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Epileptic Seizures
in Humans and Animals
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Although much remains to be learned about the causes and treatment of seizures, the following is a guide for the layman for understanding and managing seizures and epilepsy. Epilepsy is simply a condition where the patient experiences recurrent seizures. This article will apply both to humans as well as animals, with the understanding that some of the treatments may only apply to one or the other.
Seizures are both mysterious and frightening, and can range from the mildly annoying to life threatening in severity. Seizures were often referred to historically as convulsions or fits. Seizures are classified on several dimensions, including the amount of the body they affect, the cause and the duration.
Seizures can be broken down into 3 basic classes (there are many more) by how much of the body is affected:Grand Mal
A Grand Mal or Tonic-Clonic seizure involves the complete body in a convulsionPetit Mal
A Petit Mal or Focal seizure involves the convulsion of a part of the bodyAbsence
An Absence seizure is one in which the patient becomes unresponsive, often with little or no memory of the occurrence. The patient appears to be day-dreaming, but is non-rousable.
(This is extremely rare in animals, and very hard to detect)Causes
The causes of these seizures can include:
Alcohol Poisoning
Drug Overdose/Reaction
Hypoglycemia
Poisons (including toxins thrown off by liver or renal failure)
Head Injury
Neurological defect (normally genetic)
Fever (common in children)
Sepsis (especially in the brain)
Brain Tumor
Stroke or other vascular problem
Many other known/unknown causesWhat happens in a seizure
Diagram of a typical seizure
In a seizure there is normally a stimulus that starts the brain down the path to seizing; this can be either something overt, such as ingestion of a drug, flashing lights or it could be some non-obvious change such as a drop in blood-glucose level or in body temperature. Often a patient's stimulus is the same, and after they reach their stimulus threshold, they will start the seizure process. Most patients, but not all, experience an Aura which can be a ringing or sound, smell or visual disturbance, shortly before starting into an active seizure. Most patients after experiencing a seizure will know to go lie down, or call for help, when they experience an aura. Animals may seek more or less attention, often hiding or cowering on the owners lap
At this point the patient will probably enter the seizure (in an absence seizure, they will simply appear to be daydreaming), which can range from uncontrolled twitching of a limb or facial muscle (focal), to a full grand-mal seizure, with full body convulsions. During a seizure of either type, the patient will not be responsive. During this time the body is using tremendous amounts of energy to sustain a seizure, and the danger here is that the brain is using up oxygen very rapidly. If the patient remains in this state for more than 5 minutes, it is called Status Epilepticus (often shortened to "status") which is a life threatening emergency, requiring immediate medical attention.
After the seizure has ended, in a isolated seizure, the patient will enter the post-ictal phase of the seizure. This can be thought of as the "resetting" period. The patient will often lie quietly, and allow for the body to return to normal. At this point one of 2 things can happen: The patient will return to normal, or re-enter the seizure phase. The reentry, if for a few times, is called a Cluster Seizure; if on the other hand, it is an endless cycle, this is in actuality Status Epilepticus.Why are seizures harmful
The 2 basic reasons that seizures are harmful (in the short term) is that the patient can sustain trauma from the convulsions, and the brain can be starved of oxygen during sustained seizures. This can lead to brain damage, as any other oxygen deprivation of the brain will.
There are also longer term, more subtle problems, but they are beyond the scope of this article. Speak with a Doctor about long term problems.What do I do when someone (or animal) seizes
The basic field treatment of a seizing patient, is to assure that they do not hurt themselves or others while seizing. In an absence seizure, nothing needs to be done, as long as the patient emerges in a reasonable period of time. In a convulsion type seizure, the first step is to remove dangerous objects that they might hit (tables, chairs, tools...). If possible at this point, place a pad or pillow under the head, to protect it from banging into the ground.
Contrary to the old-wives tale, patients cannot swallow their tongue, but can choke on items in their mouth, such as food or their tongue.
However, DO NOT INSERT YOUR HANDS INTO A SEIZING PATIENT'S MOUTH. (this will simply add to the load of medical personell who now have a trauma patient as well) Remember the patient is not in control of their muscles, and the jaw has a set of muscles designed to cut through meat (such as fingers)!!! There is a special device called a tooth-screw designed to open the mouth of a seizing patient, that some EMT/Paramedics may have with them.
If the airway is occluded, the patient will, eventually stop seizing from lack of oxygen, and it is then safe to reach in (carefully!) and remove the obstruction, using CPR techniques. Remember that the patient could reenter the seizure, when you get enough air back into them.
If your patient has not exited within 5 minutes, or has reentered more than twice, you are now facing a much more serious problem, of having a seizing patient that needs immediate medical intervention. In the case of a human patient, call 911 (or your emergency number), and inform them that you have a patient in continuous seizure, and you need Advanced Life Support who carry the necessary drugs. If this is an animal, or ALS is not available in your area, you need to get the patient to a hospital as soon as possible. It is very important that you inform the hospital of your problem, so that they can prepare for your arrival. Tell them the following information:
The length of time of the seizure
The type of animal/Size
Age
Known epileptic/seizure prone (If so, what drugs are they on)
Cause if known (such as toxin)If neccesary, you will have to transport them yourself; this is hard, but they could die without anti-seizure medications. It is better to cause skeletal trauma, even breaking an arm or leg to get them into a car, than leaving them in "status".
What drugs are used
The hospital or paramedics will normally administer a large dose of Diazepam (Valium) via rapid IV injection, which is extremely rapid acting, and will often stop the convulsions within seconds.
The second most common drug that is used is Phenobarbital, which is slower and longer acting, and actually is an anti-seizure drug, rather than an anti-convulsant. When the patient is no longer seizing in the emergency sense, the long term management of the condition will commence, and a variety of anti-seizure drugs are used, and will be discussed with you by your doctor.
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Disclaimer!!!
Before you read any further, I want to make it clear I am not a doctor.
I AM NOT PRESCRIBING MEDICINE OR TREATMENTS BUT SIMPLY PASSING ON TO YOU INFORMATION DESCRIBING HOW OTHER SUFFERERS HAVE FOUND SATISFACTORY RELIEF
I make no guarantees.
This is simply a collection of information in the public domain.
Information conveyed herein is based on pharmacological and other records, both ancient and modern .
Take everything you read here with a grain of salt and apply it to your own experience.
Check with a doctor before you employ, attempt or invoke any of the advice you read herein.
If you are easily influenced or timid of mind and weak of volition, I urge you to read no further!
Hit the back button on your browser now and read no more!
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