What Happens During a Seizure?

Our brain is one of the most important organs of our body. Not only is it responsible for our thoughts and feelings, but it’s also responsible for things like memory, senses like taste and smell, as well as movement. So just how does the brain work? Through electricity and chemical messengers known as neurotransmitters, which cause the nerve cells (also known as neurons) to either fire or stop firing. When it comes to epilepsy, a seizure can occur when the normal electric balance of the brain gets lost and causes the neurons to misfire. This can then result in a sudden, uncontrolled burst of electrical activity from the brain, resulting in the seizure. There are three different classifications of seizures and they are generalized onset seizures, focal onset seizures, and unknown onset seizures.

Generalized Onset Seizures

These types of seizures can affect both sides of the brain and includes tonic-clonic, absence, or atonic seizures.

During a tonic-clonic seizure, the tonic phase comes first and can result in stiffening of muscles, air being forced past the vocal cords, which may cause a groan-like sound, and loss of consciousness. An individual may also bite their tongue during a tonic-clonic seizure. Following the tonic phase, the clonic phase sets in and can result in rapid movement or jerking of the arms and legs. A tonic-clonic seizure lasts anywhere from 1 to 3 minutes before consciousness slowly returns, and the individual may feel sleepy as well as confused and/or irritable.

An absence seizure, which is the most common type of seizure, can occur so quickly that an individual may not even be aware that something is wrong. Someone experiencing an absence seizure may appear as though they are staring off into space, and their eyelids may also flutter. An absence seizure generally lasts no longer than 10 seconds. There are typically no post-seizure effects from an absence seizure, and the individual is able to carry on what they were doing before the seizure occurred.

With an atonic seizure (also referred to as “drop attacks” or “drop seizures”), muscles become limp, eyelids may droop, and a person may fall to the ground which can result in injuries such as sprains, broken bones, and even head trauma. An atonic seizure generally lasts for approximately 15 seconds. Following an atonic seizure, a person can often go back to what they were doing prior. However, they may feel confused or need to rest for a short amount of time.

Focal Onset Seizures

Focal onset seizures can occur when a person is awake and aware what is happening to them; or, their awareness can be impaired. During a focal onset aware seizure, the individual may feel “frozen” and unable to respond while the seizure is occurring, but will be able to recall events during the seizure once it has passed. A focal onset aware seizure is usually brief and lasts less than 2 minutes. During a focal onset impaired awareness seizure, formally known as a complex partial seizure, your level of awareness may change and you may not even be aware that anything is happening.

Unknown Onset Seizures

A seizure can be considered an unknown onset seizure if it is not witnessed by anyone or of it is unknown why the seizure occurred. Upon further consultation with medical professional, such as a family physician like Dr. Ali Ghahary or a neurologist, an unknown onset seizure may be later diagnosed as being a focal or generalized seizure.

In the even that you witness someone having a seizure, it is important that you stay with the individual until the seizure ends and he or she has regained consciousness, and reassure them that everything is okay. During the seizure, it’s important that you do not hold the individual down to try and stop their movements. Following the seizure, gently roll the individual onto their side to help keep their airway clear. If the seizure lasts longer than 5 minutes or the individual has back-to-back seizures, call 911.