Do Seizures Come in Clusters?

Yes, seizures can come in clusters. The term seizure clusters is used when three or more seizures that occur within 24 hours (or within six hours as defined in some studies).

Yes, seizures can come in clusters. Doctors refer to this condition as seizure clusters, which are more serious than normal seizures.

The term seizure clusters is used when three or more seizures that occur within 24 hours (or within six hours as defined in some studies).

Other terms for seizure clusters include

• Acute repetitive seizures
• Serial seizures
• Crescendo seizures
• Seizure flurries
• Recurrent seizures
• Cyclical seizures

What causes seizure clusters?

Poorly controlled epilepsy is one of the most common causes of seizure clusters. One example is refractory epilepsy when the patients fail to respond to two or more medications for 18 months straight. These patients continue to have one seizure every month despite therapy.

Seizure clusters are more likely to begin when seizures begin on one side of the brain. This condition is known as focal onset seizures. They can also occur when seizures begin on both sides of the brain, which is known as generalized seizures.

Seizure clusters may also begin in patients with a history of head injury and infection of the brain.

Nearly 25 percent of patients with epilepsy will suffer seizure clusters at least once in their life.

Certain disorders, such as Lennox-Gastaut syndrome (LGS) and glycogen storage diseases in children, may also cause seizure clusters.

What triggers seizure clusters?

The source of the development of seizure clusters is not known in about 30 percent of people with seizure clusters. In others, any of the following factors can be a trigger

• Stress
• Sleep deprivation
• Missed dose of anti-epileptic medication
• Fever
• Menstrual periods
• Alcohol use
• Use of recreational drugs
• Brain abscess

How do doctors treat seizure clusters?

If the seizure trigger is known, it is better if the patient tries to avoid that factor. Doctors treat seizure clusters the same way they treat epilepsy. The medications to treat seizure clusters are divided into two groups

1. Anti-epileptic drugs: These drugs do not cure epilepsy, but are effective at keeping it under control by acting on a chemical in the brain that helps a seizure develop. The same drugs that are used to treat seizure clusters are also used for maintenance therapy. They are given daily in pill or liquid form.
2. Rescue drugs: These drugs belong to a class of drugs known as benzodiazepines. These drugs are administered immediately to a patient with seizure clusters. They can be given in any of the following forms

• Oral pill (lorazepam, diazepam)
• Rectal pill (diazepam)
• Nasal spray (midazolam)

What are the risks of seizure clusters?

Patients with seizure clusters visit the emergency room more often. They should remember to take their anti-epileptic drugs on time and never miss a dose to avoid getting seizure clusters. Seizure clusters can cause serious problems that include

• Status epilepticus: This is a long seizure, lasting for five minutes or more. Seizures may occur one after the other and the patient may not be normal in between. If it lasts for more than 30 minutes, there are high chances of brain injury.
• Impact on quality of life: Seizure clusters can harm the emotional wellbeing, daily functioning and productivity of the patient.
• Mental health issues: The patient may lose touch with reality (psychosis).
• Life-threatening conditions.