The Human Brain A brief overview of the human brain and its lobes. Show
What is a Seizure? Learn about seizures, their causes and when they are considered epilepsy. Seizure Types and Classification There are many different seizure types and groups. Seizure classification is a way of naming the different types of epileptic seizures and putting them into groups. What Seizures Look Like A more in-depth look at different seizure types. Epilepsy Syndromes Some types of epilepsy are further classified as syndromes and are defined based on a combination of symptoms. Photosensitive Epilepsy In some people, seizures can be triggered by flashing or flickering lights, or by certain geometric shapes or patterns. Nocturnal Seizures – Seizures During Sleep Looking at the relationship between seizures and sleep. Seizure Emergencies There are a small group of people with epilepsy who have severe or even life-threatening seizures. Here we cover some seizure emergency situations. The Human BrainThe brain is made up of millions of nerve cells called neurons. These cells generate electrical impulses and messages to produce thoughts, feelings, sensations, movement and control body functions. Regions of the brain The brain is divided into two halves, left and right, called hemispheres. The right hemisphere controls the left side of the body and left hemisphere controls the right. Each hemisphere has four lobes – frontal, parietal, temporal and occipital. Cerebrum This is the largest structure of the brain and contains the frontal, parietal, occipital and temporal lobes. It is the centre of intellect, memory, language and consciousness, receiving and interpreting sensory information and controlling movement. Frontal Lobes Are our behavioural and emotional control centre. They are also involved in voluntary movement, planning, initiation, problem solving, memory, language, judgement, impulse control, and social and sexual behaviour. Parietal Lobes Are involved with touch, temperature and pain perception (sensation), awareness of the body and where it is in space. Temporal Lobes Play a large role in understanding language, speech, learning, memory, personality and behaviour. Occipital Lobes Are primarily responsible for vision Cerebellum The cerebellum is responsible for co-ordination, and maintaining of posture, muscle tone, and balance. Brainstem Controls basic body functions such as breathing, swallowing, heart rate, blood pressure, consciousness, and whether you are awake or sleepy. If you want to know more about the brain and its functions, go to: Brain Function BrainFacts.org What is a Seizure?Seizures and epilepsy are not the same. A seizure happens when the regular electrical impulses in the brain are disrupted, causing them to rapidly fire all at once. Depending on where the seizure happens in the brain, this can cause changes in:
Seizures vary, and can be very brief or last up to two or three minutes. Most seizures are generally over in less than two minutes. Some seizures are severe and some very subtle. Under certain circumstances, anyone can have a seizure and not all seizures are diagnosed as epilepsy. What is epilepsy?
It is a neurological disorder and seizures are caused by a temporary disruption of the electrical activity in the brain. Approximately 3% to 3.5% of Australians will be diagnosed with epilepsy at some point in their lives and over 250,000 Australians currently live with epilepsy. Epilepsy can start at any age although it is more likely to be diagnosed in childhood or senior years. There are many different types of epilepsies and people’s experiences differ greatly. Some types of epilepsy are age-limited and the person eventually stops having seizures. For others, epilepsy is a life-long condition. Approximately two thirds of people with epilepsy become seizure free with medication. What causes epilepsy?
