Research-backed

Epilepsy And Seizures In Teens: Types, Causes, Symptoms, And Treatments

Image: Shutterstock

IN THIS ARTICLE

Seizures are physical or behavioral changes that occur due to abnormal electrical activity in the brain. Seizure symptoms may vary from blinking or severe muscular spasms to loss of consciousness, depending on the severity and the brain area involved.

Diagnosis of epilepsy (neurological disorder) is made if your teen has at least two unprovoked episodes of seizures (1). Although seizures are common in children, they may occur at any age without any gender specifications.

Read this post to know more about the causes, symptoms, diagnosis, treatment, and prevention of seizures in teens and what to do during a seizure attack.

Causes Of Seizures In Teens

Teens may have seizures due to the following reasons (2).

  1. Genetic factors can cause seizures in some teens. The genetic link is explained by the involvement of similar brain areas, causing the same type of seizure in family members.
  2. Head trauma or injury
  3. Brain tumor
  4. Stroke
  5. Infectious diseases affecting the central nervous system, such as meningitis, viral encephalitis, and AIDS.
  6. Autism
  7. Neurofibromatosis
  8. Cerebral palsy and other neurological disorders

Seizure And Epilepsy

Although the symptoms, causes, diagnosis, and treatment of epilepsy and seizure are similar, these are not interchangeable terms (1).

Seizures are the main sign of epilepsy disorder, but not all seizures are diagnosed as epilepsy. A seizure is a short-term change in the brain’s electrical activity associated with specific behavioral or physical changes. Seizure attacks can be caused by conditions such as high fever and hypoglycemia (low blood glucose levels). (2). In such cases, the seizure gets resolved once the conditions are resolved.

Epilepsy (epileptic disorder or seizure disorder) is triggered by conditions that cause brain damage. Usually, a diagnosis of epilepsy is made if your teen has two or more unprovoked seizures without any temporary triggers, such as fever or low blood sugar (2).

Symptoms Of Seizures In Teenagers

Symptoms associated with seizures may vary depending on the affected brain area, type, and severity of the seizure. The common seizure symptoms are (3):

  1. Uncontrollable eye movements
  2. Repetitive movements, such as lip-smacking, chewing, or swallowing
  3. Staring blankly
  4. Loss of bowel or bladder control
  5. Jerking movements of the body or convulsions
  6. Stiffness in parts of the body
  7. Snorting or grunting noises
  8. Clenching of teeth
  9. Drooling or frothing from the mouth
  10. Loss of consciousness

Types Of Seizures

Seizures are classified based on the affected area of the brain and sub-classified depending on the symptoms present during the seizure attack. 

1. Generalized seizures

Generalized seizures are caused by abnormal electrical activity in both hemispheres of the brain. This may include (4):

  • Absence seizures (petit mal seizures) are a type of generalized seizure, causing rapid blinking or blank staring for a few seconds.
  • Tonic-clonic seizures (grand mal seizures) are a type of seizure with symptoms such as falling, crying out, muscle spasms, jerks, or loss of consciousness. Teens may feel weak and tired after the seizure attack. 

2. Focal seizures

Focal seizures are also known as partial seizures. They are caused by abnormal electrical activity in one part of the brain. This may include (4):

  • Simple focal seizures that affect a small area of the brain, causing symptoms such as spasms, or abnormal sensation (strange smell or taste)
  • Complex focal seizures that cause a loss of awareness, random body movements, or unresponsiveness for a few seconds
  • Secondary generalized seizures that begin with abnormal nerve impulses in a smaller area of the brain and spread to both sides of the brain, resulting in a generalized seizure

Seizure symptoms may last a few seconds or minutes, depending on the cause and severity. After the episode, the teen may feel confused and may lack memory of the seizure. Seek medical care for the exact diagnosis and treatment of seizures in your teen. 

What Should You Do When Your Teenager Has A Seizure?

The following can be done during a seizure attack to reduce injuries (5).

  • Lay the teen on a floor to prevent a fall.
  • If possible, lay them on their side.
  • Place something soft under the head.
  • Remove any dangerous items nearby if your teen is moving.
  • Remove any tight clothing around the neck.
  • Do not move their limbs if they become stiff.
  • Do not restrain any convulsions.
  • Do not try to place something between their teeth or in the mouth.

