Fits, also known as seizures, are sudden, uncontrolled electrical disturbances in the brain that can cause changes in behavior, movements, or feelings. A seizure can affect how a person appears, how they feel, or how they behave during and after the event. Seizures vary widely in severity and type, ranging from brief periods of blank staring to full-body convulsions and loss of consciousness.

1. What Causes Fits (Seizures)?

Seizures occur due to abnormal electrical activity in the brain. Normally, brain cells communicate with each other through electrical signals, but during a seizure, these signals become disrupted. There are many potential causes for fits, including:

a. Epilepsy:

• Epilepsy is a chronic neurological condition that makes people more prone to recurring seizures. The cause of epilepsy can be unknown, but in some cases, it may be linked to brain injury, genetic factors, or developmental disorders.

b. Brain Injury:

• Traumatic brain injury, such as a blow to the head, stroke, or brain surgery, can lead to seizures. Brain trauma can cause scarring or other changes in the brain tissue that disrupt normal electrical activity.

c. Fever (Febrile Seizures):

• In young children, high fever can trigger a type of seizure called a febrile seizure. These are often brief and may not indicate an ongoing issue like epilepsy. They typically occur when a child has a fever above 102°F (39°C).

d. Infections:

• Brain infections such as meningitis (infection of the brain and spinal cord coverings) or encephalitis (inflammation of the brain) can cause seizures.

e. Low Blood Sugar (Hypoglycemia):

• Severely low blood sugar levels can cause a seizure, particularly in people with diabetes who take insulin or other medications that can drop blood sugar levels too low.

f. Alcohol or Drug Use/Withdrawal:

• Drinking excessive amounts of alcohol or taking certain drugs (e.g., recreational drugs) can trigger seizures. Seizures can also occur during alcohol withdrawal, especially in heavy drinkers.

g. Stroke:

• A stroke, which disrupts the blood flow to parts of the brain, can lead to seizures. This is particularly common in the first few days following a stroke.

h. Genetic Factors:

• Some people have a genetic predisposition to seizures or epilepsy. Certain genetic mutations can affect how neurons in the brain function, making them more likely to fire abnormally.

i. Electrolyte Imbalances:

• Low levels of certain minerals or electrolytes in the body (like sodium, calcium, or magnesium) can affect the brain’s electrical activity and lead to seizures.

j. Lack of Sleep:

• Severe sleep deprivation is another common trigger for seizures, especially in people who already have epilepsy.

k. Brain Tumors:

• A tumor in the brain can press against surrounding brain tissue, leading to seizures, as abnormal brain activity may result from this pressure.

l. Pregnancy-related Conditions:

• Conditions such as eclampsia, a complication of pregnancy characterized by high blood pressure and seizures, can also trigger fits.

2. Types of Seizures (Fits)

Seizures can be classified into several different types, depending on where in the brain the abnormal electrical activity occurs. The two main categories of seizures are focal seizures (partial seizures) and generalized seizures.

a. Focal Seizures (Partial Seizures):

Focal seizures start in one area of the brain. Symptoms can be localized to the body part controlled by that part of the brain, and the person may remain conscious during the event (simple partial seizure) or lose consciousness (complex partial seizure).

• Simple Partial Seizures: The person remains aware and can often remember the event afterward. These seizures might involve twitching of a hand or foot or visual disturbances.
• Complex Partial Seizures: The person may lose awareness or consciousness during the seizure, leading to confusion, staring, or repetitive movements, such as hand rubbing or lip-smacking.

b. Generalized Seizures:

Generalized seizures involve abnormal electrical activity across both sides of the brain and usually lead to loss of consciousness. Types of generalized seizures include:

• Tonic-Clonic Seizures (Grand Mal Seizures): This is the most dramatic type of seizure, marked by a loss of consciousness, stiffening (tonic phase), followed by rhythmic jerking (clonic phase) of the arms and legs. It can last from 1 to 3 minutes.
• Absence Seizures (Petit Mal Seizures): These are brief (lasting only a few seconds), often involving a sudden lapse in consciousness, where the person appears to stare blankly into space. They are more common in children.
• Atonic Seizures: These seizures cause a sudden loss of muscle tone, which can cause the person to collapse or fall.
• Myoclonic Seizures: These involve brief jerks or twitches of the muscles and usually last only a second or two.

3. Symptoms of a Seizure

The symptoms during a seizure depend on the type and severity of the event. Some common signs include:

• Involuntary muscle movements: Jerking or twitching of the limbs or face.
• Loss of consciousness: The person may fall unconscious or appear dazed and confused.
• Staring spells: Particularly with absence seizures, the person may stare blankly for a few seconds.
• Unusual sensations: People may experience odd sensations before or during a seizure, such as a strange smell, a rising sensation in the stomach, or visual or auditory disturbances.
• Uncontrolled movements: Some people may exhibit repetitive behaviors, such as lip-smacking, chewing, or hand movements.
• Loss of bladder control: Some people may lose control of their bladder during a seizure.
• Postictal state: After a seizure, the person may be confused, tired, or disoriented. This state, known as the postictal phase, can last from minutes to hours.

4. Diagnosis of Seizures

If someone experiences a seizure or fit, it’s important to get a proper diagnosis. The doctor will typically:

• Take a medical history: Ask about symptoms, family history, and potential triggers (e.g., alcohol use, trauma, or infection).
• Conduct a neurological exam: This helps assess brain function and rule out other conditions.
• Order tests:
  • Electroencephalogram (EEG): A test that measures electrical activity in the brain and can help identify abnormal brain waves associated with seizures.
  • Imaging tests: A CT scan or MRI may be ordered to look for structural issues in the brain, such as tumors or brain damage.

5. Treatment of Seizures

The treatment for seizures depends on the underlying cause and the type of seizure. Treatment options may include:

a. Medications:

• Antiepileptic drugs (AEDs): These are commonly prescribed to prevent seizures. The specific medication depends on the type of seizures and the person’s health status. Common AEDs include phenytoin, lamotrigine, levetiracetam, and valproate.
• Benzodiazepines: In cases of status epilepticus (a medical emergency involving continuous seizures), drugs like diazepam or lorazepam may be used to stop the seizure.

b. Lifestyle Changes:

• Adequate sleep: Seizures are more likely to occur when the body is sleep-deprived.
• Dietary changes: A ketogenic diet (high-fat, low-carb) can sometimes help control seizures in people with epilepsy.
• Avoid triggers: Identifying and avoiding seizure triggers, such as flashing lights, alcohol, or stress, can help reduce the likelihood of seizures.

c. Surgery:

• Surgery may be considered for people with epilepsy who do not respond to medications. Surgical options include resecting the part of the brain responsible for the seizures or implanting a vagus nerve stimulator to help regulate brain activity.

d. Other Therapies:

• Vagus Nerve Stimulation (VNS): A device implanted under the skin sends electrical impulses to the vagus nerve, which helps control seizures.