Some known causes of epilepsy include:
Seizure Types and ClassificationSeizure TypesSeizure classification is a way of naming the many different types of epileptic seizures and putting them into groups. In 2017, the International League Against Epilepsy revised its classification of seizures to make diagnosing and classifying seizures more accurate and simpler. Some of the words you may have heard to describe seizures, such as ‘tonic-clonic’ are still used while others, such as ‘partial’ and ‘grand mal’ are no longer used. Doctors look at the following three things when classifying a seizure:
Seizures can be divided into three major groups:
Most people will only have one or two seizure types. Sometimes a person with more complex or severe epilepsy may experience a number of different seizure types. 1. Focal Onset SeizuresFocal onset (formerly known as partial seizures) means the seizure starts in just one small region of the brain. It may spread to other areas of the brain. These seizures can often be subtle or unusual and may go unnoticed or be mistaken for anything from being intoxicated to daydreaming. About 60% of people with epilepsy have focal onset seizures – which are also simply known as focal seizures. Focal onset seizures can be further divided into two groups relating to a person’s awareness during a seizure:
A focal seizure may progress to a bilateral tonic-clonic seizure meaning that it starts in one area of the brain and then spreads to both sides causing muscle stiffening and jerking. 2. Generalised Onset SeizuresGeneralised onset means the seizure affects both hemispheres (sides) of the brain from the onset. Because of this, a person may lose consciousness at the start of the seizure. Generalised onset seizures almost always affect awareness in some way, so the terms ‘aware’ or ‘impaired awareness’ aren’t used. However, they can be classified further by movement:
Types of Generalised Onset SeizuresThere are many types of seizures in this classification. They include:
3. Unknown Onset SeizuresUnknown onset means the seizure cannot be diagnosed as either focal or generalised onset. Sometimes this classification is temporary and as more information becomes available over time or through further testing, the type of seizure may be changed to a generalised or focal onset seizure. Rarely, doctors might be sure that someone has had an epileptic seizure, but can’t decide what type of seizure it is. This could be because they don’t have enough information about the seizure, or the symptoms of the seizure are unusual.
More information EAA Seizure Classification Factsheet EAA Seizure Classification Chart Seizure Classification ILAE VideosWatch here for the most common types of seizures explained What the Seizures Look LikeFOCAL ONSETFocal seizures are classified by whether awareness is retained or impaired (altered). If awareness is unknown, then they are simply classified as a focal seizure. Focal seizures – retains awareness People often refer to these seizures as their “aura” but they are actually a seizure which may or may not lead on to a more significant seizure. For instance, the seizure may spread to become a focal impaired awareness seizure or evolve into a bilateral tonic clonic seizure. Examples of focal aware seizures include:
Focal seizures – impaired awareness In some types of focal seizures, the person has a change in awareness, consciousness, and behaviour. These are called focal impaired awareness seizures. They can also be called focal seizures. These focal seizures vary greatly, depending on where they start and spread within the brain and are frequently not recognised as seizures by onlookers. Many of these seizures begin with:
GENERALISED ONSETTonic clonic seizures A tonic clonic seizure is a seizure that has a tonic (muscle stiffening) and a clonic (muscle jerking) phase, typically in this order, but variations such as clonic-tonic-clonic can also be seen. Tonic clonic seizures are the most recognised seizure type and can be frightening to witness. There are slight variations, but a typical tonic clonic seizure will look like:
Myoclonic seizures A myoclonic seizure is a seizure where a single jerk or series of single jerks (very brief muscle jerks) occur. They frequently affect the upper body, neck shoulders and arms. A person having a myoclonic seizure usually has sudden jerks on both sides of the body at the same time. They vary in severity but can cause someone to spill or drop what they are holding, or fall off a chair. If severe enough, a myoclonic seizure can also cause a fall. The seizures are often mistaken for clumsiness before diagnosis. Note: Even people without epilepsy can experience myoclonus or sudden jerks just as you are falling asleep. These are normal and not seizures. Tonic seizures A tonic seizure involves increased muscle tone of the body usually very brief, lasting a few seconds. If the person is standing they will suddenly fall stiffly to the ground. This is often termed a “drop attack” (astatic seizure). Tonic seizures often