him/her. (S)he cannot stop a car at a red light, open a parachute at the appropriate time, or lift his/her head above the water level to prevent drowning.

Seizures are not usually dangerous in and of themselves (tongue swallowing is a vastly overstated risk). Seizures are dangerous because they prevent the person from being able to protect him/herself from external dangers.

Often, seizures are associated with convulsive activity - violent shaking in which muscles alternately contract and relax. Some seizures, though, are associated with staring off into space, so-called “absence” (pronounced ahb SONCE) seizures. Other seizures can cause a person to experience strange sensations - smells are the most common. These can be hard to differentiate from hallucinations. Other seizures can result in a person performing certain actions over & over again. These are more common as desperate legal defense strategies (the mom in VA who microwaved her infant daughter?) than in real people, but it can happen… Some seizures cause convulsive activity only affecting one body area (say the Right arm) with the person remaining conscious & aware of the movement, but unable to control it. Sometimes these “partial” seizures generalize, and the person becomes unresponsive & their whole body begins shaking.

What unites all these disparate events is the presence in the brain of abnormal electrical activity. Neurons use electrical activity to transmit signals. Neurotransmitter X from neuron A hits a receptor on neuron B which sends electricity down its axon triggering release of neurotransmitter Y which in turn hits a receptor on neuron C & good brain activity happens. Imagine playing pinball with 1 ball. This is normal brain activity. Imagine playing pinball with 100 balls. This is analogous to a seizure…

If electrodes are stuck in one’s brains & stimulated, anyone can be made to have a seizure. The concept that this happens more easily in some of us than in others is referred as a seizure threshold. For Epileptics, lights flashing at a certain frequency may be sufficient to trigger a seizure. For another person, flashing lights while they are feverish, withdrawing from alcohol, and sleep-deprived may be enough to trigger a seizure. For another person only something drastic like a brain tumor releasing abnormal neurotransmitters would be enough to trigger a seizure. These are examples of progressively higher seizure thresholds.

Some medicines raise the seizure threshold, Some of these are called anti-convulsants, and are useful in the treatment of seizures. Other medicines lower the seizure threshold. It sounds as if your friend was prescribed a medication which lowers the seizure threshold. (S)he should talk to his/her doc about:

Does (s)he have any other condition that would make them likely to have a low seizure threshold?
Should (s)he not drive while taking this medication?
Should (s)he refrain from alcohol, caffeine, and get plenty of sleep while taking this medication (Common sense suggests yes).
What is the real risk of seizing while on this medication?
What alternatives are there to this medicine?

  • other meds?
  • consequences of not treating the original problem?
  • things that can be done to minimize the risk of seizing while on this med…

Epilepsy = unexplained seizure disorder.
If a person has a bad head injury & ever afterwards seizes every other week, they have a seizure disorder. If a person has seizures without identifiable precipitant (meningitis, brain surgery, brain tumor, aneurysm, etc.) AND has at least 2 seizure 6 or more months apart, (s)he has epilepsy. the time frame is important to not label people who have a serious infection & get seizures while febrile, but never seize again.

This is probably way more than what you asked for, & listing all the different kinds of seizures may create the impression that these are real common - they aren’t. A short course of antibiotics is very unlikely to cause seizures while a lifelong treatment with a blood sugar lowering agent that lowers the seizure threshold is still fairly unlikely to cause seizures.

While I’m here… first aid for someone having seizure - recommendations have changed drastically since my first first aid course in Girl Scouts. Do not try to put anything into a person’s mouth. Do not hold them to prevent the shaking. Do put soft objects around them, and push/pull them away from stairs, and steer cars away from them. In other words, protect them from external dangers. Most seizures end on their own within 5 minutes. Unless you know the person well & have been told otherwise, do call 911. When the seizure is over, if the person is not conscious, roll them onto their side so that their tongue does not close off their airway.

Sue from El Paso

Wow, that was very informative! I’ll pass the information along. Thanks.

I used to have grand mal seizures and was once labeled with the “epilepsy” tag. Mine used to provoked by lack of sleep combined with sickness or indulgence in recreational drugs. I’d pass out, hit my head on the floor and blamo, grand mal seizure time. Happened about 6 different times. It always freaked out the witnesses. I guess it can be very scary to watch one. I’d stop flopping and regain conciousness and there would be one or more very scared-looking people in my face. I’d feel very worn out and feel like sleeping afterward. Nobody ever called 911. After it was over, it was over. A Neurologist tested the heck out of me to try to invoke one (via sleep deprivation, strobe lights, etc), but he never could. He placed me on tegretol. He later got pissed off when he found out that I stopped taking it (I hated how it made me feel) and turned me in to the State who promptly yanked my driving priviledges. It took 5 years of being seizure-free without medication (and a different nuerologist) to get them back. I basically stopped the seizures myself by giving up all-nighters, recreational drug partying, and head trauma. There’s lots of predjudice against epileptics. In days of old you were thought to be a witch or possessed by demons. Even in the 20th century people were given lobotmies and shock treatment or locked up in sanitariums.