Seizures

Seizures are a scary topic for many people. If you have ever seen a person or an animal have a grand mal seizure, it can take your breath away. What many people do not know is that seizures can come in many forms. They can be the grand mal seizure that involves violent shaking and tonic-clonic motions (the stiffening and clenching of the body) or they can be barely noticeable – just a flicker of the eyes or a specific muscle group (focal seizures) or a vacant expression with loss of awareness (absence seizure). In animals we can see things like “fly-biting” seizures where the animal snaps its muzzle around like it is trying to catch an annoying fly. Once you see them, you don’t forget them. I had a friend recently ask for help, because she really didn’t know what to expect or what to do even after going to her veterinarian when her dog starting having seizures over the weekend. She had a basic idea, but the details were not explained to her. So, I thought I would share some details.

NOTE: this article does not constitute medical advice, it is purely informational. Please speak to your doctor or veterinarian if you have questions or if your or a loved one experience seizures. I will attempt to put all of the “medical speak” into every day language.

What is a seizure?

A seizure is a series of electrical impulses in the brain that have gone “haywire.” Normally, the brain uses electrical impulses to control everything you do in a day – moving, talking, thinking, and so forth. These impulses are regulated to not cause problems. When those impulses are no longer regulated properly (like with epilepsy) or if the pathways that the impulses travel are blocked (such as with a brain tumor), one of the outcomes can include seizures.  When the brain has impulses that go unregulated, it is like a house being hit by lightening, the electricity finds the path of least resistance (such as wiring) despite what might be damaged in doing so. In the case of a tumor or blockage of the pathway, imagine that you are driving down the interstate and everything is moving along normally, but then there is an accident up ahead interrupting the normal traffic patterns, you then have to find a new route. The same thing happens in the brain. When something happens to interrupt those impulses, they have to find a new route. In either case, too many or to high of impulses or redirection of impulses, the brain is overloaded and a seizure results.

There are three phases to seizures that I tend to discuss with my clients. They are the preictal (before the seizure), ictal (during the seizure), and postictal (after the seizure) phases.

During the preictal phase some people experience auras, or changes to their mood, thought process, or body. We cannot say specifically if animals have auras or not, but I suspect that they can and do. Some of my clients have reported that when their dogs and cats is about to have a seizure they have a sudden change in behavior – becoming very clingy when they are usually more aloof or going to hide away from everyone when they are usually in the middle of activity, other report a vague sense that something “was not right”, still others do not notice anything amiss. Now, before you worry that your dog or cat is about to start seizing because it is sitting on your lap or just went under you bed, these are normal behaviors! The idea is that if your pet does have seizures (or a person you care for), try and pay attention to subtle clues that may indicate a seizure is coming on as this can help prevent injury and increase the availability of medical aid in a timely manner. On the human side, people report seeing colors, smelling odors, tingling around the lips, or just a vague sense of unease to name a few.

The ictal phase is the actual misfiring of the brain that results in the seizure activity. As I mentioned before these can come in many forms. During this phase you may see tremors or shaking, urination (peeing), defecation (pooping), foaming at the mouth, or an array of other behaviors. In most cases, the person or animal is unaware of what is going on around them. If you suspect that your pet or person is having a seizure, call out to them and see if they respond to you. In the case of seizures the body is not normally able to respond in a normal manner – looking, speaking, and so on. Seizures can be confused with syncope, when the heart stops for a short period of time, that results in collapse with or without tremors. Individuals that have seizures or syncope should receive medical attention to determine what is causing the seizure and also to prevent them in the future.

The postictal phase can last seconds to weeks. In this phase, the brain and body are recovering. Some people report that their auras continue and some do not. Animals that have a prolonged postictal phase often appear anxious and unable to get comfortable. They may pace or pant, they may seek company or try and hide.

During all three phases, it is imperative for both yourself and the patient to stay safe. Decrease stimulus (noise, lights, etc.) so that you are decreasing the information that is going into the brain and move to a safe location if possible such as the floor in the middle of a room or large area to prevent damage from objects or falling on stairs or off of beds, couches, or chairs. Be cautions around heads and mouths as animals (and people) may bite unexpectedly as their mouth clenches – this is not only painful for the person that gets bit, but will also result in the requirement for rabies testing if the animal dies within 10 days of the bite. If anyone gets bit while your pet has a seizure, be honest and report bites to your veterinarian as seizures and other neurologic changes can be a sign of rabies. The person that gets bit should also receive medical attention for the bite.

What are the treatments for seizures?

Immediate treatment of seizures is usually medication injected directly into the blood stream in a medical facility, for people or animals with known seizures rectal medications can be prescribed and given at home, in the worst cases anesthesia may be administered to stop the seizures. Long term treatment or prevention of seizures is generally performed using daily medication taken orally (by mouth). Your doctor or veterinarian will determine what constitutes the best course of treatment for the patient. Brain tumors are often treated with surgery, chemotherapy, or radiation. A relatively new modality of treating brain tumors includes TomoTherapy – this is a treatment that directs radiation at the tumor from multiple angles while decreasing radiation and effects to other areas of the head, such as stopping the radiation while going over the eyes. Sometimes there is no treatment or treatment is directed at the cause of the seizure – underlying disease, trauma, etc.

There is a lot to know about seizures and this listing is not complete, but please take them seriously and talk to your medical professionals with any questions that you have.

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