occur during sleep and in clusters of varying intensity of tonic stiffening. The person is unaware during these events. At the beginning of tonic seizures with more intense stiffening, people may make an exhalation or loud sigh sound. With more severe and prolonged tonic seizures the person may look like they have a tremor or shaking. Tonic seizures often occur in people with intellectual impairment or more complex epilepsies. Atonic seizures An atonic seizure is a type of seizure that involves the sudden loss of muscle tone. If standing, this can cause a “drop attack” where the person suddenly slumps to the ground. If sitting, a simple head nod (as if the person is trying to fight off sleep) may be seen. These seizures are very brief, less than 2 seconds and may involve the head, body or limbs. Atonic seizures often occur in people with intellectual impairment or more complex epilepsies. *Clonic seizures (less common) A clonic seizure is a seizure involving bilateral rhythmic jerking and may occur alone or in combination with tonic (increased muscle tone) activity typically lasting a few seconds up to a minute. The jerking in a clonic seizure is more sustained and rhythmic than seen in a myoclonic seizure. Absence Seizures The most common absence seizure is the typical absence seizure. There are other less common types of absence seizures that are briefly discussed here. A typical absence seizure starts and ends abruptly, is very brief with altered awareness during the seizure. Absence seizures usually begin in childhood (but can occur in adolescents and adults) and are easily missed, or misinterpreted as daydreaming or inattentiveness. Typically, it will look like:
These seizures can happen numerous times a day causing learning to be disrupted. They generally respond well to medication. The below group are less common absence seizure types: *Atypical absence seizures The seizure does not start and end as suddenly as a typical absence, it can be more gradual. They are often seen with other features such as loss of muscle tone of the head, trunk or limbs (often seen as a gradual slump) and subtle jerking. These seizures often occur in people with intellectual impairment and complex epilepsies. The loss of awareness may be minor with the person continuing an activity, but more slowly or with mistakes. *Myoclonic absence Rhythmic myoclonic jerks of the shoulders and arms and lifting of the arms during the seizure can be seen. The myoclonic jerks are usually seen in both arms, but may be one-sided or not symmetrical. Puckering (jerking) of the lips, twitching of the corners of the mouth, or jaw jerking can also be seen. Sometimes rhythmic jerks of the head and legs may occur. Seizures last 10-60 seconds and typically occur daily. The level of awareness varies from complete loss of awareness to retained awareness. *Absence with eyelid myoclonia These are absence seizures accompanied by brief, often rhythmic, fast myoclonic jerks of the eyelids at the same time with an upward movement of the eyeballs and of the head. This can look like fluttering of the eyelids and simultaneous rolling back of the eyes. These seizures are typically very brief and occur many times a day. Mostly awareness is retained. UNKNOWN ONSETThis is a relatively new classification. There are seizures that cannot be clearly diagnosed as focal or generalised, and may even be considered both. The “Unknown Onset” classification is used when a seizure is unable to be classified due to either:
Unknown onset seizures are not truly separate types of seizures, but temporary labels for seizure types for which the onset is unknown. As more information becomes available over time or through further testing, the seizure type may be changed to a generalised or focal onset seizure. For instance a person reports having a tonic clonic seizure, but the start of the seizure was not seen. Therefore it is uncertain if it was a focal or generalised onset. Epileptic spasms are classified in unknown onset Epileptic spasms (which include infantile spasms) are seen in infants and appear like:
Each seizure lasts only a second or two but they usually occur in clusters, several in a row. Seizure classification chart What do seizures look like? (video) Epilepsy SyndromesWhat is a Syndrome?There are many different types of epilepsy classifications. Many people are now given a specific diagnosis or name for their epilepsy, rather than just told that ‘you have epilepsy’. Some types of epilepsy are further classified as syndromes and are defined based on a unique combination of symptoms. An epilepsy syndrome is a type of epilepsy that depends upon:
A diagnosis of a particular epilepsy syndrome is useful in deciding the possible treatment options, what course the condition may take, and the possible genetic risk of passing it on to offspring. Some types of epilepsy syndromes are:
