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Brain seizures: When The Brain Has Too Much Energy

Brain seizures: Some of us have to deal with them every single day, whilst others can be witnesses of someone having a  brain seizure. Most commonly, people having to experience someone suffering from a brain seizure are overwhelmed when their loved ones jerk uncontrollably and subsequently lose consciousness. Not only are the witnesses clueless about which steps to take, but also the patients if his/her seizure occurs for the first time. This article will give you a guide on what brain seizures are, their symptoms, treatments and what steps to take in order to increase the quality of life of the patient. 

What are brain seizures?

What are brain seizures?

Brain seizures are changes in the brain’s electrical activity. This change can cause dramatic, noticeable symptoms or it may not cause any symptoms. Patients that experience brain seizures possess abnormal neural activity which is uncontrolled and happens spontaneously.

The brain function, however, is often not abnormal. The involuntary change in neural activity is considered epilepsy, in which the brain seizures are the symptoms. Though, brain seizures can also be induced in a normal brain under a variety of conditions different species, from humans to flies. Brain function is not abnormal but cognitive aspects might be threatened by many brain seizures.

Brain Seizures Types

Generally, we differentiate between three different types of seizures. Usually, they are dependent on the number of brain cells showing abnormal activity. This is crucial in order to select a suitable treatment for the patient, as different medications have to be used for each seizure type.

  1. Generalized onset brain seizures: In this case, there is no identifiable onset meaning a starting point in the brain cannot be determined. The seizure starts and spreads too quickly making a reliable decision about the trigger impossible. For this reason, treatment using surgery to suppress the symptoms is not available.
  2. Focal onset brain seizures: Whereas in generalized onset seizures the location is not known, in this type of brain seizure, doctors are able to determine the starting point of the seizures. Focal brain seizures can start in one area of the brain or in a specific group of cells either in the left or right hemisphere. Furthermore, patients can have full or impaired awareness during their fit.
  3. Unknown onset brain seizures: If the nature of the seizure cannot be determined, they belong to this group. This is mostly at the beginning or if the patient lives alone without witnesses observing the person with the seizure. As more information is obtained, the seizure is later classified as generalized onset brain seizure or focal onset brain seizure.

How is a brain seizure caused?

Aspects of the brain affected by different brain seizure

The emergence of a brain seizure can be down to several reasons, but determining the exact cause has proven to be challenging. At least half of all patients display idiopathic seizures meaning the cause is unknown. Nevertheless, depending on the age of the patient, determining the trigger of a brain seizure can be narrowed down.

Generally, genetics plays a large role whether someone will experience a seizure in their lives or not. Pinpointing the specific genes which are responsible for the symptoms though is a struggle. This diagnosis is mostly very vague as the relationship between the genes in the brain and the nature of seizures is poorly understood.

What is known on the other hand is a prevalence of about 3 out of 10 patients having a change in brain structure which leads to some sort of brain seizure. Mostly this is the case for children born with alterations in brain regions.  For the elderly, incidence such as a stroke is usually the cause of developing recurrent seizures.

When suffering from epilepsy, an imbalance in the brain’s chemistry is frequently observed. This refers to the neurotransmitters being present in the wrong concentrations (too little or too much in the brain). In general, everybody has got two kinds of neurotransmitters with opposing functions: Neurotransmitter of excitatory and inhibitory qualities, with the former increasing the firing rate and the latter reducing the activity of the neurons. The balance of both kinds has to be maintained and if not given, can result in hyperactivity of the neurons causing epilepsy.

The best-studied neurotransmitter is GABA, or gamma-aminobutyric acid, which possesses inhibitory qualities counterbalancing neuronal excitation. GABA’s counterpart glutamate, the principal excitatory neurotransmitter, plays a crucial role in the initiation and spread of brain seizures. This was demonstrated by During and Spencer in 1993 when they tested the concentration of these two neurotransmitters in the hippocampus before and during a seizure. Before seizures, the glutamate concentration in this brain area was found to be higher than in the control group, whereas the concentration of GABA was observed to be lower. During the seizure, GABA concentrations increased in both groups, however in the control group a greater increase was found. Consequently, drugs to treat epilepsy revolve around these two neurotransmitters, by either reducing the concentration of glutamate or by increasing GABA content in the synapses in order to reduce hyperactivity of the neurons.

