This informal CPD article ‘Seizures and Epilepsy in Adults’ was provided by Wossenseged Asrat, MD from The Edge Medical Writing, an organisation that provides high quality medical writing support, tailored to meet the needs of medical education, product development, and the dissemination of medical information. It focuses on unraveling the enigmatic tapestry of seizures and epilepsy in adults, weaving together comprehensive insights and practical strategies to empower healthcare professionals to pursue optimal patient outcomes.
A seizure is an uncontrolled electrical disturbance in the brain that can cause changes in behavior, abnormal body movements (convulsions), feelings, or levels of consciousness. It is a characteristic symptom of epilepsy that can also be caused by factors like head injuries, brain tumors, or certain medical conditions like hypoglycemia. (1)
Epilepsy is defined by the International League Against Epilepsy (ILAE) as "a disease characterized by an enduring predisposition to generate epileptic seizures." (2) According to World Health Organization, the prevalence of epilepsy in the general population is approximately 6 to 8 per 1,000 people, corresponding to a prevalence rate of 0.6-0.8%. (3)
Seizures and epilepsy are neurological disorders that require healthcare professionals to stay updated and engaged in Continuing Professional Development (CPD). Healthcare professionals must understand seizures and epilepsy in adults to provide high-quality patient care. They should thoroughly comprehend seizures and epilepsy in adults to identify symptoms and provide immediate life-saving interventions.
In many low-resource countries, there is a widespread misconception and stigma surrounding seizures and epilepsy. Healthcare professionals in these countries have an essential role in breaking down these misconceptions and educating the community about the medical nature of the disease.
CPD activities also allow healthcare professionals to enhance their understanding of the psychosocial impacts of seizures and epilepsy on adults. This knowledge enables healthcare providers to offer comprehensive care that addresses the medical aspects and their patients' emotional and social needs.
Types of seizures in adults
In adults, seizures can be classified into two main categories:
- Focal seizures and
- Generalized seizures
Understanding the differences is crucial for accurately diagnosing and optimally managing seizure disorders and epilepsy syndromes.
Focal seizures, previously known as partial seizures, originate from a specific brain area. They can be further classified into two subtypes: focal onset aware seizures (formerly called simple partial seizures) and focal onset impaired awareness seizures (formerly called complex partial seizures). (2) Focal onset-aware seizures do not cause loss of consciousness and may involve abnormal sensations, emotions, or movements localized to one part of the body. In contrast, focal onset impaired awareness seizures involve altered consciousness or loss of awareness, with symptoms such as automatic behaviors, repetitive movements, or confusion. (2)
Generalized seizures involve both sides of the brain from the seizure onset. It can be further categorized into several types:(2)
- Absence seizures, also known as Petit-Mal seizures, typically occur in children but can persist into adulthood. They involve brief episodes of staring and temporal loss of awareness. Typical absence seizures start and end abruptly, lasting for a few seconds, while atypical absence seizures have a longer duration, and individuals may have some awareness of their surroundings during the seizure.
- Tonic seizures are characterized by sudden muscle stiffness.
- Rhythmic jerking movements
- Characterize clonic seizures.
- Brief shock-like muscle contractions characterize myoclonic seizures.
- Tonic-clonic seizures (formerly known as Grand-Mal seizures) involve loss of consciousness, body stiffness, rhythmic jerking movements, and atonic seizures (drop attacks), which cause sudden loss of muscle tone.
Healthcare professionals must comprehensively understand these seizure types to provide accurate diagnoses and appropriate management for individuals with seizures and epilepsy disorders.