Seizure types, causes, assessment, and management
A seizure is the transient occurrence of signs or symptoms due to abnormal excessive or synchronous neuronal activity in the brain. Seizures can manifest as a disturbance of consciousness, behaviour, cognition, emotion, motor function, or sensation.
An isolated seizure can be caused by toxic, metabolic, structural, and infectious factors and should not be confused with epilepsy. Epilepsy is a neurological disorder in which a person experiences recurring seizures.
A cause of epilepsy is only identified in about one third of people with the disorder. Causes include:
Conditions which may present with similar features to epilepsy include:
A patient presenting with a first seizure may be discharged home, accompanied by a responsible adult, if they have normal neurological and cardiovascular examination and the ECG and bloods are normal.
| Seizure Type | Key Characteristics | Duration | Post-ictal State |
|---|---|---|---|
| Tonic | Short-lived, abrupt, generalized muscle stiffening (may cause fall) | Less than 1 minute | Rapid recovery |
| Generalized Tonic-Clonic | Generalized stiffening and rhythmic jerking, urinary incontinence, tongue biting | 1-3 minutes | Drowsiness, confusion, amnesia |
| Absence | Behavioral arrest, staring spells | 10-20 seconds | None |
| Atonic | Sudden loss of muscle tone (drop attacks) | Seconds | Rapid recovery |
| Myoclonic | Brief, shock-like involuntary single or multiple jerks | Seconds | None |