Seizures; Best First Aid Practices
What exactly is a seizure?
The medical name for a fit or convulsion is a seizure. At some point in their life, one out of every twenty people will have a seizure. Not everyone who experiences a seizure, however, will develop epilepsy.
Electrical activity in our brains is continual and regulates our motions and biological functions. If the blood flow to the brain is disrupted, a seizure can occur, resulting in uncontrollable movement of the eyes, limbs, and body.
What occurs when you have a seizure?
The brain has an impact on the entire body. As a result, depending on which portion of the brain is involved, different parts of the body are affected. A seizure can range from an absence seizure, which is characterised by a momentary loss of awareness, to a tonic-clonic seizure, which involves the entire body in uncontrolled movements.
Seizures are usually only a few minutes long. Because the body’s ability to circulate blood to the brain is reduced during this time, it’s critical to call 999 (or provide medicine to end the seizure if prescribed) if the seizure lasts more than 5 minutes or if there are multiple seizures.
What can lead to a seizure?
Head injury, brain tumours, stroke, meningitis, malaria, eclampsia in pregnancy, poisoning, lack of oxygen, elevated body temperature, epilepsy, drug and alcohol use and withdrawal, fainting, cardiac arrest, and many more causes can trigger seizures or disrupt blood flow to the brain.
Feverish convulsions in young children
Five out of every 100 children under the age of six can experience febrile convulsions. They’re not unheard of.
These are seizures that occur when a person’s fever rises while they are sick. Seizures are terrifying, but they are rarely life threatening, and your child will usually grow out of them by the time he or she reaches the age of five.
When someone has had at least one unprovoked seizure that cannot be traced to any other cause, they are diagnosed with epilepsy.
Epilepsy is a brain disorder in which a rush of electrical activity causes messages to become confused, resulting in epileptic seizures.
Epilepsy affects roughly 600,000 people in the UK, making it one in every 100 people. It can begin at any age, but it is most common in children and those over the age of 60.
Although some varieties of epilepsy only last a short time and some children become epileptic as adults, epilepsy is generally thought to be a life-long disorder that is best managed with medicine.
However, the cause of epilepsy is unclear in more than half of all cases, despite the fact that many persons with epilepsy have a family history, implying a genetic component.
What is the treatment for epilepsy?
Anti-epileptic medications can be used to treat epilepsy. Although these treatments do not cure the illness, they can help to stop or lessen the frequency of seizures.
In some circumstances, brain surgery or vagus nerve stimulation surgery may be effective.
For children with epilepsy, a ketogenic diet may be recommended.
Consider the following factors if you have epilepsy:
Many people who suffer with epilepsy are able to regulate their seizures and have completely normal lives. However, having epilepsy should be taken into account in certain activities, such as driving, and some medications can harm the foetus, so this should be discussed with your doctor if you’re planning a pregnancy.
If you are epileptic, the DVLA will need to be notified, and they will give you the following advice:
Car drivers and motorcycle riders are often awarded a three-year licence if they have not had an epileptic attack in the previous 12 months unless they have seizures that fall under one of the exceptions.
Follow their doctor’s or consultant’s advice regarding therapy and check-ups.
After five years of seizure-free driving, drivers are normally awarded a licence that lasts until they are 70 years old.
If a driver has their first unprovoked epileptic seizure, they must take 6 months off driving from the date of the seizure unless there is a substantial risk of subsequent seizures, in which case they must take a year off. Any seizure must be reported to the DVLA.
A generalised seizure’s first aid
Remove anything that could cause them harm and loosen any tight clothing.
Make a note of when the seizure began and, if possible, try to record the distinct phases of the seizure. When it comes to determining the cause of a seizure and initiating therapy, timing it can be incredibly helpful to the medical team. Specific details, such as if one side of the body is afflicted more than the other, can aid in their diagnosis.
Check the airway and breathing once the seizure has ended, and if the person is unresponsive and breathing, place them in the recovery position, or start CPR if they are not breathing.
Remember that people sometimes appear to be having a seizure when they are actually having a cardiac arrest; if you suspect this is the case, begin CPR and use an AED immediately.
If you are in any of the following situations, you should always call for an ambulance:
It’s their first time having a seizure.
More than 5 minutes have passed since the seizure began.
They experience another seizure immediately after the individual is hurt. They are prone to seizures, but this one is unusual.