Brain Seizures Symptoms

Clinicians group the symptoms into two categories, generalized and partial or focal seizures, in order to find out if a patient suffers from epilepsy.
The different types are:

Generalized brain seizures (produced by the whole brain)

  • “Grand Mal”: The most known form where the patient loses consciousness and collapses. The body stiffens and violent jerking begins usually lasting for about 30-60 seconds. Afterwards, the patient goes into deep sleep.
  • Absence: Individuals experiencing an absence seizure stare into space for a few seconds. They are most common in children and a brief loss of consciousness is reported.
  • Myoclonic: These seizures are brief, shock-like jerks or twitches of a muscle or a whole muscle group. This usually does not last for a long time (only about 1-2 seconds) and the person experiencing it retains full consciousness.
  • Clonic: This type of seizures is very similar to the myoclonic seizure with the difference of a more regular and sustained jerking.
  • Tonic: The muscle tone, the muscle’s normal tension at rest, is highly increased leading to tense feelings in arms, legs or body in general. Awareness usually does not change much and the symptoms subside within 20 seconds.
  • Atonic: Atonic seizures are substantially the opposite of tonic seizures. Instead of the muscles becoming stiff, a person experiencing an atonic seizure will feel their muscles going limp. For instance, a person standing might fall to the ground when suffering an atonic seizure. As tonic seizures, they do not last for a long time either.

Partial or Focal brain seizures

Focal brain seizures are known to originate from a specific brain region causing a variety of symptoms depending on the brain area affected. Generally, doctors differentiate between seizures causing a (partial) loss of consciousness and the ones where consciousness is preserved.

Symptoms of focal seizures with impaired awareness (once called complex partial seizures) could be the following:

  • Staring into space
  • Response to the environment is abnormal or impaired
  • Execution of repetitive movements (hand rubbing, chewing, walking in circles, etc…)

Symptoms of focal seizures without loss of consciousness (once called simple partial seizures):

  • Change of emotions
  • Difference in perception
  • Involuntary jerking of a body part
  • Sensory symptoms (eg. tingling, dizziness and flashing lights)

Note: If an individual experiences seizures repeatedly (once a week or even once every single day), their symptoms will most likely remain similar.

Brain seizures: Diagnosis and what to expect when visiting a doctor?

If a person suffers from a brain seizure (or thinks they have suffered one), the first stop will be consulting your general practitioner. Make an appointment and if the seizure was witnessed by someone, ask this person to join.

Depending on the type of seizure, most likely you were unconscious which makes it difficult for you to describe what happened. However, the doctor will ask you a series of questions, also called the medical interview, in which he will ask you about your general health and incidences before, during and after the seizure. Especially for the medical interview, it is advisable to have someone near you answer questions which you might not be able to answer.

The doctor will most likely be able to diagnose a brain seizure based on the answers of the patient. However, to obtain a clearer idea of the clinical picture of the patient, more tests will be necessary.

The primary physician will ask a neurologist to take a look at the inside of the individual’s brain. Every single brain is different and finding the most suitable treatment for a patient is far from straightforward. The following tests are used when attempting to diagnose brain seizures in detail:

  • Blood tests: The most common blood test is the CBC (Complete Blood count) in which the doctor determines important parameters in your blood, e.g the number of red blood cells, white blood cells, hemoglobin, etc. Therefore a blood test serves to determine the appropriate medication for infections, allergies, and other abnormalities are revealed.
  • Metabolic tests: This test assesses the functioning of your organs, more specifically your body’s ability to metabolize. The evaluation is also done via a blood sample and includes an assessment of the content of important molecules in your blood. The sodium, potassium and blood sugar levels are evaluated. Not only will this help determine an electrolyte imbalance, but also reveal any malfunction of the kidney or the liver. The importance of looking at these organs is to find out whether a disease could trigger the brain seizures, which was found to be the case for instance in patients with diabetes. In this case, doctors focus on treating the symptoms of the illness causing the brain seizures (in this case diabetes) rather prescribing drugs targeting the brain seizures directly.
  • An EEG (electroencephalography) test: The term might sound familiar to most of us, but what is this exactly and how can it help doctors make a more accurate diagnosis? An EEG can reveal the electrical activity of the brain and in which regions abnormal/normal activity is present. The specialists can make conclusions if the brain seizures come from a single area or are more widespread looking at the EEG pattern.
  • CT and MRI scan: Computer Tomography (CT) and Magnetic Resonance Imaging (MRI) are two techniques that will look into your brain. The aim here is to find physical abnormalities that cause the seizures. Although for a lot of people suffering from brain seizures the test results will be negative, it is still an important procedure. In cases where brain seizures are very frequent and strong, determining the exact cause is crucial since the possibility to undergo surgery could be an adequate treatment option.

What to do and not to do when faced with a brain seizure?

If we see our loved-ones suffering from a seizure, it would be normal to be frightened and expect the worst. However, most brain seizures are not dangerous and the person regains his/her normal state within a few minutes without permanent damage. Fact is: Once a seizure is going, you cannot simply force the person to stop jerking, however, you can protect the person inflicting damage to his own body.

The DO’S!

  • Make sure other people are not standing too close to the person having a seizure
  • Remove sharp or hard objects from the surroundings
  • Do not stop the movements of your friend
  • Take a look at his/her watch to record the seizure duration
  • To keep the airway clear, put the person on his/her side
  • And most importantly: Keep calm!

