Thanks to the work of our brain, we think, feel, hear and see. We can perform various motor activities, breathe and speak. The brain also regulates the work of other important organs, such as the heart or digestive system. In a person with epilepsy, there is a temporary disorder of these functions during an epileptic seizure. Then various symptoms appear unpleasant to the patient and usually visible to the environment.
An epileptic seizure comes suddenly and leaves no time for action. It disrupts other brain functions, causes loss of consciousness and loss of control over the body. How does it come about and what is it really like?
An epileptic seizure is an “electrical storm” in the nerve cells of the brain.
In a person who suffers from focal epilepsy, this electric storm usually begins with a group of neurons – an epileptic focus. The nerve cells of this foci begin to discharge, that is, they lose their normal negative potential. After that, the discharge is transferred to the next and subsequent neurons of the brain, causing in a person, who suffers a seizure, among other things:
- “Strange” sensations, such as feeling full in the stomach, feeling anxious, feeling that something has already happened or feeling disorientated.
- Autonomic symptoms such as rapid heartbeat, rapid breathing, goosebumps, fading or sweating of the face and body skin.
- Visual hallucinations, such as seeing colored circles.
- Sensory disturbances in the form of tingling of the skin on one side of the body, e.g. of the hand, face and tongue.
- Uncontrolled movements such as convulsions of the arm or leg or forced straightening of one limb.
Then discharge in the brain expands over the entire hemisphere, which leads to loss or reduced consciousness, when they can also occur:
- Various seemingly deliberate, but in fact automatic movements, performed unconsciously in the likeness of normal activities: for example, fastening the buttons of the shirt, reaching for a glass of water.
- Gibberish, repeating the same words or sentences.
- Violent movements, jerking, loud screaming.
When discharge already covers the entire brain, there is a loss of consciousness, loss of posture and epileptic seizure, which usually takes the form of a tonic-clonic seizure, that is:
- Severe contraction of all muscles, often with temporary respiratory arrest, screaming (in fact, it is a spasm of the larynx), bruising of the skin, unwiing urination and stool, tongue bite
- Rhythmic convulsions of the whole body
After an epileptic seizure, post-seizure confusion occurs, when the brain gradually regains its function. The person experiencing it may not remember what his\her name is, where he\she is and where he\she lives, nor does he\she know what happened just before, during and after the robbery.
People with generalised epilepsy, which is often genetically determined, usually suffer a seizure with complete loss of consciousness very quickly, without any warnings. This is because in these people the whole brain has a low convulsive threshold; for this reason, the seizure can begin anywhere in their brain and quickly spread to all of its cells.
The function of predicting “large” seizures is performed by myoclonuses, that is, rapid and violent tearing of the hands (and sometimes also the head and legs), which usually occur in the morning and are the result of short electrical discharges in the brain, as well as short “exclusions” of consciousness.
Both myoclonus and “shutdowns” should not be underestimated, because they testify to the readiness of the brain to provoke an “electric storm”, and their appearance can overtake the occurrence of the first tonic-clonic attack by up to several years.
Remember:
- Our brain is responsible for the proper function of other organs like the digestive system, respiratory system and heart.
- Thanks to the work of the brain, we think, speak, see and perform various motor activities.
- During an epileptic seizure, an “electrical storm” occurs in certain nerve cells, which quickly spreads to the entire brain.
- This “electric storm” disrupts normal brain function, causing a person suffering from seizures to experience motor, sensory and visual symptoms, as well as loss of awareness and consciousness.
Dr. Ewa Czapińska-Ciepiela is a scholarship holder of the Polish Neurological Society and Michael Foudation for Epilepsy, thanks to which she completed two clinical internships on the diagnosis and treatment of epilepsy in Austria, at the Christian Doppler Clinic in Salzburg. For many years she has been co-organizing the conference “Psychosocial Aspects of Epilepsy” in Krakow. She deals with patients suffering from epilepsy at the Epilepsy and Migraine Treatment Center in Krakow. He publishes articles for patients on the website www.okiemneurologa.pl.