February 4, 2020
Only a third of people who experience one seizure will have a second seizure in their lifetime. However, if two seizures occur more than 24 hours apart, the chance of another seizure rises to 76%, usually within a year.
Seizures are an excess of neurons firing in the brain, said Dr. Catherine Ikard, an assistant professor of neurology for the College of Community Health Sciences. In a presentation for the Mini Medical School program, a collaboration of the College and The University of Alabama OLLI program, Ikard explained that epilepsy is a problem with brain function that causes unprovoked seizures on more than one occasion.
“You can have seizures and not be epileptic,” Ikard said. “Epilepsy can present as different types of seizures as well.”
Ikard also cares for patients at University Medical Center, which the College operates.
The diagnosis of epilepsy is largely clinical with supporting evidence from MRI and EEG testing. Patient history is the foremost factor in the diagnosis process. Imagining can help, but it is unreliable and sometimes shows no abnormalities, Ikard said.
There are many classifications and terms for seizures, some meaning the same thing. There are two overarching categories of seizures – focal onset and generalized onset. Generalized onset involves both sides of the brain and is always accompanied with impaired awareness. Focal onset seizures can either be simple, partial or complex partial, said Ikard.
“With partial, the person is aware and awake during the seizure,” Ikard said. “In complex, they lose that time. They have impaired or no memory of it.”
Seizures can differ greatly across patients and any part of the brain can be affected, so it’s important to seek the help of a neurologist if there are any unusual behaviors that appear out of character or out of the norm, Ikard said.
“In young children it becomes even harder to tell,” she said. “They can’t tell you something is wrong, or they are losing moments of time.”
Ikard said that in Tuscaloosa, with a large population of college students, she often sees recurring seizures that haven’t been noticed before because they are a type that occurs only near waking. The seizures are exacerbated in college from lack of sleep, poor diet and alcohol consumption, which can all trigger a seizure in a patient who is prone to them.
Ikard said most importantly, if someone is having a seizure, don’t do what movies show. Don’t hold the person down, it could hurt them; don’t put something in their mouth. Help them to lie flat, put a pillow or rolled up jacket under their head to prevent injury and have them on their side in case they vomit.
The Mini Medical School program has been put on by faculty and resident physicians of the College since 2016. It provides an opportunity for adults and community learners to explore trends in medicine and health, and the lectures offer important information about issues and advances in medicine and research.