and many more. More Information Not Your Everyday Epilepsy For more information and support about Epilepsy and Related Syndromes Epilepsy Syndromes Photosensitive EpilepsyWhat is photosensitive epilepsy?In some people, seizures can be triggered by flashing or flickering lights, or by certain geometric shapes or patterns. This is called photosensitive epilepsy. Some people with epilepsy only have photosensitive seizures, whilst others may have other seizure types as well as photosensitive seizures. This is a type of reflex epilepsy is seen in up to 5% of people with epilepsy, and because the seizures are usually triggered by some sort of visual stimulation, they can be reduced with simple avoidance strategies. Medication is usually used to help gain seizure control. Although prognosis is generally very good, photosensitive seizures may persist. How do I know if I have photosensitive epilepsy?It is important to have a clear diagnosis, and keep good records or a seizure diary to help differentiate the seizures and their triggers. Photosensitive epilepsy can be diagnosed by having a routine EEG with strobe (flickering) light or pattern stimulation. A routine EEG should include this. Today’s lifestyle can involve spending many hours using (visual) technology. While a seizure may occur in these conditions, it may also be a spontaneous or chance event – so don’t conclude your seizures are photosensitive seizures just because you had one or two when using technology. How is it treated?In most cases the photosensitive seizures can be well controlled by antiepileptic medication and avoiding known triggers. What are the triggers?Our modern environment is a rich source of potentially seizure-triggering visual stimuli. Typical sources can include:
Less common stimuli are:
New potentially provocative sources turn up now and then unexpectedly. What are other factors involved?Whether or not a photosensitive seizure happens is also influenced by:
Managing photosensitive epilepsyTypes of stimuli that may trigger a seizureAlmost all people with photosensitive epilepsy are sensitive to flickering lights. Many natural light sources can provoke epileptic seizures as well. With the increasing use of technology, there is more exposure to provoking factors (e.g. screen time, visual images and strobe lights) than ever before. Avoiding sources of triggers is the best advice. The following precautions only apply to those people who are diagnosed with photosensitive epilepsy. Television: There are many different types of screen technology, and modern television screens are much less likely to trigger seizures. An older cathode ray tube (CRT) TV created its picture with flicker and although not recommended, if you get very close to the screen you can see the flicker. Liquid crystal display (LCD) and plasma screen televisions do not use the scanning lines and therefore are less likely to trigger seizures than the older CRT televisions. Plasma screens tend to be brighter and have higher contrast than LCD televisions; this increased contrast may increase the risk of seizure activation. For people with photosensitive epilepsy, the current advice is to opt for an LCD TV over a plasma TV. It is important to keep a good distance from any screen because seizures may be provoked by images on the screen such as, flashing sequences or rapid changes from light to dark or to contrasting colours, such as from red to blue, rather than from the screen itself. So, the further away you sit from the screen, the less likely a seizure will occur.
Tips:
Video games: Apart from the screen display, the content and images of video-games are play a role in photosensitive seizures. Other factors that may play a role, particularly if the game is being played for a long time, include emotional excitement or tension, fatigue, eyestrain and difficulties sleeping, which can contribute to seizures. Also, people tend to sit closer to a video game screen than when watching a TV program. Tips:
Computer monitors: It is uncommon for a computer screen to trigger a seizure. Only in exceptional cases would it be necessary to restrict computer work. If you are sensitive to screen flicker on older monitors, a screen filter may help. You could always try an anti-glare filter to reduce screen glare. High quality monitors, liquid crystal or LCD screens with a flicker (refresh) rate of at least 60Hz may not pose a problem. Once again, it is more likely to be the images on the screen that may cause a seizure.
3D movies: There is much hype and concern about the effect of 3D movies being a seizure trigger, but this is not the case. In people with photosensitive epilepsy, the risks of a seizure being triggered by 3D movies is no greater than conventional 2D programs. For people with non-photosensitive epilepsy the risk of 3D movies triggering a seizure is negligible. Lights: The frequency of a flashing or flickering light most likely to trigger seizures will vary from person to person. Generally it is between 8-30 flashes per second, but this can vary. Many people seem to be sensitive around 15-20 flashes per second. Again, it is also dependent on the brightness and intensity of the light, and how long the person is exposed to it.
