• Posted November 2, 2023

Could You Recognize the More Subtle Signs of a Seizure?

A seizure doesn't always look like what you see in the movies, but a new survey finds most Americans don't know what the more subtle signs of seizures are.

“Anything that interrupts your brain's circuit can cause seizures, from tumors, infections and strokes to high or low blood sugar, or glucose levels, to inherited genetic features. And different types of seizures can present with dozens of different symptoms,” said Dr. Dipali Nemade. She is a neurologist at the Orlando Health Neuroscience Institute.

“But because they often look different than those 'cinematic seizures' we see in movies and television, they can go undiagnosed for a long time,” Nemade added.

The standard mental picture of a seizure is someone falling to the ground with full body convulsions, which can be what a generalized tonic-clonic seizure looks like.

A new national survey by Orlando Health found most Americans recognize these symptoms. Yet only 32% believe numbness or tingling signals a seizure, while about 35% think of blinking rapidly as a sign. Meanwhile, roughly 13% see crying out or screaming as a seizure symptom, while just 6% think of laughing as such.

Pay attention to any odd behaviors and address them with your doctor, Nemade suggested.

“Even seizures with these less dramatic symptoms can make everyday activities like driving and cooking dangerous,” she said in an Orlando Health news release.

"For some people, their seizures present outwardly, with very subtle signs like smacking their lips, picking at their clothes or just staring into space, and it's important to recognize when you or someone around you is experiencing them so they can be accurately diagnosed and treated," she said.

“By looking at their brainwaves (EEG), we can see if those behaviors are being caused by seizures,” Nemade explained.

One patient, Mike Sail, described his seizures as a flushed feeling that travels from his abdomen to his throat. That is followed by raised arm hair.

His condition was initially misdiagnosed as acid reflux, until he lost his memory for an entire week. Sail was then referred to Nemade, who diagnosed his condition as epilepsy.

“I kept saying that it can't be acid reflux because that doesn't cause the hair on your arms to stick up,” Sail said.

“For the most part, these episodes were not very disruptive. They only lasted a minute or two and usually only happened once every few weeks. Sometimes I'd have them while I was doing things like playing golf, and afterwards I would just go about my business. So, I was shocked to find out they were seizures because it wasn't what most people think a seizure looks like,” Sail explained.

Now, Sail's epilepsy is well-controlled with antiseizure medication, lifestyle changes and adequate sleep. He no longer fears that uneasy feeling he gets before having what he now knows were seizures.

Nemade said education is needed to help others like Sail know to get help if they're having unexplained symptoms regularly.

“If people don't know that these symptoms can be caused by epileptic seizures, their condition will be misdiagnosed or ignored, and it will continue to affect their quality of life. That can be very isolating and frustrating, which is why many people with uncontrolled epilepsy experience anxiety and depression,” Nemade said.

“Too many people never go to the doctor because they don't feel like it is profoundly affecting their lives, or they don't know how to explain what they're feeling,” she added.

Rarely, epilepsy can be resistant to antiseizure medication.

One alternative is intracranial monitoring and mapping the brain to find the exact spot where seizures are originating and removing that small piece of tissue.

If surgeons can't remove the tissue safely, then neurostimulation, deep brain stimulation and vagus nerve stimulation are effective options.

These treatments can prevent sudden unexpected death in epilepsy, which kills about 3,000 people in the United States each year.

If you suspect someone is experiencing a seizure, sit them down in a safe place without any sharp or heavy objects near them. Ensure they can breathe freely.

If a seizure lasts more than five minutes, call 911.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more on epilepsy.

SOURCE: Orlando Health, news release, Nov. 2, 2023