Many factors contribute to seizures, including head injuries and brain damage. If you’re wondering about the link between seizures and brain damage, potential medications to treat seizures, and when you should seek medical attention, read on to learn more.
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A seizure¹ is a transient event with symptoms such as changes in mood, awareness, motor control, behavior, etc., due to abnormal excessive or synchronous electrical activity within the brain. Numerous types of seizures can occur, each stemming from different areas in the brain and displaying various symptoms.
However, they are currently classified in two broad categories by researchers — generalized or partial seizures, as well as unknown-onset seizures in rare circumstances.
Generalized onset seizures affect both halves of the brain at the same time. This type of seizure is typically motor in nature and is characterized by sustained rhythmic jerking of limbs. Most individuals who experience both motor and nonmotor generalized seizures lose awareness while the seizure is occurring.
Focal-onset seizures, also known as partial seizures, only affect a single brain area. Because of this, most individuals who experience focal seizures tend to stay conscious and remain aware of various sensations throughout the seizure.
Having a seizure doesn’t mean you will be diagnosed with epilepsy. The definition of epilepsy is a condition of recurrent seizures (often two or more) that are unprovoked and uncontrolled in nature.
All types of seizures can be scary and potentially serious, so it’s important to check in with a health professional if you’ve experienced one.
Various factors can trigger seizures. No one seizure is the same, and what can trigger one person’s seizure may be different for someone else.
Seizures can be triggered by certain acute infections and illnesses, including the common cold and lung infections. Researchers believe this may be due to the physical stress placed on the body or a disrupted sleep pattern due to severe sickness.
Fever brought on by bacterial or viral infections and certain vaccinations is also a common seizure trigger, particularly in children. Although, the exact reason for how fever triggers a seizure is mainly unknown.
Stress is highly subjective, and its impact on seizures varies depending on the individual.
While research surrounding stress and seizures is still in its infancy, existing research² has shown that both acute and chronic stress can promote neuroinflammation and increase the risk of developing depression, a common comorbidity in patients with epilepsy.
Both acute and chronic stress may promote seizure occurrence. Examples of these types of stress include emotional trauma, accidents, and arguments.
It’s best to avoid consumption of illicit drugs and high alcohol intake to reduce your risk of having a seizure, especially if you’ve been diagnosed with epilepsy. Although small amounts of alcohol may not impact seizure frequency, heavy alcohol intake increases this risk, particularly during withdrawal.
Alcohol and drugs can cause seizures in several ways. Alcohol can interact with epilepsy medications to reduce the amount of the drug being metabolized or increase the adverse side effects. Various recreational drugs also interact with seizure medications or directly affect the brain.
Traumatic brain injury (TBI)³ can result from a wide range of blunt or penetrating trauma. This includes a penetrating brain gouge or a quick blow to the head area. These types of injuries can affect the structural integrity of neurons (cells of the brain) and even cause cell death.
TBIs range in severity from mild to medium to severe. Mild forms of TBIs (mTBI, i.e., concussion) cause temporary side effects that gradually decline a few weeks after treatment.
However, medium to severe forms of TBIs can cause permanent brain damage with long-term consequences, including:
Vulnerability to neurodegenerative disorders
Decreased intellectual changes
For patients diagnosed with severe TBI, post-traumatic epilepsy (PTE) can occur in up to 25% of cases. PTE refers to unprovoked, recurrent seizures at least one week after a TBI incident.
Several studies⁴ have shown periods of abnormal neuronal excitation that can continue anywhere from weeks to years after the initial injury. The location of your brain injury can also affect the likelihood of developing seizures.
The risk factors for PTE include intracranial hemorrhage or cerebral contusion, depressed skull fracture, and penetrating trauma. For example, in penetrating missile combat injuries, the PTE incidence was over 50%.
While severe cases of TBI can cause seizures, epilepsy and seizures may also lead to neuronal death. It’s currently difficult to pinpoint when and where seizures kill neurons. But researchers⁵ have proposed the possibility of the early steps in neuronal death promoting the generation of seizures even if the neurons don’t completely die.
The type and duration of seizures can also increase the likelihood of brain damage occurring.
Most mild seizures won’t last longer than five minutes, but a tonic-clonic seizure that lasts longer than this or more than one seizure in a five-minute period between which the consciousness is not fully regained is considered status epilepticus.