Fans: Ceiling fans in a lit room can create a flicker effect. A pedestal fan is best if you feel the ceiling fan may trigger a seizure. Geometric patterns: Some people are sensitive to geometric patterns which have strong contrasts of light and dark such as stripes or checks. Some of these patterns can create an optical illusion. Some buildings and public places may have large areas like this, such as carpet. The average person will just feel some visual distortion, but if you feel strange in this environment, it is important to leave or at least cover one eye. These patterns may also be on a television or computer screen, or something in the natural environment, such as sunlight through trees, or through Venetian blinds. Such contrasting patterns are more likely to be a trigger if they are moving, changing direction or flashing, rather than if they are still. Camera flashes: These rarely trigger seizures unless fired in rapid succession. Red flickering light and strobe/disco lights: These can trigger seizures, particularly if the room is darkened and there are other triggers such as stress, excitement, tiredness, sleep deprivation and alcohol. For those who are photosensitive, the risk will greatly depend on the speed of the flashing light. Tip:
Sunlight: This can trigger seizures in a number of ways such as: the shimmering of light off water or through leaves of trees, and light flickering through posts or railings when moving quickly, such as travelling past in a vehicle. Some people may even be affected by looking outside through a screen door. Tips:
TreatmentKnowing what sources may trigger your photosensitive seizures, and reducing your exposure to them plays a significant role in reducing or stopping this type of seizure. Many people still need medication, but try to: Tips:
These are general suggestions, and depending on your sensitivity, not all approaches may be necessary or effective. For more information go to:Factsheet: Photosensitive Epilepsy Reflex epilepsies Nocturnal Seizures – Seizures during SleepSleep and seizures – the facts
Why do so many seizures happen during sleep?Seizures during sleep can occur with any type of epilepsy. Some people have seizures occurring only during sleep whilst others have both daytime and night-time seizures. People who have only night-time seizures in their sleep are defined as having nocturnal epilepsy. The International League Against Epilepsy (ILAE) defines nocturnal seizures as ‘seizures occurring exclusively or predominantly (more than 90%) from sleep.’ It is estimated around 12 percent of people with epilepsy have nocturnal seizures. Why do nocturnal seizures occur?Epileptic seizures are often strongly influenced by the sleep-wake cycle. When we go off to sleep, we have a change of state – from awake to asleep. But during sleep, there are many changes of state, which are called sleep stages. It is thought that a change of state has an effect on the brains ‘epileptic activity’ in people with epilepsy. Some seizures occur predominantly at a certain stages of sleep. It’s believed that nocturnal seizures are triggered by changes in the electrical activity in your brain when moving between the different stages of sleep, and between sleep and awakening stage. As an example, in wakefulness, our brain waves remain fairly constant, but during sleep there are many changes. We go to bed and shift from
There are dramatic changes on EEG during these sleep stage changes. Stages of SleepSleep is divided into 5 stages: Non-REM Stages 1, 2, 3, and 4 and REM sleep. Seizures don’t seem to happen during REM sleep, but may occur at any other time during the sleep cycle, often in light sleep – that is, stages 1 and 2 of sleep. Nocturnal seizures can also occur when waking or stirring during the night. This generally means there are more common times at which nocturnal seizures happen:
Seizures that occur during sleep may also happen during a daytime nap – they are not limited to night time. Table 1 Stages of Sleep
Diagnosing nocturnal seizuresIt can be difficult to diagnose nocturnal seizures because they happen during sleep, and the person may not be aware of them happening. Also, nocturnal seizures, particularly focal seizures, can be confused with some sleep disorders. As with most other forms of epilepsy, a good history of the seizures, or even better, an eyewitness account is very important for diagnosis. The doctor may also suggest a video sleep EEG, often done during the day after being sleep deprived.
This can impact concentration, attention and learning as well as behaviour and emotions resulting in reduced quality of life. Are there specific types of epilepsy where people have nocturnal seizures?Nocturnal seizures can happen to anyone with epilepsy, but they are often associated with certain types of epilepsy, including:
Nocturnal seizures can be any type of seizures. Sometimes they are too subtle to detect. Can they change to daytime seizures?If a person has seizures only during sleep for several years, the chances of the seizures happening during wakefulness is small. However this does not mean daytime seizures won’t occur. For example, in situations of extreme stress, sleep deprivation or illness, medication changes or withdrawal, the risk of a seizure is increased, day or night. Daytime seizures may also occur if someone with nocturnal epilepsy decides to take a nap, or even becomes excessively drowsy during the day. With good seizure and lifestyle management however, the risks of a daytime seizure can be greatly reduced. How are they managed?
