Seizures are a medical emergency. Whether the seizure is a first-time onset or a recurring episode, it is advisable to dial 911 and call for help. A group of drugs called benzodiazepines is usually administered to stop multiple seizures.
A group of drugs called benzodiazepines is usually administered to stop multiple seizures. These work by altering the level of a chemical messenger in the brain called gamma-aminobutyric acid or GABA. However, their side effects may include drowsiness and dizziness. Benzodiazepines are usually considered rescue medications. A caregiver may identify the cluster symptoms and they can start a rescue treatment right away until help arrives. They can give these medications in the following ways.
- Rectal method
- This method is usually used when a patient is having a seizure.
- The caregiver may inject a gel, Diastat (diazepam), into the rectum using a syringe without a needle.
- This method of administration works much faster than other methods.
- Side effects may include sleepiness, dizziness, headache and pain.
- Nasal method
- Valium (diazepam) and Nayzilam (midazolam) are simple options and the body absorbs them quickly.
- The caregiver may spray them into the nose to stop cluster seizures.
- Midazolam works quicker than diazepam, but it doesn't last long in the body.
- Side effects of nasal diazepam and midazolam include nasal irritation, fatigue, watery eyes and an odd taste in the mouth.
- Cheek method
- The caregiver can also put midazolam inside the cheek. This is also called the buccal method. However, it is not always possible to access the cheek in a person having major (tonic-clonic) seizures. It may be an option for those who have partial seizures or absence seizures.
- Side effects include a bitter taste and risk of aspiration (when the medication gets into the airways or lungs).
- Besides, this method might not be right for people who tend to vomit or create a lot of saliva during a seizure.
What is a seizure?
A seizure is an uncontrolled, sudden change in the brain's normal electrical activity. During a seizure, brain cells fire uncontrollably. This briefly affects the way a person behaves, moves, thinks or feels. Recurrent seizures are called epilepsy. Seizures are usually categorized into three types depending on the onset, which include
1. Unknown onset
- The beginning of a seizure is unknown, which is known as an unknown onset seizure.
- A seizure could also be called an unknown onset if it’s not witnessed or seen by anyone. For example, when seizures happen at night or in a person who lives alone.
- Unknown onset seizure may later be diagnosed as a focal or generalized seizure.
2. Generalized seizures: Generalized seizures are characterized by widespread electrical discharges in both sides of the brain. They are further divided into six types.
- Tonic seizures: The seizure may cause a patient to fall or collapse. Body stiffening is usually noticed. The back, arm and leg muscles are affected most often.
- Clonic seizures: It usually affects the face, neck and arms and may last for several minutes. It includes jerking, rhythmic muscle movements.
- Tonic-clonic seizures/grand mal seizures: This is the most common type of seizure. They involve a loss of consciousness, stiffening of the body and shaking or jerking. It is sometimes followed by a loss of bladder or bowel control.
- Myoclonic seizures: They are short and involve uncontrollable jerking. Usually, the jerking is seen in the arms and/or legs and lasts for only a second or two.
- Atonic seizures/drop attack seizures: This type of seizure may cause the person suffering to drop objects. Usually, a sudden collapse is noted. It usually involves a sudden loss of muscle tone, a head drop or leg weakening.
- Absence seizures/petit mal seizures: People who have absence seizures usually lose awareness for a short time and have no memory of the seizure afterward. This type of seizure usually begins between the ages of 4 and 14 years old. It may resemble daydreaming. Subtle body movement may accompany the seizure.
3. Partial seizures/focal seizures: Usually, this begins in one side of the brain and falls into one of the following groups.
- Simple partial seizures: This type of seizure may alter emotions or change the way things look, smell, feel, taste or sound. It may also result in involuntary jerking of a body part (such as an arm or leg) or spontaneous sensory symptoms (such as tingling, dizziness and flashing lights).
- Complex partial seizures: They usually alter consciousness or responsiveness. The person having the seizure may appear to be staring into space or moving without purpose. Some common movements include hand rubbing, chewing, swallowing and repetitive motion, such as bicycling leg movements or walking in circles.
Treatment options for seizures
- Doctors may prescribe an anti-epileptic drug or anticonvulsant to treat seizures. These drugs are taken every day, sometimes several times a day and/or for as long as needed.
- Common drugs include Dilantin (phenytoin), Tegretol (carbamazepine), Depakote (valproic acid) and Luminal (phenobarbital). These drugs may be used alone or in combination with each other when seizures are difficult to control.
- Most of them have side effects, such as fatigue, drowsiness, nausea and blurred vision.
- Doctors usually consider surgery when the condition is not improved by medication. Surgery is done in the portion of the brain responsible for seizures (e.g., brain resection, disconnection or stimulation).