Neurologist Says Seizures Can Indicate Brain Abnormalities (8/2/2007)

On Monday, Supreme Court Chief Justice John Roberts suffered a "grand mal" or generalized seizure. University of Missouri-Columbia neurologist Pradeep Sahota said that seizures such as this represent abnormal electrical activity in the brain. It is like an electrical storm, Sahota said.

"Depending on whether a seizure starts in a focal area, which is considered a partial seizure, or involves the whole brain (generalized seizures may involve both hemispheres), there can be many different symptoms that indicate a seizure including violent shaking, staring, and semi-automatic movements such as chewing, swallowing, blinking and repetitive hand movements," said Sahota, chair of the Department of Neurology in the MU School of Medicine. "Once a seizure has occurred, it is important to try and determine the cause. In the case of Chief Justice Roberts, it is unlikely that an abnormality such as a tumor or stroke caused the seizure because he had a previous episode many years ago and based on available information, the evaluation conducted thus far has not revealed any abnormality."

For those people near a person who has a seizure, Sahota suggests taking the following actions:

1. Be calm - observing a person having a seizure, especially a generalized seizure with shaking, can be a scary experience.
   
   
2. If possible, help the person lie down in a soft place - away from hard or sharp objects because the person having a seizure might fall and injure themselves.
   
   
3. Loosen any tight clothing and turn the patient on his or her side to prevent choking on one's own saliva, vomit or blood. Tongue biting also might occur during a seizure.
   
   
4. If the person's mouth is closed due to forceful contraction of jaw muscles, do not try to forcibly open it.
   
   
5. Find a pillow (something soft) to help support the neck.
   
   
6. Do NOT try to stop the shaking. This is almost impossible and could result in an injury to the patient or the person trying to help. Most seizures last two to three minutes. Stay calm and help orient the person after the seizure stops. It may take several minutes before the patient is fully oriented.

The key is to make sure that injury due to ongoing violent movements is prevented during the seizure, the person has nothing blocking his airway as the seizure occurs and stops and calm reassurance is given at the end to help the person to reorient after the seizure, Sahota said. If there is an ongoing breathing difficulty or the patient has choked on something, it must be addressed immediately.

"Keep them on their side and let the seizure run its course - usually two to three minutes, rarely more than five minutes," Sahota said. "It could take the person several minutes to reorient after the seizure is over. After the first seizure, the person should get a complete neurological exam to try and discover the cause of the seizure. A seizure is just a symptom and can occur in many different situations."

Note: This story has been adapted from a news release issued by the University of Missouri-Columbia

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