SUDEPSudden Unexpected Death in Epilepsy (SUDEP) is when a person with epilepsy dies suddenly and prematurely and no reason for death is found. SUDEP deaths are often unwitnessed with many of the deaths occurring overnight during sleep. There may be obvious signs a seizure has happened, though this isn’t always the case. Although the risk of SUDEP is very low, the risk increases for people with tonic-clonic seizures, especially if they happen at night or when asleep. Click here to take action against this risk We also have a SUDEP and Safety Checklist which your GP or Epilepsy Nurse can discuss with you. Practice good sleep habitsSome tips for getting a good night’s sleep include:
SafetyFor a person with nocturnal seizures, it is suggested:
For more information go to:Sleep and epilepsy – Neurologist Dr Dan McLaughlin speaks about epilepsy and sleep Factsheet – Nocturnal Seizures SUDEP Epilepsy and sleep apnoea The Impact of Sleep on the Body The Best Sleeping Position Sleep Health Seizure EmergenciesWhat are seizure emergencies?Most seizures last less than one or two minutes and stop on their own. Although many people with epilepsy have good seizure control, one in three people with epilepsy do not, and they continue to have seizures. Some people only have occasional seizures, but others may have frequent seizures. There are a small group of people with epilepsy who have severe or even life-threatening seizures. These seizures are considered an emergency because they can be longer than usual (prolonged seizures) or happen in short succession one after the other (cluster seizures) with little or no recovery in-between. Both of these situations can lead to a medical state called status epilepticus. All these situations are considered seizure emergencies and can lead to brain injury or even death if not treated quickly. What is status epilepticus?Status epilepticus (SE) is a prolonged or continuous seizure lasting longer than 5 minutes or seizure clusters (seizures occurring repeatedly) without full recovery in-between. Although any seizure type, convulsive or non-convulsive, can become status epilepticus, the convulsive (tonic-clonic) seizures are the most serious form and pose a greater risk of complications. Whatever the seizure type, SE is regarded as a medical emergency and can be life threatening or have long term consequences if it is not treated quickly. Studies show that it is unlikely that a prolonged or cluster seizures will stop after 5-10 minutes (without giving medication) and the best outcome is when an emergency seizure medication can be given as soon as possible. The sooner medication is given, the more likely the seizures are to stop and the better the outcome is for the person. This is why some people have medication prescribed to be given by caregivers, outside the hospital setting, before an ambulance arrives. Causes of Status Epilepticus [i]SE can happen in people with and without epilepsy. Sometimes it is the first seizure the person has ever had, sometimes it is caused by a medical condition, or it may happen in someone with epilepsy or an epilepsy syndrome. Up to 5% of adults and 10-25% of children with epilepsy will have one episode of SE. The main causes of SE are having epilepsy, febrile seizures, and stroke but there are many other causes, which include: [ii]
Effects of Status EpilepticusSE can happen with any seizure type, so it can be convulsive or non-convulsive. Symptoms will depend on the type of seizure and can range from appearing vague and confused (non-convulsive) to more serious muscle jerking (convulsive) and loss of consciousness. Short term effects can cause bodily changes which worsen the longer the seizures continue. These include increased blood pressure and heart rate, irregular heartbeats, and changes in blood sugar levels. The long-term effects of SE depend on the cause and how long the seizures continue. Seizures lasting longer than 60 minutes and are convulsive are linked with poorer outcomes. Some long-term effects of SE can include:
Medications for seizures outside the hospital settingEmergency seizure medications are prescribed for people who have had, or likely to have episodes of SE or prolonged or cluster seizures. These medications can be given in the community setting in an easy to administer route and work quickly with the intention to stop a seizure early to prevent complications before it progresses to SE.[iii] Outside the hospital setting, the medication is given either by drops or spray in the nose (intranasal), or in-between the teeth and cheek (buccal). When given this way, it is absorbed into the bloodstream through the mucous membranes. Because of the ease of administration, they can be given by family or caregivers in the community. These medications are usually benzodiazepines – a group of medications known as sedatives which have a calming effect on the brain. They are administered in a way that:
The aim of these medications for seizures, is to:
In many situations, early treatment outside the hospital setting can stop the seizures and prevent the progression into SE and the need for lengthy hospitalisation. [iv] The longer a seizure lasts, the harder it can be to stop. Since most seizure emergencies occur in the community, effective pre-hospital treatment relies on the use of fast absorbing and easy to administer drugs. Growing evidence supports the use of non-intravenous benzodiazepines in the out-of-the-hospital environment. Emergency seizure medications are usually very effective, but if they don’t work and seizures continue or complications occur, then emergency medical treatment will be needed at hospital. Having a plan for seizures and emergenciesThere is often the need to have a more formalised plan in place if a seizure occurs outside the home environment such as at school or in the workplace. These are often referred to as seizure management plans (SMP). A seizure management plan (SMP) is a document that provides essential information to anyone who may be able to assist someone having a seizure – whether that be family, friends, carers, teachers, colleagues or other involved professionals. It helps caregivers in all settings with quick access information about how to manage seizures and seizure emergencies, treatments, seizure first aid and safety specific to the person with epilepsy that they care for. This can help to lessen the impact of seizures on the person’s daily life and the risk of injury.
