Seizure Disorder

Seizure Disorder: Overview

A seizure disorder includes any condition in which there are repeated episodes of seizures of any type.  In the brain, neurons must be timed correctly to control body movements and keep organs functioning correctly.  When neurons misfire, a seizure occurs which can influence a person's consciousness, movement or actions.  Usually, this state exists for just a few moments before everything appears to return back to normal.  A seizure disorder affects about 0.5% of the population; a single seizure does not mean that someone has epilepsy. Psychomotor epilepsy is also known as temporal lobe epilepsy or complex partial seizures.  Epilepsy is a chronic brain disorder in which the electrical activity of the brain is periodically temporarily interrupted resulting in a seizure.

Epilepsy, also called idiopathic seizure disorder, is a common cause of seizures and is characterized by seizures of any type that occur on a chronic, recurrent basis that cannot be attributed to any other cause.

Disorders that may cause symptoms resembling seizures include transient ischemic attacks, rage or panic attacks, and any disorder that causes loss of consciousness or that causes tremors or tics as symptoms (abnormal muscle movements that are not caused by abnormal brain electrical activity).

Incidence; Causes and Development

Epilepsy affects people in all nations and of all races.

While epilepsy may be caused by some original injury, that injury is usually unknown.

Known causes of seizures include:

  • High fever in children
  • Metabolic abnormalities found in diabetes mellitus, electrolyte imbalances, kidney failure, uremia, nutritional deficiencies and phenylketonuria (PKU)
  • Alcohol and drug use or withdrawal
  • Hormone changes experienced during pregnancy and menstruation
  • Brain injury.  May affect any age, but the highest incidence is in young adults.  Seizures usually begin within 2 years of the injury.  Early seizures (within 2 weeks of injury) do not necessarily indicate that chronic seizures (epilepsy) will develop.
  • Congenital defects and birthing injuries.  Seizures usually begin in infancy or early childhood.
  • Tumors and brain lesions that occupy space.  These are more common after age 30.They may begin as partial seizures and progress to generalized tonic-clonic seizures.
  • Degenerative disorders such as senile dementia which affect older people.
  • Infections of the brain, any severe infection of any part of the body, and chronic infections such as neurosyphilis and AIDS.
Seizures can sometimes be triggered by an illness or by sensory stimuli such as lights, sounds or touch.  The amount of stimulation required to cause a seizure is called the seizure threshold.  Many people with epilepsy are considered to have a low seizure threshold, whether or not their seizures are stimulated by external influences.

Signs and Symptoms

Epilepsy may involve non-specific symptoms and/or signs that may occur along with the seizures, including headache, changes in mood or energy level, dizziness, fainting, confusion or memory loss.  An aura – a sensation indicating a seizure is imminent – may occur in some persons just prior to a generalized seizure.

There are over 30 different types of seizure and each type has its own characteristics.  Seizures are classified as either generalized or partial depending upon how much of the brain is affected.  Generalized seizures are divided into tonic-clonic and absence seizures.

Generalized – Tonic-clonic seizures (also known as grand mal seizures) have these characteristics:

  • they last 1 to 5 minutes
  • they involve the entire body with falling, stiffening and jerking
  • the person may cry out
  • there may be tongue biting
  • the sufferer may become bluish through lack of oxygen during the seizure
  • the sufferer may urinate or have a bowel accident during the seizure
  • tiredness will usually result.
A prolonged seizure is dangerous because during its course the brain does not get enough oxygen, blood or other nutrients.  A clonic-tonic seizure lasting longer than 10 or 15 minutes can be considered a medical emergency.

Generalized – Absence seizures (also known as petit mal) have these characteristics:

  • they last a few seconds
  • there may be a staring spell and/or eye blinking
  • the sufferer may appear to be day dreaming
Partial – Complex seizures have these characteristics:
  • they last 1-2 minutes
  • the sufferer appears to be engaged in purposeless activity
  • consciousness may be impaired
  • the sufferer may appear confused, drunk or drugged
  • the sufferer may fidget with clothing
  • the sufferer may smack their lips
  • if restrained, they may struggle.
Partial – Simple seizures are characterized by:
  • the jerking of one limb or one side of the body
  • the patient usually remaining conscious
  • the patient perhaps saying that they are having a seizure.
Psychomotor epilepsy has cyclical phases.  The pre-seizure stage can last for hours or up to seven days with symptoms of moodiness, depression, anxiety or constant low-level anger, irritation, or annoyance, accompanied by general unhappiness and constant arguments.