If the person is unconscious for more than 5 minutes following the seizure, you should be concerned.
Finally, never, ever, ever, ever, ever, ever, ever, ever, ever, ever, ever, ever…
- To prevent children from biting their tongue, never put your fingers or anything else in their mouth — this will result in terrible injury.
- If they aren’t in urgent danger, don’t try to relocate them.
- Don’t limit their movements while they’re fitting, and don’t offer them anything to eat or drink until they’ve fully recovered.
- Never attempt to ‘bring them around.’
Seizures of various sorts
Seizures come in a variety of forms, each with its own set of causes.
One sort of seizure affects some people. Others, on the other hand, have more than one type.
Seizure classification allows seizures to be categorised and grouped together. This is significant because some medications and treatments are effective for some seizures but not others. It’s also critical that medical practitioners use the same terminology when describing seizures. The International League Against Epilepsy (ILAE) proposed a new classification system for seizures in 2017 to help clinicians better diagnose and treat them. The following is a breakdown of the new classification:
Three factors were considered in the classification system:
1) The location in the brain where the seizure began
2) The level of awareness of the patient during the seizure
3) Whether or not the seizure was associated with movement.
The onset of the seizure (the onset)
Seizures might have a focal, a generalised, or an undetermined onset.
The onset of a single event
The term “focal onset” refers to a seizure that begins on only one side of the brain. These seizures were previously known as partial seizures. A seizure can sometimes begin as a focal seizure and subsequently extend to both sides of the brain. A localised to bilateral tonic-clonic seizure occurs when this happens.
The onset is more widespread.
When a seizure has a generalised onset, it affects both sides of the brain from the start.
The onset is unknown.
The term “unknown onset” refers to the fact that the start of the seizure is unknown. Doctors may be able to determine whether the seizure is focal or generalised as additional information about it becomes available.
Doctors may be certain that someone has experienced an epileptic seizure but are unable to determine the type of seizure. This could be due to a lack of information regarding the seizure or because the signs of the seizure are uncommon. This is referred to as an unclassified seizure.
2. The level of consciousness
Depending on your level of awareness during the seizure, you can categorise focal onset seizures into one of two classes.
Even if you can’t communicate or respond, you’re fully aware of what’s going on around you during a focal conscious seizure. Simple partial seizures used to be the name for these types of seizures.
Focused impairment of awareness
A focal impaired awareness seizure occurs when your awareness is disturbed at any point during a focal seizure. The phrase “complex partial seizure” has been replaced by this term.
Because generalised onset seizures virtually always damage your consciousness, the terms “aware” and “impaired awareness” aren’t used to describe them.
Whether or not the seizure is accompanied by movement
Seizures can also be classified as either motor seizures or non-motor seizures, depending on whether or not they involve movement.
Seizures of the motor system
Any seizure that involves a change in your movement is referred to as a motor seizure. A tonic-clonic seizure, for example, is a form of motor seizure in which all of your muscles stiffen before generating rhythmic jerking movements.
If the major symptom of a focal seizure is movement, such as picking at garments or swallowing repeatedly, the seizure may be classified as a motor seizure.
Seizures that are not motor in nature
Any seizure that does not involve movement is referred to as a non-motor seizure. A non-motor seizure is characterised by a change in vision, smell, or hearing as the primary symptom. Non-motor seizures are sometimes known as absence seizures.
During a seizure, the following things may happen
Tonic Phase: They collapse to the ground when they lose consciousness during the tonic phase. The body stiffens and becomes hard. They may scream as though in pain, which is caused by involuntary muscle contractions that drive air out of the lungs. The casualty, on the other hand, is usually not in agony and is oblivious of the noise they are creating. It’s possible that they’ll start to turn blue around their mouth and fingertips.
Clonic phase – The muscles alternately relax and tense, causing them to rigidly jerk about. As the tongue flops to the rear of the airway, it may generate a snoring noise. It’s possible that they’re incontinent and are biting their tongue.
Phase after ictal — (A medical word to mean after a seizure). They may be puzzled, tired, anxious, or completely unresponsive once the jerking ceases. If you are concerned about someone, place them in the recovery posture. It’s possible that neither they nor you are aware of who they are. It can take a few minutes to put everything back together. They may stay perplexed and act aggressively, tearfully, fearfully, or in ways that are out of character for them.
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