While status epilepticus is rare, it happens mainly in young children and elderly adults. When this occurs, it can lead to permanent brain damage. Several causes of status epilepticus⁶ have been identified, including:
Central nervous system infections
Antiseizure medication nonadherence or discontinuation
Acute structural brain injury such as Head trauma
Metabolic abnormalities such as hypoglycemia
Drugs that lower the seizure threshold or withdrawal from alcohol or benzodiazepines
Various autoimmune disorders
Researchers have long been interested in investigating the relationship between brain damage and seizures due to severe conditions like epilepsy. It is well known that cognitive problems and impairments are common in people with epilepsy.
But studies have shown that even a single seizure can have a direct adverse impact on cognition.
In particular, the frequency of generalized tonic-clonic seizures (a generalized onset seizure) was the strongest predictor of cognitive decline. This included a decline in memory recall and executive skills, like self-control.
Other studies⁷ have indicated that children with seizures in early infancy or childhood — especially when they occur frequently — have a higher risk of developing cognitive impairment. This suggests that persistent and severe seizures in children may harm brain development.
It’s clear from the wide variety of studies with evidence that the association between severe epilepsy and brain damage, as well as cognitive outcomes and epilepsy in general, is clear.
However, more long-term studies involving participants of different ages, sexes, seizure severity, and epilepsy diagnosis are required before making any conclusive claims about the subtypes of epilepsy and brain damage and deciding if antiepileptic medication has a neuroprotective role.
While seizures don’t generally require emergency medical attention in a patient known to have seizures, it can be scary for the individual if it’s the first time they’re experiencing a seizure or if you see a loved one having one.
You should call emergency services if more than one of the following is true:
The seizure lasts longer than five minutes.
You’ve never had a seizure before.
You find it difficult to breathe or walk after the seizure has finished.
You have another seizure soon after the first one has ended.
You have an underlying health condition (pregnancy, diabetes, heart, and high blood pressure).
When someone has a seizure, it can be scary to move them around. However, getting them in the optimal seizure recovery position after it has ended is crucial to maintain airway flow and prevent them from injuring themselves.
While the person is having a seizure, cushion their head with a pillow or something similar if they’re on hard ground like concrete. Then, check if any tight clothing items around their neck can impact breathing (ties, scarves, or heavy accessories) before removing or loosening them carefully.
After the seizure stops, you can move them into the optimal seizure recovery position:
With the person lying on their back, kneel to one side.
Move the arm closest to you at a right angle to their body, with the elbow bent and palm facing up.
Move the other arm, so the back of their hand rests on the cheek closest to you.
Gently place your hand under the knee furthest away from you and pull it up so their leg is bent and their foot is placed flat on the ground.
Slowly pull their knee towards you, so they roll over facing you.
Move the bent leg closer to the floor and in front of their body.
Gently raise their chin and tilt their head slightly, checking that no blockages are in their mouth.
While the research is still in its infancy, evidence suggests that even isolated and brief seizures are likely to cause adverse changes in brain function. Uncontrolled seizures can also lead to memory, attention, and perception loss.
However, only a seizure lasting over five minutes before returning to a normal level of consciousness or multiple seizures occurring within five minutes (known as status epilepticus) can lead to permanent brain damage.
This depends on the severity of the seizure and your individual constitution. For most people, the recovery stage after the seizure takes anywhere from a few minutes to a few hours, after which your brain returns to normal activity levels.
Here are some questions to ask the person during seizure recovery:
What were you doing just before the seizure?
Did you notice any odd smells or tastes before or during the seizure?
What symptoms did you experience during the seizure?
You can write the answers down in a seizure diary to present to a healthcare professional.
Seizures and brain damage are linked as one can influence the other. In some cases of traumatic brain injury, brain damage can occur and result in seizures. For prolonged, frequent, and severe cases of epilepsy, neuronal death may occur, resulting in brain damage.
You should talk to your healthcare professional if you’re concerned about brain damage due to seizures. They’ll be able to talk you through potential medications and treatments that can help.
Seizure | NIH: National Library of Medicine
Traumatic brain injury | NIH: National Library of Medicine
Status epilepticus | NIH: National Library of Medicine
Partial epilepsy | NIH: National Library of Medicine
Types of seizures | Epilepsy Foundation
Information on alcohol and epilepsy | Epilepsy Action
Status epilepticus | Johns Hopkins Medicine
Seizure first aid | Centers for Disease Control and Prevention
Recovery position | NHS
Status epilepticus | Epilepsy Foundation
Using seizure diaries | Epilepsy Foundation