The seizure stage of 60 to 90 seconds can include misperceptions of the environment, hallucinations, and bizarre sensations.  Between seizures, personality is affected by excessive, tangential speech, overly emotional feelings, and lack of sexual desire.  Under physical or emotional stress, psychotic episodes can occur.

Diagnosis and Tests

The diagnosis of epilepsy and/or seizure disorder involves noting down a careful history of seizure activity.  A physical examination, including a detailed neuromuscular examination, may be normal or may show localized abnormalities of brain function.  An electroencephalograph (EEG), a reading of the electrical activity in the brain, usually confirms the presence of various types of seizures and may indicate the location of the lesion.

Treatment and Prevention

According to the Epilepsy Foundation of America seizures can be successfully controlled by appropriate medication and treatment in about 85% of cases.  Serum carnitine levels should be monitored in children treated with antiepileptic drugs.  As children treated with Dilantin, Tegretol or phenobarbital experienced significant declines in total carnitine levels.  [J Child Neurol 1998;13: pp.546-9]

References and Further Information

New York University Comprehensive Epilepsy Center: The largest epilepsy program in the Eastern United States, offering testing, evaluation, screening, treatment, drug trials, alternative therapies and surgical intervention for children, adolescents, and adults with all forms of epilepsy.

Conditions that suggest Seizure Disorder:

Symptoms - Mind - General

Risk factors for Seizure Disorder:

Autoimmune

Gluten Sensitivity / Celiac Disease may increase risk of Seizure Disorder Gluten Sensitivity / Celiac Disease

Blood tests for gluten sensitivity antibodies were performed on 783 patients referred for seizures.  In 36 patients who also had clinically evident celiac disease, no further seizures were noted after treatment with a gluten-free diet.  In a second group of 9 patients, celiac disease was not recognized because of mild or absent symptoms, but the diagnosis was confirmed by jejunal biopsy.  [Lancet 1992;340: pp.439-43]

Environment / Toxicity

Nutrients

Manganese Requirement often increases risk of Seizure Disorder Manganese Requirement

At least six different studies have confirmed confirmed that people who experience seizures have below normal manganese levels.  Epileptics have low whole blood and hair manganese levels, and those with the lowest manganese levels typically have the highest seizure activity.

Symptoms - Mind - General

Tumors, Malignant

Leukemia often increases risk of Seizure Disorder Leukemia

Seizures can occur due to involvement of the central nervous system in ALL and AML.

Seizure Disorder could instead be:

Mental

Schizophrenia is very occasionally misdiagnosed as Seizure Disorder Schizophrenia

Not all seizures are jerking motions.  In psychomotor (mind-motion) epilepsy the seizures are manifested in personality, emotional, thinking, and behavioral changes.  This condition is very likely to be misdiagnosed as a mental disorder.  People with psychomotor epilepsy have been given schizophrenia, manic depressive, depression, attention-deficit disorder, and other diagnoses.

Recommendations for Seizure Disorder:

Amino Acid / Protein

L-Taurine often helps with Seizure Disorder L-Taurine

Taurine is an inhibitory neurotransmitter, its main use being to help treat epilepsy and other excitable brain states.  Research shows low taurine levels at seizure sites and its anti-convulsant effect comes from its ability to stabilize nerve cell membranes, which in turn prevents the erratic firing of nerve cells.  Taurine functions as a mild sedative; doses for this effect are 500mg three times daily.

Botanical

Marijuana may help with Seizure Disorder Marijuana

October 5th, 2003: Researchers from the Max-Planck Institut in Munich, Germany, have found that natural brain chemicals which resemble cannabis extracts can interrupt a process which can trigger a seizure.  There have been trials of cannabis compounds in MS and cancer patients, as well as reports dating back to the 15th century of the use of cannabis to ease the symptoms of epilepsy.  However, there have been few organised trials in humans in recent years, even though cannabis or its extracts are being evaluated in trials against several other illness.

Diet

High/Increased Fat Diet often helps with Seizure Disorder High/Increased Fat Diet

The ketogenic diet has been in use and discussed in medical literature since the 1920s.  It was replaced when the modern anti-convulsants became available, even though it has a very good success rate at controlling seizures.  In some cases it is actually better than drugs at controlling seizures, having a success rate of 75%.  Seizures are stopped in 50% of cases and reduced in 25%.

A ketogenic diet is one that is high in fat, low in carbohydrate and protein.  This diet produces circulating ketones and a state called ketosis, where ketones are found in the urine.  Ketones, like glucose, are burned for energy, but indicate that either fat is being taken from body fat stores or dietary fat intake is high.  In attempting seizure control, this ketotic state exerts an anti-epileptic effect but its mechanism of action is not completely understood.

