A seizure is a sudden electrical disturbance in the brain that causes uncontrollable physical symptoms and movements. Seizures can be scary to witness and experience, but can they put your life in danger?
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When electrical disturbances occur in your brain, they can induce a seizure. Seizures can happen as a single occurrence, but multiple seizures are likely indicative of epilepsy (a seizure condition).
Seizures can upset your normal functioning and cause uncontrollable movements and behaviors. The typical form of seizure that most people are probably familiar with is a tonic-clonic seizure, which produces violent jerking of the limbs and body, stiffened muscles, and unconsciousness.
There are other types of seizures, with symptoms that may not be as familiar. Common types of seizures include:
Tonic-clonic (or grand mal) seizures affect both hemispheres of the brain. Their symptoms include:
Loss of consciousness
Stiffened muscles and arched back
Spasms and jerks
Confusion or agitation
Absence (or petit mal) seizures can easily be mistaken for a lack of focus or daydreaming. These seizures also affect both areas of the brain, and symptoms include:
Staring off into space
Suddenly stopping mid-conversation or action
Small hand and arm movements
Partial seizures only affect one hemisphere of the brain, so the individual may experience loss of consciousness due to abnormally decreased activity in brain networks. Symptoms of partial seizures include:
Isolated temporary paralysis
Hallucinations and aura
The different symptoms that can occur with seizures place people at varying risks of harm and exposure to injury. Tonic-clonic seizures, for example, can place patients at risk of injuring themselves while falling or biting their tongues.
Unfortunately, the risk of mortality is significantly higher in people with epilepsy than it is in a healthy population. Causes of epilepsy-related deaths include:
Status epilepticus - a medical emergency classified by a seizure lasting longer than 5 minutes or more than one seizure within a 5-minute period, which can result in permanent brain damage and death¹
Anti-seizure drug effects
Motor vehicle and bicycle accidents
Sudden unexpected death in epilepsy, or SUDEP, refers to the death of an individual with epilepsy for which there is no known cause but for which there is evidence of an associated seizure.
There are around 3,000 SUDEP deaths every year in the United States, with SUDEP occurring in roughly 1 in every 1,000 patients every year.² ³
Experts don’t know exactly what causes SUDEP to occur, but it may involve changes in respiration and/or heart rhythm resulting from a seizure.
The risk of dying from a sudden unexpected death in epilepsy will vary depending on the type of seizure experienced, medical history, and certain lifestyle factors.
Overall, the risk of SUDEP is rare, but factors that can increase its likelihood include:
Experiencing tonic-clonic seizures - the presence of more than 3 tonic-clonic seizures in a year can increase the risk of SUDEP 15-fold
Having had epilepsy for many years
Poor medicine adherence
If you experience seizures, there are some things you can do to reduce your risk of death, both from secondary injuries and sudden unexpected death in epilepsy.
Ways to reduce seizure danger include:
Seek diagnosis and medical help if you experience a seizure
Adhere to your medication regimen
Identify the triggers for your seizures and reduce your exposure to them (these can include alcohol consumption, stress, sleep deprivation, and bright lights)
Use seizure-monitoring devices, e.g., alarms, heart rate monitors, bed sensors
Proper treatment management is crucial to reducing the risk of seizures. Treatment options for seizures include:
Medication - Medication options include anti-epileptic drugs (AEDs) such as carbamazepine, lacosamide, phenytoin, and oxcarbazepine. More recently approved medication options include the cannabinoid product Epidiolex.
Surgery - Surgery can be effective in helping to manage seizures when medication is ineffective. Surgery for seizures involves severing connections in the area of the brain where misfiring electrical activity is occurring.
Diet - Diet can be useful in helping to manage seizures. The ketogenic, low glycemic index, and modified Atkins diets have all shown promise in reducing seizures.⁴
Electrical stimulation - Implanting electrodes into certain areas of the brain and to the vagus nerve (located in the neck) can help to block seizures.
Seizures are not only scary to witness, but they can also increase a patient’s risk of death. Certain symptoms and seizure types are riskier than others, but some things can be done to reduce the risk of death.
Medication, early detection, monitoring, and certain lifestyle changes can help to improve outcomes for people who experience seizures.
Sudden unexpected death in epilepsy (SUDEP) occurs in roughly 1 in every 1,000 people with epilepsy. In adults, the mortality rate of patients with status epilepticus range from 30-40%.⁵
Patients can also die from secondary injuries like drowning or choking during a seizure.
Epilepsy is associated with a high rate of premature mortality. Tonic-clonic seizures carry the highest risk of status epilepticus and sudden unexpected death in epilepsy (SUDEP).
Status epilepticus | Johns Hopkins Medicine
Sudden unexpected death in epilepsy (SUDEP) | Centers for Disease Control and Prevention
Practice guideline summary: Sudden unexpected death in epilepsy incidence rates and risk factors: Report of the guideline development, dissemination, and implementation subcommittee of the American academy of neurology and the American epilepsy society (2017)
Generalized seizures | Johns Hopkins Medicine
Seizure medications (2022)