Your brain is an incredible machine that requires a delicate electrical balance to keep all
those neurons firing at all the right times.
But when that balance gets thrown off, that can cause epilepsy.
Seizures can be scary, and when someone has a seizure, you might feel helpless.
Let’s explore it a little deeper and talk about what you should do if someone has a
seizure.
First off, not everyone who has a seizure has epilepsy.
Epilepsy is diagnosed if a person experiences at least two unprovoked seizures.
That means that the seizures appear to be random, and not caused by something like low
blood sugar.
So sometimes epilepsy is related to other neurological conditions, like traumatic brain
injuries, but sometimes there’s no clear cause.
There are a lot of misconceptions about what epilepsy is - like some people think only
kids can have it, or that it means a person is disabled and can’t work or drive.
Epilepsy has a wide range of severity and symptoms and can affect almost anyone.
But for most people, having epilepsy isn’t a barrier to living a relatively normal, fulfilling
life.
In fact, epilepsy isn’t even that rare - it’s the fourth most common neurological disorder.
But that doesn’t mean that seizures can't be dangerous.
Scientists estimate that at least 20,000 deaths in the U.S. are directly related to prolonged
seizures.
Seizures themselves are caused by an imbalance in the excitatory and inhibitory signaling
in the brain, leading to a surge of electrical activity.
Remember our Neuro 101 series, where we talked about action potentials and synapses?
I’ll summarize the important bits, but you can brush up on those topics by clicking up
here.
See, your neurons use electrical signals to send messages through the brain - and those
signals are passed from cell to cell at synapses by chemical messengers called neurotransmitters.
One of the most common neurotransmitters is glutamate, the main excitatory neurotransmitter.
What makes it excitatory?
Well, it’s basically sending a “go” signal.
Glutamate tells the neuron to send an action potential, which pushes the signal further
down the line.
But one of the other common neurotransmitters, GABA, is the main inhibitory neurotransmitter.
That means that it’s sending a “stop” signal - when GABA binds to a neuron, it blocks
that cell from sending an action potential, stopping the signal up short.
These neurotransmitters are flying inside your brain all the time, and everything you
do - driving a car, sipping your soda, or even just watching and listening to this video
- depends on your brain’s ability to maintain a careful balance.
When you have a seizure, that balance gets off-kilter.
Excitatory neurons - which usually have a mechanism that makes it harder for them to
fire for a while after they send a signal - become too active, and many excitatory neurons
begin to send signals at the same time.
Those signals become a synchronized wave of electrical activity.
Like an earthquake, these waves often begin in a particular structure or region of the
brain, called the seizure focus, and then get pushed out across the brain, interrupting
normal signaling and leading to the physical symptoms of a seizure.
There are many different kinds of seizures, and they have a wide range of symptoms.
A person having a seizure may be conscious and aware while it’s happening, or they
may /just/ lose awareness for a moment, or they may experience a loss of awareness, muscle
contractions, and shaking.
And the length of a seizure can range from just a few seconds to several minutes.
If a seizure lasts more than 5 minutes, it’s considered status epilepticus, and is often
cause for serious concern, since long seizures can be deadly.
You can learn more about specific kinds of seizures and their symptoms by checking out the links in the description below
Epilepsy is treated through a variety of medications and treatments.
Anti-epileptic or anti-convulsant drugs are often a good first approach.
The kind of medication prescribed depends on a lot of factors, like the kinds of seizures
a person has and their age and lifestyle.
It’s not totally clear /how/ these medications work, but they all essentially work the same.
They make it harder for that excessive electrical activity to get started in the brain and prevent
seizures from happening.
Surgery to remove the seizure focus is sometimes an option for people with epilepsy that is
resistant to other treatment, or that is unusually severe.
And some patients and doctors have found success with dietary changes or the use of unusual
medications.
The ketogenic diet is reported to reduce the frequency and severity of seizures in some
patients, and medical marijuana seems to be helpful for some particularly difficult to
control forms of epilepsy.
So what should you do if you see someone having a seizure?
According to the CDC, there are several things you can do to help.
First, and maybe most importantly, stay calm, and encourage others around you to stay calm too.
If you can, help the person get down to the floor safely, so they don’t hurt themselves
falling.
Turn them onto their side to help them breathe, and make sure the area is clear of anything
hard or sharp.
Then, try to make them comfortable - place something soft, like a folded jacket, under
their head, remove their glasses, and loosen any ties or tight collars.
You can check for an emergency ID bracelet, or if they have other emergency information available. You should also try to time the seizure.
You should stay with the person until the seizure has ended, and the person is fully
awake and safely seated somewhere.
Once they know what’s going on, explain what happened and comfort them if necessary.
Offer to call a friend or a ride to make sure they get home safely.
You only need to call 911 if the seizure lasts longer than 5 minutes, if the person has a
hard time waking up afterward, if they were injured while it was happening, if it happened
in water, or if they have another seizure soon after the first one.
You should also call 911 if the person has never had a seizure before, as it can sometimes
indicate another underlying condition.
Some things you should /never/ do when someone is having a seizure include trying to hold
them down or putting anything in their mouth.
People can be injured if you try to stop their movements, and a person having a seizure can’t
swallow their tongue but they /can/ injure their teeth or jaw if you try to force something
in there.
Epilepsy and seizures are scary stuff, but the most important part is that you’re there
for them to help.
Do you know anyone with epilepsy in your life?
When we were growing up, my brother had childhood epilepsy, but he grew out of it when he got
older.
If you want to hear about what that was like and my experience, head over to our Patreon
page where we’ve got an extra video!
Even if you don’t support us there, you can still check it out.
Thanks for watching this episode of Neuro Transmissions.
If you liked it, hit that thumbs up button, and subscribe to learn more about other neurological
conditions in the future.
Thanks to all of our Patreons for their support, and thank you to the Vlogbrothers their sponsorship
of this video.
We’re really thrilled that our YouTube heroes believe in what we’re doing.
Until our next transmission, I’m Alie Astrocyte - over and out.