When someone is likely to have prolonged or cluster seizures, they will also have an emergency medication order and plan to accompany the seizure management plan. Your treating specialist will write up the emergency medication order, but if you need either of these documents – seizure management plan or an emergency medication plan – we can assist with this and offer the necessary training to caregivers or staff. If you want to learn more about seizure management planning, seizures, seizure emergencies or the administration of emergency medication for epilepsy, go to: Seizure Management Planning Education and Training References [i] Trinka, E., Cock, H., Hesdorffer, D., Rossetti, A.O., Scheffer, I.E., Shinnar, S., Shorvon, S. and Lowenstein, D.H. (2015), A definition and classification of status epilepticus – Report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia, 56: 1515-1523. https://doi.org/10.1111/epi.13121[ii] Sánchez, S., & Rincon, F. (2016). Status Epilepticus: Epidemiology and Public Health Needs. Journal of clinical medicine, 5(8), 71. https://doi.org/10.3390/jcm5080071[iii] Fedak Romanowski, Erin M. et al.(2020) Seizure Rescue Medications for Out-Of-Hospital Use in ChildrenThe Journal of Pediatrics, Volume 229, 19 – 25, Oct 2020 https://doi.org/10.1016/j.jpeds.2020.10.041[iv] Arzimanoglou, A., Lagae, L., Cross, J.H. et al. (2014) The administration of rescue medication to children with prolonged acute convulsive seizures in a non-hospital setting: an exploratory survey of healthcare professionals’ perspectives. European Journal of Pediatrics 173, 773–779 (2014). https://doi.org/10.1007/s00431-013-2255-5Shah, A., and Kelso, A. (2015) Treating status epilepticus in the community. Prescribing in practice. 5 September, pg 21-24. https://wchh.onlinelibrary.wiley.com/doi/pdf/10.1002/psb.1380 Accessed June 2021What is the drug of choice for the immediate treatment of status epilepticus?Diazepam. Diazepam is one of the drugs of choice for first-line management of status epilepticus.
What is the best treatment for status epilepticus?Refractory status epilepticus should be treated with a continuous infusion of an antiepileptic drug. Choices include an intravenous (IV) infusion of midazolam, pentobarbital, thiopental, or propofol (propofol infusion should not be used in children due to the risk of propofol infusion syndrome).
How is an acute seizure treated?Treatments include:. medicines called anti-epileptic drugs (AEDs). surgery to remove a small part of the brain that's causing the seizures.. a procedure to put a small electrical device inside the body that can help control seizures.. a special diet (ketogenic diet) that can help control seizures.. How are seizures treated in hospital?Antiseizure medicine may be used to treat a seizure lasting longer than five minutes or for multiple seizures. For a person with epilepsy, a Dignity Health neurologist will prescribe medications to prevent or reduce the frequency of seizures. For more severe conditions, electrical stimulation or surgery may be needed.
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