Earlier this week, Commerce Secretary John Bryson resigned sighting his seizure problems (he allegedly committed two hit and runs while seizing) and was leaving his office to seek treatment. So the next time I get caught running someone over in Grand Theft Auto and I can’t make it to the car garage, I’ll be sure to tell police I had a complex partial seizure and they’ll let me off the hook, right?…that was a joke, just fyi. People being run over in Grand Theft Auto is a serious problem.
Although people often associate seizures with violent thrashing, seizures come in several forms of unusual physical effects. About 4% of people experience an unprovoked seizure by the time they’re 80. Out of those people, 30 to 50% of them will experience a second seizure. Seizures can produce a wide variety of effects from violent thrashing to deja vu to paralysis and syncope (fainting). There are several different kinds of seizures, both epileptic and non-epileptic.
Epileptic seizures occur where there is access number of neurons sending off electrical signals in the brain. There are several different speculations as to why seizures occur but there is no cure for epilepsy. About 50 million people worldwide suffer from epilepsy and 90% of those people live in developing countries. Some cases of epilepsy, such as photo-epilepsy, seizures brought on by bright or flashing lights, can be controlled. Most epileptic seizures occur without warning and can lead to serious injury depending on the environment the seizure is taking place in.
Types of Seizures
Seizures are classified by two categories, location of neural activity and whether or not syncope occurs. If the electrical activity is localized to a specific area of the brain it is a partial seizure. If the activity is widely distributed it is a generalized seizure. If loss of consciousness does not occur it is a simple seizure, otherwise it is a complex seizure. If a partial seizure develops into a generalized seizure, it is then classified into one or more categories: abscence (short, 20-second syncope), myoclonic (twitches or jerks), clonic (muscle contractions or relaxations), tonic (sudden, rigorous, and extreme contractions), tonic-clonic (tonic stage with violent shaking after), and atonic (loss of muscle tone). Those six categories only apply to generalized seizures.
In the case of John Bryson, he suffered a complex partial seizure, meaning the area of activity was localized and he experienced syncope. It is unclear what part of the brain it affected, though. The type of seizure most people define as a “seizure” and is featured the most on medical shows is a complex generalized tonic-clonic seizure.
Causes of Epilepsy
The most common cause of epilepsy in people under 18 is an infection in the Central Nervous System or a congenital defect. As people age, the chances of developing epilepsy grow because there are more potential causes such as stress, trauma, brain tumors, drug or alcohol withdrawal, and cerebrovascular disease (a condition that limits blood supply to the brain).
However, the most severe and uncontrollable cases of epilepsy are the result of a genetic mutation. When your brain sends an electrical signal, it uses sodium and calcium to deliver the electric charge. When this genetic mutation occurs, the sodium gates stay open for too long and causes the release of glutamate, a transmitter that makes the nerves hyper sensitive. The release of too much glutamate results in the release of Calcium molecules that carry an electric charge. The nerves get overloaded with signals and thus a seizure occurs.
The most modern medicine suggests that people who are susceptible to epilepsy have a weak blood-brain barrier, a sheath that separates the blood vessels in the brain and the raw brain matter. It moderates the transportation of proteins to neurons and prevents pathogens from destroying neural matter. Most of the anti-seizure medications available are used to help the blood-brain barrier function. These anticonvolusant medications do carry side effects, however.
In severe cases of epilepsy, for people who experience over 4 seizures a day, surgery may be the only way to treat seizures. A lobectomy, the removal of one of the lobes of the brain (usually the temporal), might be necessary. In children 2-5, a hemispherectomy, the removal of the entire left or right hemisphere, is also an option. Most seizure activity stems from the hippocampus, a portion of the brain that separates short term and long term memory and is also responsible for spacial recognition. A hippocampectomy is shown to be effective for those kind of seizures. Other methods such a deep brain stimulation, vagus nerve stimulation, and radiation treatments are known to reduce or remove seizure activity. However, some surgical options are only used as a last resort effort and carry high risks.
Difference Between Epilepsy, Non-epileptic Seizures, and Provoked Seizures
Many people are diagnosed with epilepsy even when the do not have a seizure disorder. There are several different kinds of episodes that may look like epileptic seizures but are not, or there are seizures that have a treatable outside cause. Provoked seizures are often caused by other medical conditions including dehydration, sleep deprivation, a cavernous malformation, infection and fever, withdrawal, metabolic disorders, head injuries, and more. These types of seizures usually occur once and are often caught by doctors. If you or someone you know experiences a seizure and you think there might by an underlying cause, alert a doctor of any potential physical abnormality. Don’t ever assume it’s epilepsy.
Non-epileptic seizures are episodes that often mimic epilepsy. It is more common for children to be misdiagnosed than adults. About 40% of children who suffer non-epileptic seizures are misdiagnosed with epilepsy. In adults, the figure is around 26%. They are caused by pathophysiological effects including vertigo, repetitive behavior, tics, migraines, night terrors, CNS lymphoma, and more. Most of these conditions can be treated or even cured, either with medicine or some sort of psychological therapy.
What happens if you or someone you know has a seizure.
If you’ve been diagnosed with epilepsy or are known to be prone to experience seizures, make sure your close friends and family know proper protocol. If someone experiences a seizure and they lose consciousness, call 9-1-1 immediately. If the person is thrashing and moving violently, do not attempt to stop them from moving. Move any objects he/she could hit out of range and put your hands around the head to attempted him/her from sustaining a head injury.