Be calm during the episode and stay by the teen’s side. Take a note of the symptoms and the time of seizure to share it with the medical professionals.

Some teens may have seizures due to fever (febrile convulsions); it is essential to seek medical care since acetaminophen or sponging may not control future risk for febrile seizures. You may also seek medical care if your teen has seizure attacks even though they are on anti-epileptics. 

When To See A Doctor

You should consult a doctor right after the seizure episode. Call emergency services if the following occurs (5).

  • Seizure lasts for more than five minutes
  • Multiple seizures occur over a short span
  • Teen seems to have problem breathing during or after the seizure
  • Teen is hurt during the seizure
  • Teen has abnormal behavior or is unresponsive even 30 minutes after the seizure

You may intimate emergency services if it is the first time the teen had a seizure or if the seizure seems more severe than the previous ones. 

Diagnosis Of Seizure In Teens

Your teen’s doctor may diagnose the seizure based on the medical history and symptoms present. A detailed neurological exam can be done to assess motor skills, behavior, mental functions, and other brain functions.

The following tests are also ordered to evaluate the structural and functional status of the brain (6).

  • Blood tests are useful to diagnose infections, genetic disorders, etc.
  • Electroencephalogram (EEG) helps record the electrical activity of the brain using electrodes on the scalp. Teens with seizures may have abnormal wave patterns on EEG while awake or asleep.
  • High-density EEG uses more electrodes on the scalp to identify the precise location of the affected area of the brain.
  • Computerized tomography (CT) scan and magnetic resonance imaging (MRI) help visualize the brain structures, tumors, or any lesions.
  • Functional MRI (fMRI) measures blood flow to evaluate the functions of parts of the brain.
  • Positron emission tomography (PET) helps identify tumors and other areas of abnormalities based on the presence of radioactive material injected during the procedure. 
  • Single-photon emission computerized tomography (SPECT) uses radioactive material to identify blood flow in the brain and create a 3D substantial image of the brain for detailed analysis.

Neuropsychological assessment of thinking abilities, memory, speech skills, etc., is performed to determine the affected area of the brain. Sometimes, doctors may use a combination of methods to identify the affected area.

  • Statistical parametric mapping (SPM) compares areas with increased metabolism during a seizure to a healthy brain.
  • Curry analysis uses EEG data with MRI imaging.
  • Magnetoencephalography (MEG) measures the magnetic fields during brain activity.

Prognosis of the condition can be well understood after a detailed analysis. Diagnosis of type and location of seizures is also essential for choosing effective treatment methods.

Treatment For Seizure In Teens

Anti-seizure (anti-epileptic) drugs are first-line treatment given for a teen with seizures. If epilept

ic seizures are not controlled by medication, other procedures or surgery is recommended depending on the frequency and severity of seizures (7).

Single-dose medication can stop a seizure in some teens, whereas others may require a combination of drugs. Treatment usually begins with low doses and an increase in dosage is done if needed.

Many teens may become seizure-free after medications; you may discuss with your teen’s doctor for the duration of treatment. If an epileptic seizure is not controlled by medication, other procedures are recommended depending on the frequency and severity of seizures (7).

The following treatment options are considered in severe cases of epilepsy (7).

  1. Epilepsy surgery: It is the removal of part of the brain with abnormal electrical activity. Surgeries are useful for focal (partial) seizures that do not affect brain areas that control vital functions.
  1. Vagus nerve stimulation: It is a method of delivering electrical impulses to the brain through a device (vagus nerve stimulator) placed under the skin in the chest area.
  1. Ketogenic diet may help reduce the risk of seizures in some teens.
  1. Deep brain stimulation: It is a method of electrically stimulating the brain with electrodes implanted into the brain.

How To Prevent Seizures In Teens?

About 25% of seizure cases can be prevented. These preventive steps may include the following (8).

  • Post-traumatic epilepsy can be prevented by reducing the risk of head injuries in teens by using safety equipment for sports, following road traffic rules, etc.
  • Observing health precautions could reduce the risk of central nervous system infections. Prenatal care may reduce birth-related brain damage. Eating healthy and exercising may minimize the risk of stroke.
  • Reducing the risk of central nervous system infections
  • Treating fever on time may prevent febrile seizures.