The DONT’S!

  • Do not restrain the person as you might injure him or get injured yourself
  • No offering of food or drinks to the sufferer: A sip of water might be a trigger for choking
  • Do not insert anything into his/her mouth! They will not swallow their tongue
  • No CPR (unless the patient is not breathing after the seizure)

Tips to reduce brain seizures

Since the underlying trigger for a brain seizure is often unknown, it is crucial to reduce the odds of a brain seizure to a minimum. Take the following provisions:

  • Reduce stress by getting enough sleep (it is best to adhere to a regular sleeping schedule)
  • Physical activity or yoga may help feeling more relaxed, as well as deep breathing
  • Limit noise sources and make sure the room is well illuminated when watching TV or when playing video games
  • When going for a run you should do it in the park, rather than in high-traffic areas or unpaved trails
  • But most importantly: Stick to your medication your doctor prescribed you unless he/she tells you otherwise!

Have you witnessed a brain seizure or are you suffering from this condition? Please feel free to comment below.

Sensory Processing Disorder: What is it? What are the symptoms, treatments and does my child exhibit any signs? Take the mini quiz!

“Sometimes the noise in my life bothers me. It hurts my ears.” These are common things people with Sensory Processing Disorder (SPD) or Sensory Integration Disorder tend to say when describing what is happening to them. Find out more about what is sensory processing disorder, its signs, symptoms, treatments and take a mini quiz on different signs of over responsive sensory processing disorder.

Sensory processing disorder

What is Sensory Processing Disorder?

Sensory Processing Disorder or sensory integration disorder is a condition in which the brain has difficulty receiving and responding to information that comes in through the senses. Some experts like A. Jean Ayres, PhD, linked SPD to a neurological “traffic jam” that prevents the brain from receiving signals or information needed to interpret sensory information correctly. Whether if you are biting into your favorite New York style pizza, driving a car, or simply texting, the completion of the activity requires precise processing of sensation and attention.

Sensory processing disorder may affect one or more of the senses like hearing, touch (tactile), smell or taste, movement (vestibular) and body awareness (proprioceptive sense). Some children may even seem unresponsive to the things they have difficulties with. For example, the sounds of a lawn mower may cause a child to experience headaches, then nausea, dizziness, confusion, trembling or panic. They may scream when touched or shy away from certain textures of foods. However, others may also seem unresponsive to anything around them. They may fail to respond to extreme heat, cold or even pain. This is very common among children with autism.

Sensory Processing Disorder- Symptoms 

Symptoms may range from mild to severe. Common symptoms include:

  • Hypersensitivity: Hypersensitive (or oversensitive) children may notice sounds that others do not, or have an extreme response to loud noises. They may be fearful of large crowds, unwilling to play on playground equipment or worried about their safety (falling).
  • Hypo-sensitive: Hypo-sensitive (or under sensitive) children, as mentioned above, may lack sensitivity to their surroundings. For example, because they might have a high tolerance for pain, they are known to be “sensory seeking” meaning they have a constant need to touch people or things, even when it’s not appropriate. Some may be gustatory/oral seeking (crave certain textures and flavors excessively), olfactory seeking (crave certain smells excessively), auditory seeking (often speak louder than necessary), and visual seeking (crave bright lights). 

Often, children with sensory processing disorder show signs of both hypersensitivity and hyposensitivity. They may reach in one of both ways:

  • Extreme response to change in environment: Kids may be fine in settings they are familiar with, however, in crowded environments like a wedding, they may experience a sensory meltdown such as throwing a tantrum and screaming.
  • Fleeing from stimulation: children who are undersensitive might get a fight or flight response from something that is too stimulating. For example, if a child flees from a playground or parking lot, oblivious to the danger, this indicates they may be heading away from something upsetting.

Sensory Processing Disorder-Skills Affected

  • Resistance to change and inattention: they may be struggling with adapting to change and new surroundings. Some cognitive skills might be affected by this.
  • Problems with motor skills: the child may seem awkward and clumsy, an activity such as running or jumping may be hard for kids who may have difficulty knowing the orientation of their body. They may either move slowly or avoid activities they find challenging.
  • Lack social skills: oversensitive kids will most likely get anxious around other children and will avoid playing, making it hard for the child to be socially friendly. Under sensitive kids also lack social skills because they may be too rough which in turn may lead other kids to avoid them and exclude them from activities.

