Understanding Seizures and Epilepsy: A Brief Guide by Dr. Ritesh Bhalla

Introduction

In a recent informative video, Dr. Ritesh Bhalla, Neurosurgeon at Lokmanya Hospital, sheds light on a commonly misunderstood condition—seizures, also referred to as fits, convulsions, or epilepsy. He clears up the confusion around these terms and provides insights into causes, symptoms, risk groups, and first-aid response.

What Happens During a Seizure?

Seizures are caused by abnormal electrical activity in the brain. This excessive synchronous activity may be localized or spread across the brain, leading to physical symptoms such as:

• Sudden shaking of hands and legs
• Loss of consciousness
• Falling down
• Tongue biting (which may lead to bleeding)
• Involuntary urination

Breathing may pause temporarily, reducing oxygen supply to the brain. If vomiting occurs and enters the lungs, it can lead to pneumonia.

Common Causes of Seizures

While seizures can occur due to structural or genetic brain issues, sometimes they are triggered by factors like:

• Sudden brain bleeding
• Electrolyte imbalances (e.g., low sodium)
• Lack of sleep
• Exposure to flashing lights
• Stress
• Genetic predisposition (especially with family history)

Age Groups at Higher Risk

• Seizures are more common in children and the elderly.
  Children (especially under 5): Risk is five times higher.
• Ages 5–20: Incidence typically reduces.
• Above 40 years: Risk increases again due to aging-related factors.

Difference Between Seizure and Epilepsy

• Seizure: A one-time event of abnormal brain activity.
• Epilepsy: Recurrent seizures over time (e.g., once 6 months ago and another now).

Warning Signs Before a Seizure – The “Aura”

Some individuals experience early signs known as "aura," which act as warnings:

• Stomach pain
• Numbness in hands or feet
• Visual flashes or blurriness
• These symptoms may help a person recognize an oncoming seizure.

First Aid During a Seizure

If someone is experiencing a seizure:

• Lay the person on their side to prevent choking.
• Never insert fingers or sharp objects into their mouth.
• If necessary, place the flat side of a spoon in the mouth to prevent tongue injury.
• Do not attempt to feed water immediately after the seizure.
• A nasal spray called Midazolam can be administered (one spray in each nostril) during active seizures for faster relief.

Precautions for People with Seizure History

• Get at least 8 hours of sleep
• Avoid flashing lights (e.g., in theaters)
• Avoid swimming or operating heavy machinery alone
• Always have a companion while driving
• Prefer sitting in the rear seat while traveling on two-wheelers

FAQs

1. What is the main cause of seizures?
Seizures are mainly caused by abnormal electrical activity in the brain. Triggers may include brain bleeding, stress, sleep deprivation, or low sodium levels.
2. What’s the difference between seizures and epilepsy?
A single episode is called a seizure, while repeated episodes over time are diagnosed as epilepsy.
3. Are seizures common in children?
Yes, children—especially under 5 years—are five times more likely to have seizures than adults.
4. Can epilepsy be genetic?
Yes, epilepsy can be hereditary if there is a history of seizures in first-degree relatives like parents.
5. What are aura symptoms?
Aura symptoms are early warning signs like stomach pain, numbness, or visual disturbances that occur before a seizure.
6. What to do if someone is having a seizure?
Lay them on their side, don’t insert anything sharp into their mouth, and if available, use a Midazolam nasal spray.
7. What precautions should epilepsy patients take?
They should get enough rest, avoid stress, stay away from flashing lights, and refrain from risky activities like swimming alone or driving unaccompanied.