Generalized seizures
Generalized seizures are a common type of seizure in which abnormal electrical impulses affect the whole brain, temporarily preventing it from carrying out its usual function. These are different from another type of seizure known as focal (or partial) seizures where only a part of the brain is affected.
Symptoms of generalized seizures can vary, and may cause someone to lose consciousness, their bodies and limbs may become rigid and they may have jerking movements. Afterwards, they may feel very sleepy and take some time to regain their full level of consciousness.
Epilepsy is the most common condition causing seizures – around 1% of the US population has it - and is diagnosed if you suffer persistent seizures and are likely to continue getting seizures. Anti-epileptic medication is available to reduce the chance of future seizures.
There are 6 main types of generalized seizures:
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Absences. These mainly affect children (but can occur in adults) and cause the person to become unaware of their surroundings, sometimes looking as if they are staring into space or daydreaming. This typically lasts for 10-15 seconds and afterwards they have no memory of the event, which can happen several times a day. This means that things like school performance and tasks such as crossing the road can be affected.
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Myoclonic seizures. This type of seizure often happens in the hours after waking, and causes the body and limbs to twitch for a few seconds. You remain awake the whole time if this occurs.
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Clonic seizures. The symptoms here are the same as with myoclonic seizures but they last longer – for a minute or two – and you can lose consciousness with this type of seizure.
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Atonic seizures. These are sudden and cause all the body muscles to instantly relax, meaning you can fall to the ground without warning.
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Tonic seizures. In this type, unlike with atonic seizures, all the muscles of the body suddenly become very stiff. This means you can also fall to the ground suddenly as a result of losing your balance.
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Tonic-clonic seizures. This is the type of seizure that most people would call ‘an epileptic fit’ and has two stages. First, the body becomes very stiff, and this is followed by generalized twitching of the arms and legs, sometimes with incontinence of urine (wetting yourself). It causes you to become unconscious, and usually lasts a minute but sometimes longer.
People may have warning signs that a seizure is about to happen and this is called an aura. This is because abnormal electrical activities can start in one part of the brain before spreading to the whole brain.
If seizures last longer than 5 minutes this is a medical emergency and you need to call 911 for urgent medical attention. If this is a first seizure for someone, they should also get an ambulance to the hospital urgently.
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What triggers a seizure
Many people who have seizures can’t identify any particular triggers, but others can be sensitive to certain conditions – either within themselves or the environment – that make a seizure more likely. Poor sleep, stress, certain medications, alcohol and street or party drugs and flashing lights are all well-known triggers for a seizure.
Keeping a diary can be helpful in identifying potential triggers.
What causes generalized seizures?
Epilepsy is the condition that causes most seizures. Other conditions that can put you at higher risk of developing seizures include head injuries, infections of the brain such as meningitis, brain tumours or a stroke.
Serious events at birth, such as the brain being deprived of oxygen briefly, can result in seizures. Seizures can develop at any age, but most start in childhood or in those over 60. There can also be a family link, with you being more likely to develop epilepsy and seizures if a close family member also suffers from it.
What will my doctor do?
If this is your first seizure, it’s important to tell your doctor what led up to the seizure, what you were doing at the time, what any witnesses said they saw, and how you felt afterwards. You may not be able to give an accurate account, as memories are usually wiped out during and after any seizure.
Your doctor will also be concerned as to whether you injured yourself during the seizure, for example, in falling to the ground. It’s important your doctor counsels any family members about how to keep you safe during any future seizures.
You will be referred urgently to a clinic where a specialist neurologist will investigate you further by organizing EEG and further imaging of the brain.
While being investigated and pending a diagnosis, for your own safety and that of others, you should not drive or operate heavy machinery, in case you have another seizure at a critical time. Similarly, you will be advised not to go swimming or bathing alone, for fear of drowning.
Am I fit for work with generalized seizures?
Your doctor will help you determine if you are fit for work based on the activities required.
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