Sensory Processing Disorder-Diagnosis and Causes

There have been many assumptions and speculations about the causes of sensory processing disorder or sensory integration disorder; nothing concrete has been identified just yet. However, many researchers say some causes of SPD could be:

  • Coded into the child’s genetic material
  • Prenatal and birth complications (low birth weight or prematurity, etc.)
  • Environmental factors (an adopted child who was might have had poor prenatal care)

Sensory processing disorder has yet to be classified as an illness in the Diagnostics and Statistical Manual (DSM-5), which is often used by psychiatrists and many other clinical professionals such as pediatricians and psychologists in diagnosis. However, it is identified as part of the assessment in the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood-Revised in the first clinical axis. Sensory processing disorder was first identified by occupational therapists as a source of distress for many children and for inexplicable behaviors. Sensory integration disorder can be often misdiagnosed due to its confusion with autistic children and their problematic sensory responses.

Below is a small quiz with common situations that may happen when a child has a over-response to sensory stimuli and may have sensory processing disorder.

1. We have to avoid public loud spaces such as malls, parks, etc. because the noise seems to hurt my child's ears.
  • A red X indicates that your child may have this symptom of sensory processing disorder. A green checkmark indicates that your child does not have this symptom

2. My child doesn't like to be hugged or kissed and when I do it seems like it hurts (not to be confused with shyness or social difficulties)
  • A red X indicates that your child may have this symptom of sensory processing disorder. A green checkmark indicates that your child does not have this symptom

3. My child has a hard time falling asleep and wakes up crying to any noise, change in temperature or minimal stimuli with high level of discomfort and it's difficult to comfort him back to sleep
  • A red X indicates that your child may have this symptom of sensory processing disorder. A green checkmark indicates that your child does not have this symptom

4. When we buy clothes we have to take all of the tags off because my child can't stand the touch on his skin (not to be confused with normal discomfort).
  • A red X indicates that your child may have this symptom of sensory processing disorder. A green checkmark indicates that your child does not have this symptom

5. Sounds, lights, movements, smells, tastes and any other sense seems to be heightened to the point where my child feels great discomfort or even pain while being exposed to these stimuli
  • A red X indicates that your child may have this symptom of sensory processing disorder. A green checkmark indicates that your child does not have this symptom

*IMPORTANT: While this mini quiz can’t diagnose a child with sensory integration disorder, it can be a helpful guide to see if additional testing should be done. 

Sensory processing disorder symptoms

Sensory Processing Disorder-Treatment

For diagnosis and treatment, it’s generally recommended to see an occupational therapist. The therapeutic approach for occupational therapy, in this case, includes the use of sensory integration, which was originally created by A. Jean Ayres, PhD, and is formally known as Ayres Sensory Integration (ASI).

An occupational therapy session using the Ayres Sensory Integration system begins with an evaluation, and once it’s complete, the therapist will develop a plan aimed at enhancing the child’s ability to utilize their sensations. When the occupational therapist is using ASI intervention techniques, some core elements include:

  • An ASI intervention will challenge the child to develop ideas about what to do, allow the child to plan out these ideas and then successfully carry out the plans
  • The environment is rich in tactile, proprioceptive, and vestibular opportunities and that creates both physical and emotional safety for the child
  • Many therapeutic activities will promote postural control and balance, which may include the use of special equipment such as suspended apparatus, scooters, and balls.

Sensory processing disorder- treatment

Tips and Creative Forms of Therapy

There are also many creative ways to help your child manage SPD in their daily life. The Ayres Sensory Integration system has created something called “Sensory Diet”, which refers to an individualized set of sensory based activities in which the child will participate throughout the day. Think of a “sensory diet” in the same way that healthy eating habits are distinguished by feeding our bodies the nutrients we need; a sensory diet “feeds” the child the right sensory needs of the child. A sensory diet allows the child to re-train the brain to process sensory information, which will then promote self-control. An example of a sensory diet would be:

  • A child who is an avoider and under-sensitive may be overwhelmed by loud sounds and stressful stimuli. In this case, the child would need breaks from distressing sounds, unpleasant tactile stimulation, etc.
  • A child who is not as aware of their body would need to incorporate lifting, pushing and pulling heaving objects as an activity into their everyday life. These activities will help the child gain an understanding of their body.
  • For children who have tactile issues, it is sometimes recommended to have the child drink seltzer water to experience bubbles in their mouth.

Overall, there are many forms of sensory diets that are individualized based on the child’s needs. You can create a sensory diet by working alongside your occupational therapist that will provide the correct form of activities to help the child.

Now that you know how to identify Sensory Processing Disorder and how to treat it, I hope you find this article useful and can become more aware of your child’s behavior. Feel free to leave a message below.

 

References:

Impact and Treatment of SPD. Retrieved from https://www.spdstar.org/basic/impact-and-treatment-of-spd

Understanding Sensory Processing Issues. Retrieved from  https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/sensory-processing-issues/understanding-sensory-processing-issues#item2

Dr. A. Jean Ayres, PhD. (1972). Ayres Sensory Integration. Retrieved from https://www.siglobalnetwork.org/ayres-sensory-integration