Introduction to Fits (Seizures): Warning Signs

What is Fits?

Fits are sudden, uncontrolled electrical disturbances in the brain. It can cause changes in your behavior, movements, feelings, and levels of consciousness. If you have two or more fits or a tendency to have recurrent fits, you have epilepsy.

There are many types of fits, which range in severity. Fit types vary by where and how they begin in the brain. Most fits last from 30 seconds to two minutes. A fit that lasts longer than five minutes is a medical emergency.

Fits are more common than you might think. Fits can happen after a stroke, a closed head injury, an infection such as meningitis, or another illness. Many times, though, the cause of fits is unknown.

Most fit disorders can be controlled with medication, but the management of fits can still have a significant impact on your daily life. The good news is that you can work with your healthcare professional to balance fit control and medication side effects.

Types of Fits

The International League Against Epilepsy (ILAE) introduced updated classifications in 2017 that better describe the many types of fits. The two major types are focal onset fits and generalized onset fits.

Focal Onset Fits:

• Impaired Awareness:Involves changes in consciousness, such as staring into space or performing repetitive movements.
• Without Loss of Consciousness:Alters emotions or sensory perceptions without loss of consciousness, which may involve involuntary jerking or sensory symptoms.

Generalized Onset Fits:

• Tonic-Clonic (Grand Mal):Involves muscle stiffening followed by jerky movements, often leading to loss of consciousness.
• Absence (Petit-Mal):Brief episodes of blinking or staring into space.
• Atonic (Drop Attacks):Sudden loss of muscle tone, leading to falling or nodding of the head.
• Clonic:Characterized by rhythmic muscle jerks, typically affecting the neck, face, and arms.
• Myoclonic:Sudden, brief jerks or twitches of arms and legs.

Unknown Onset Fits:

Occur when the beginning of a fit is not observed, often waking up to witness the fit, and are classified due to insufficient information about the onset.

What Are the Main Causes of Fits?

Neurons in the brain create, send, and receive electrical impulses, which allow the brain's nerve cells to communicate. Anything that disrupts these communication pathways can lead to fits.

The most common cause of fits is epilepsy. But not every person who has fits has epilepsy.

Sometimes fits happen because of:

• HighFever, which can be associated with an infection such as meningitis
• Lack of sleep
• Hyponatremia, which can happen with diuretic therapy
• Medications, such as certain pain relievers, antidepressants, or smoking cessation therapies, that lower the seizure threshold
• Head trauma that causes an area of bleeding in the brain
• Stroke
• Brain tumor
• Illegal or recreational drugs, such as amphetamines or cocaine
• Alcohol abuse, during times of withdrawal or extreme intoxication
• COVID-19

When to See a Doctor for Fits?

Seek immediate medical help if any of the following occurs:

• Fits last over five minutes
• Breathing or consciousness doesn't return after the fits stop
• A second fits follow immediately
• You have a high fever
• You are experiencing heat exhaustion
• You are pregnant
• You havediabetes
• You injure yourself during fits

Diagnosis of Fits

The Doctor will examine you and will ask questions related to your medical history and symptoms.

Doctors can have difficulty diagnosing seizure types. They might recommend certain tests to diagnose a seizure accurately and to help ensure effective treatment.

Your doctor will consider your full medical history and the events leading up to the seizure. Conditions such as migraine headaches,sleep disorders, and extreme psychological stress can cause seizure-like symptoms.

Lab tests may help your doctor rule out other conditions that can cause seizure-like activity. The tests may include:

• Blood testing to check for electrolyte imbalances
• Aspinal tap to rule out infection
• Atoxicology screening to test for drugs, poisons, or toxins

Anelectroencephalogram(EEG) measures brain waves and helps diagnose seizures by observing brain wave patterns during an episode.

Imaging scans such as CT scans or MRI scans provide detailed brain images, helping detect abnormalities like blocked blood flow or tumors.

Treatment of Fits

Not everyone who has one fit will have another one, and because fits can isolate an incident, your doctor may not decide to start treatment until you've had over one.

The optimal goal in fits treatment is to find the best possible therapy to stop fits, with the fewest side effects.

Medication for Fits

Treatment for fits often involves the use of anti-fit medications. Several options exist for anti-fit medications. The goal is to find the medicine that works best for you and has the fewest side effects. Sometimes, your doctor might recommend more than one medication. Finding the right medication and dosage can be complex.

Your doctor will consider your condition, your frequency of fits, your age, and other factors when choosing which medication to prescribe. Your doctor will also review any other medications you may take, to ensure the anti-epileptic medications won't interact with them.

Surgery and Other Therapies

• Surgery:The goal of surgery is to stop fits from happening. Surgeons locate and remove the area of your brain where the fits begin.
• Vagus nerve stimulation:A device implanted underneath the skin of your chest stimulates the vagus nerve in your neck.
• Responsive neurostimulation:A device implanted in the brain detects fit activity and delivers electrical stimulation to stop fits.
• Deep brain stimulation:Electrodes are implanted to regulate brain activity using electrical impulses.
• Dietary therapy:A ketogenic diet or variations like the modified Atkins diet may reduce the frequency of fits.

Pregnancy and Fits

Women who've had previous fits typically can have healthy pregnancies. However, some medications like valproic acid may cause birth defects. Consult your doctor before and during pregnancy.

Contraception may also be affected by anti-fit medications, so check with your doctor for alternatives.

Home Remedies

• Take medication correctly
• Get enough sleep
• Wear a medical alert bracelet
• Be active and hydrated
• Make healthy lifestyle choices

Personal Safety

• Don't swim alone
• Wear a helmet for risky activities
• Take showers instead of baths
• Use safety furnishings
• Display first-aid instructions visibly

Fits First Aid

• Roll the person onto one side
• Place something soft under their head
• Loosen tight clothing
• Do not put anything in their mouth
• Do not restrain the person
• Clear away dangerous objects
• Stay with the person until help arrives
• Observe and record the duration of the fits