The ketogenic diet is used to treat intractable epilepsy in children.  It may be prescribed when seizures are out of control, and when the side-effects of anticonvulsant drugs and/or surgery are considered unacceptable.  The diet is safe, with rare side effects only when not strictly followed.

Most kids can stay on the diet for two years, get off it and never have another seizure again.  The diet works best in children under the age of ten: they are less likely to cheat and young children can maintain ketosis better than adults or older children.

The diet mimics the effects of starvation.  It has long been known that fasting has a beneficial effect on seizure control.  Doctors at the Mayo Clinic came up with a way to induce the effects of starvation (fat burning, ketosis and a change in blood pH levels) by feeding the patient large quantities of fat and limiting protein and carbohydrate.  The diet has to be rigidly controlled as any deviation can throw the patient out of ketosis and produce a seizure.

Most people investigate this diet as a last resort.  The diet is unpalatable and demands great commitment from the entire family for a considerable period of time.  The diet is deficient in many vitamins and in calcium, so a good (carbohydrate-free) vitamin supplement is important.

For those interested in more information, The Ketogenic Diet: A Treatment for Epilepsy by J.  Freeman (2000) is often recommended.

Aspartame (Nutrasweet) Avoidance may help with Seizure Disorder Aspartame (Nutrasweet) Avoidance

In 1984, there were 3 reports about large amounts of Aspartame causing a lowering of the seizure threshold and therefore increasing seizure activity.  The Center for Disease Control in Atlanta did a review of this and were unable to find any cause or effect relationship at normal doses.  More recently, Aspartame has been found to be unsuitable for some children with generalized absence Epilepsy.  A Queen's University study looked at the brain-wave patterns in 10 children and the effects of the artificial sweetener "NutraSweet".  A 40% increase in abnormal brain-wave activity associated with absence seizures was found in this study.  However, there was no effect on the actual number of seizures.  Research on this topic is continuing.

Not recommended
Increased Water Consumption is sometimes not recommended for Seizure Disorder Increased Water Consumption

Studies show that water intoxication increases susceptibility to seizures even in normal individuals.  Through a complex process, excessive water intake can lower sodium content in body fluids and predispose one to seizures.

Drug

Not recommended

Hormone

Melatonin is highly recommended for Seizure Disorder Melatonin

In a preliminary study, 6 children with severe intractable seizures were given a 3mg tablet of melatonin 30 minutes before bedtime in addition to their usual anti-seizure medication for three months.  A reduction in seizure activity, particularly during the night, was experienced by 5 out of 6 starting 3 days after treatment began.  The mean seizure rate decreased from 3.6 per day to 1.5 per day.  According to the parents, daytime behavior also improved.  This therapy should be monitored closely as a previous study with melatonin found increased seizure activity in some children.  [Epilepsia 2001;42: pp.1208-10]

Lab Tests/Rule-Outs

Test for Manganese Levels may help with Seizure Disorder Test for Manganese Levels

Sohler (1979) compared blood manganese (Mn) levels in a group of patients with seizure activity to those in a control group.  Blood Mn levels from control subjects had a mean of 14.8ng/gm (ppb).  The blood Mn levels were significantly lower in the patients with seizure activity, at 9.9 +/- 4.9ng/gm, p < 0.005).  In uncontrolled trials several doctors found that Mn is helpful in controlling seizures of both minor and major types. 

In one case report, a twelve-year-old boy with poorly controlled epilepsy experienced a reduction in seizure frequency after receiving 20mg per day of manganese.  Although this research is encouraging, it must still be considered preliminary.

Mineral

Magnesium may help with Seizure Disorder Magnesium

Through its nerve- and muscle-relaxing effect, magnesium may be helpful in reducing epileptic seizures caused by nerve excitability.

Nutrient

TMG (Tri-methyl-glycine) may help with Seizure Disorder TMG (Tri-methyl-glycine)

TMG has been noted to reduce seizure activity in some individuals.

Not recommended

KEY

Weak or unproven link: may increase risk of; is very occasionally misdiagnosed as
Weak or unproven link:
may increase risk of; is very occasionally misdiagnosed as
Strong or generally accepted link: often increases risk of
Strong or generally accepted link:
often increases risk of
Definite or direct link: strongly suggests
Definite or direct link:
strongly suggests
May be useful: may help with
May be useful:
may help with
Moderately useful: often helps with
Moderately useful:
often helps with
Very useful: is highly recommended for
Very useful:
is highly recommended for
Caution: is sometimes not recommended for
Caution:
is sometimes not recommended for
Often counterindicated: is often not recommended for
Often counterindicated:
is often not recommended for
Should be avoided: is NOT recommended for
Should be avoided:
is NOT recommended for