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.
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. While epilepsy may be caused by some original injury, that injury is usually unknown. Epilepsy affects people in all nations and of all races.
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.
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.
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 mall 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.
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.
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.
An informative web site to visit regarding brain disorders in children is Childbrain.com.
Risk factors for 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]
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.
History of seizures
Seizure Disorder suggests the following may be present
Seizure Disorder can lead to
Schizophrenia
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.
Dupuytren's Contracture
See the link between Diabetes II and Dupuytren’s Contracture.
Recommendations for Seizure Disorder
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.
High 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.
The types of epilepsy most often treated with a ketogenic diet include juvenile absence epilepsy, West syndrome, Lennox-Gastaut syndrome, benign rolandic epilepsy and benign occipital epilepsy.
Artificial Sweetener 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.
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.
Conventional Drugs / Information
Many anti-epileptic drugs inhibit glutamine synthase, which may partly explain their toxic side effects.
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]
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.
Lithium (low dose)
Anti-convulsant medications cause abnormal levels of brain cell death. However, lithium significantly protects against this type of cell death. This effect is so pronounced that it has been called “robust”.
Magnesium
Through its nerve- and muscle-relaxing effect, magnesium may be helpful in reducing epileptic seizures caused by nerve excitability.
TMG (Tri-methyl-glycine) / SAMe
TMG has been noted to reduce seizure activity in some individuals.
Key
| Weak or unproven link |
| Strong or generally accepted link |
| May do some good |
| Likely to help |
| Highly recommended |
| May have adverse consequences |
| Reasonably likely to cause problems |
| Avoid absolutely |
Glossary
Seizure
While there are over 40 types of seizure, most are classed as either partial seizures which occur when the excessive electrical activity in the brain is limited to one area or generalized seizures which occur when the excessive electrical activity in the brain encompasses the entire organ. Although there is a wide range of signs, they mainly include such things as falling to the ground; muscle stiffening; jerking and twitching; loss of consciousness; an empty stare; rapid chewing/blinking/breathing. Usually lasting from between a couple of seconds and several minutes, recovery may be immediate or take up to several days.
Epilepsy
Chronic brain disorder associated with some seizures and, typically, alteration of consciousness.
Idiopathic
Arising spontaneously or from an obscure or unknown cause.
Chronic
Usually Chronic illness: Illness extending over a long period of time.
Metabolism
The chemical processes of living cells in which energy is produced in order to replace and repair tissues and maintain a healthy body. Responsible for the production of energy, biosynthesis of important substances, and degradation of various compounds.
Diabetes Mellitus
A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.
Electrolyte
An element or compound that, when melted or dissolved in water or other solvent, breaks up into ions and is able to carry an electric current.
Chronic Renal Failure
(CRF) Irreversible, progressive impaired kidney function. The early stage, when the kidneys no longer function properly but do not yet require dialysis, is known as Chronic Renal Insufficiency (CRI). CRI can be difficult to diagnose, as symptoms are not usually apparent until kidney disease has progressed significantly. Common symptoms include a frequent need to urinate and swelling, as well as possible anemia, fatigue, weakness, headaches and loss of appetite. As the disease progresses, other symptoms such as nausea, vomiting, bad breath and itchy skin may develop as toxic metabolites, normally filtered out of the blood by the kidneys, build up to harmful levels. Over time (up to 10 or 20 years), CRF generally progresses from CRI to End-Stage Renal Disease (ESRD, also known as Kidney Failure). Patients with ESRD no longer have kidney function adequate to sustain life and require dialysis or kidney transplantation. Without proper treatment, ESRD is fatal.
Uremia
Condition characterized by excessive urea and other nitrogen compounds in the blood due to renal insufficiency.
Phenylketonuria
An inherited disease caused by a lack of an enzyme necessary for converting phenylalanine into a form the body can use.
Hormones
Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Tonic-Clonic
A muscle spasm which is both tonic, occurring over an extended period of time, and clonic, marked by contractions and relaxations of the muscle occurring in rapid succession.
Dementia
An acquired progressive impairment of intellectual function. Marked compromise exists in at least three of the following mental activity spheres: memory, language, personality, visuospatial skills, and cognition (i.e., abstraction and calculation).
Serum
The cell-free fluid of the bloodstream. It appears in a test tube after the blood clots and is often used in expressions relating to the levels of certain compounds in the blood stream.
Carnitine
A compound found in skeletal and cardiac muscle and certain other tissues that functions as a carrier of fatty acids across the membranes of the mitochondria. Carnitine has been used therapeutically in treating angina and certain deficiency diseases.
Celiac Disease
(Gluten sensitivity) A digestive disease that damages the small intestine and interferes with absorption of nutrients from food. People who have celiac disease cannot tolerate a protein called gluten. Common symptoms include diarrhea, increased appetite, bloating, weight loss, irritability and fatigue. Gluten is found in wheat (including spelt, triticale, and kamut), rye, barley and sometimes oats.
Antibody
A type of serum protein (globulin) synthesized by white blood cells of the lymphoid type in response to an antigenic (foreign substance) stimulus. Antibodies are complex substances formed to neutralize or destroy these antigens in the blood. Antibody activity normally fights infection but can be damaging in allergies and a group of diseases that are called autoimmune diseases.
Biopsy
Excision of tissue from a living being for diagnosis.
Manganese
An essential mineral found in trace amounts in tissues of the body. Adults normally contain an average of 10 to 20mg of manganese in their bodies, most of which is contained in bone, the liver and the kidneys. Manganese is essential to several critical enzymes necessary for energy production, bone and blood formation, nerve function and protein metabolism. It is involved in the metabolism of fats and glucose, the production of cholesterol and it allows the body to use thiamine and Vitamin E. It is also involved in the building and degrading of proteins and nucleic acid, biogenic amine metabolism, which involves the transmitting of nerve impulses.
Schizophrenia
Any of a group of psychotic disorders usually characterized by withdrawal from reality, illogical patterns of thinking, delusions, and hallucinations, and accompanied in varying degrees by other emotional, behavioral, or intellectual disturbances. Schizophrenia is associated with dopamine imbalances in the brain and defects of the frontal lobe and is caused by genetic, other biological, and psychosocial factors.
Contracture
An abnormal, often permanent shortening, as of muscle or scar tissue, that results in distortion or deformity, especially of a joint of the body.