Preventing seizures may not be possible in certain cases. However, the below-listed tips may help your teen to have better control of seizures (9).

  • Take medications as prescribed.
  • Get good sleep since lack of sleep may trigger seizures.
  • Do regular exercises as per doctor’s recommendations.
  • Eat healthy food.
  • Avoid stress.
  • Avoid exposure to secondhand cigarette smoke.

Not taking medication as prescribed and stopping medication without medical supervision are significant causes of seizure-related complications. Therefore, consult a doctor for any doubts about medication. You may discuss with your teen’s healthcare provider to know more about the triggers of seizure in your teen.

Frequently Asked Questions

1. Is epilepsy a communicable disease?

Epilepsy is a chronic non-communicable disease, which means it does not spread from one person to another (8). It is a brain disorder caused by abnormal discharge of nerve impulses.

There are social stigma and discrimination towards people with epilepsy and their families in some communities. It is possibly due to misunderstanding that it is a contagious disease or due to misbeliefs associated with supernatural or superstitious reasons. However, epilepsy is a brain disorder that can be controlled or cured with appropriate treatments.

2. Can teenagers grow out of epilepsy?

Two-thirds of children may outgrow epilepsy during teen years with proper treatment and follow up (10). Some teens may require a longer duration of treatment, while most get well during the teen years.

Seizures may stop after long-term treatment, and you may follow the doctor’s recommendation to stop treatment gradually to prevent a recurrence. You may also visit doctors on follow up for evaluation of effectiveness and side effects of medications.

3. Can medical marijuana help epilepsy?

Medications derived from cannabis plants are called medical marijuana. A chemical derived from the cannabis plant, cannabidiol (CBD), is used to treat severe forms of epilepsy associated with a couple of rare disorders.

The anti-epileptic drug named Epidiolex is the first FDA-approved cannabidiol for treating seizures due to Lennox-Gastaut syndrome and Dravet syndrome in patients older than two years (11).

Note: Medical marijuana (cannabidiol) does not cause euphoria or intoxication, as marijuana (cannabis) does. Cannabidiol-based medicines should only be used as per doctor’s prescription.

4. Can a ketogenic diet help teens with epilepsy?

Some children have a reduction of seizures by following a strict ketogenic diet. It is a high fat, low carbohydrate diet where the body breaks down fats instead of carbohydrates for energy. The exact mechanism of epilepsy reduction in a keto diet is not yet understood. It could be due to changes in neuronal metabolism and excitability (12).

Keto diet should be followed under the supervision of an expert to prevent side effects such as:

  • Dehydration
  • Constipation
  • Nutritional deficiencies or malnutrition
  • Kidney stones

After a few years, they can be back to a regular diet. It may be impossible to follow a ketogenic diet in some cases. A low glycemic index and Atkins modified diet are often recommended for children with epilepsy. Consult the teen’s doctor to know which diet would be appropriate for your teen.

Seizure is a brain disorder that can be treated with appropriate treatment. Support of parents of teens with epilepsy is essential to prevent social stigma and encourage long-term treatment. You may seek help from epilepsy support groups to overcome any issues. Creating awareness about seizure and epilepsy among friends and family can be helpful to avoid negative reactions due to a lack of knowledge. 

References:

1. The 2014 Definition of Epilepsy: A perspective for patients and caregivers; The International League Against Epilepsy
2. Epilepsy; Frequently Asked Questions About Epilepsy; The Centers for Disease Control and Prevention
3. Seizures; MedlinePlus; The United States National Library of Medicine
4. Types of Seizures; Johns Hopkins Medicine
5. Seizure Safety; Nationwide Children’s Hospital
6. Diagnosing Seizures and Epilepsy; Johns Hopkins Medicine
7. Epilepsy; Treatment; National Health Service
8. Epilepsy; The World Health Organization
9. Living with Epilepsy; National Health Service
10. Epilepsy in Children: Diagnosis & Treatment; Healthychildren; The American Academy of Pediatrics
11. FDA Approves First Drug Comprised of an Active Ingredient Derived from Marijuana to Treat Rare, Severe Forms of Epilepsy; The U.S Food and Drug Administration
12. Isabella D’Andrea Meira, et al.; Ketogenic Diet and Epilepsy: What We Know So Far; The United States National Library of Medicine

Recommended Articles