Seizures - Inpatient

This occurs when there is abnormal electrical activity in the brain that causes changes in movement, sensation, or level of consciousness.




This occurs when there is abnormal electrical activity in the brain that causes changes in movement, sensation, or level of consciousness.



Seizures occur when there is abnormal electrical activity in the brain that causes changes in movement, sensation, or level of onsciousness. Epilepsy is another name for a seizure disorder. It is diagnosed when there have been at least two seizures not caused by a reversible condition, such as low blood sugar or alcohol withdrawal. According to the National Institute of Neurological Disorders and Stroke (NINDS) “the epilepsies are a spectrum of brain disorders ranging from severe, life-threatening and disabling, to ones that are much more benign. In epilepsy, the normal pattern of neuronal activity becomes disturbed, causing strange sensations, emotions, and behavior or sometimes convulsions, muscle spasms, and loss of consciousness.

  • In some people the cause of epilepsy is known (e.g., head trauma, brain tumors, or congenital abnormalities), but in some people the cause cannot be identified (idiopathic epilepsy).

There are many different types of seizures in adults and children, but they can generally be divided into generalized seizures and focal seizures (also known as partial or local seizures).

  • Focal seizures affect one side of the brain. Sometimes the person remains conscious and experiences tastes, smells, sounds, flashing lights, a tingling sensation, or uncontrollable movement in an arm or leg. They may sit motionless and appear to be staring off into space.
  • Generalized or convulsive seizures are more severe and affect both sides of the brain. The person loses consciousness and may fall to the floor when the seizure begins. The muscles will spasm, causing the person to thrash about with their arms and legs jerking uncontrollably. Sometimes the person will lose control of their bladder and bowels.

It is often difficult to determine the exact cause of recurrent seizures (epilepsy). Some possible causes include:

  • head trauma
  • various medical conditions, such as a stroke, brain tumor, AIDS, liver and kidney failure, thyroid disease, or infection in the brain
  • electrolyte imbalance or water intoxication
  • drug or alcohol use or withdrawal
  • poisoning from lead, mercury, strychnine, or insecticides
  • certain medications
  • eclampsia (serious condition that can develop during pregnancy)

In addition, seizures are more common in younger children, older adults, and people who have a family history of seizures. Children who have seizures do not typically have a brain disorder and a cause is often not found. When a cause is present, seizures in children may be the result of fever, infection, head trauma, blood sugar that is to low or to high, lack of oxygen, poisoning (lead, mercury, strychnine, or insecticides), and an abnormal heart rhythm.

For someone who has a seizure disorder, seizures may be triggered by stress, missed anti-seizure medications, certain prescription or over-the-counter medications, alcohol withdrawal and drug use, lack of sleep, and menstruation. Prior to a seizure, some people have an “aura,” indicating a seizure is going to happen. An aura can be a variety of strange sensations, such as tingling, abnormal smells, flashing lights, or emotional changes. If you believe you have had a seizure, or a family member or companion observed a possible seizure, you should contact your healthcare provider immediately. He or she will do a physical examination and ask questions about your symptoms, including the duration of your seizures. Obtaining information from family members who were present during a seizure may be helpful.

  • An electroencephalogram (EEG), which records brain waves using electrodes placed on the scalp, is the most common diagnostic test to evaluate seizures. If possible, this test should be done within 24 hours of the first seizure.
  • If a brain tumor or cyst is suspected, you may need imaging studies such as a MRI or CT scan
  • Blood work also may be recommended to exclude possible causes of a seizure. This blood work will also be helpful if the decision is made to start anticonvulsant medications.

Most patients with a seizure disorder can be managed as an outpatient. This care path includes the costs for inpatient evaluation and treatment of a seizure disorder. Inpatient care may be needed if seizures are not well controlled or resulted in a severe injury. An inpatient stay may also be necessary when someone requires prolonged observation with EEG monitoring. This procedure is often done to make a diagnosis of seizures, determine how well the seizure disorder is controlled, and to determine the effect of treatment.

If you have had a seizure, you should see your healthcare provider.

  • Before your appointment, make a list of your medical history, including past illnesses, surgeries and hospitalizations; your medications (including over-the-counter); and any questions or concerns you want to discuss.
  • During your appointment, ask about your overall health, what symptoms you might have, when you may start to see improvement; what the follow-up plans are, if any; and what symptoms you should report before your next appointment.
  • After your appointment, you should know your diagnosis, what tests you might need, the reason for those tests, and if the test results will change your treatment plan. You should also understand your treatment plan, any possible alternatives, and what medications are recommended (including possible side effects).
  • If your healthcare provider prescribes a medication for you, ask for a generic version. If your doctor thinks that a generic version is not right for you, ask for a medication on the lowest available tier of your Prescription Drug List (PDL).

What should I ask my healthcare provider about my seizures?

  • Do I have epilepsy? If so, what type of epilepsy do I have?
  • What are my treatment options?
  • Why do I have to be hospitalized? Can my seizures be managed as an outpatient?
  • What are the potential side effects of the medications? What if the medication does not work?
  • How long will I have to take the medication?
  • How often will I need blood work?
  • What do I do if I have a seizure? How can I help prepare my family?
  • Can I drive? If not, when will I be able to drive again?
  • Do I need to restrict any of my activities?

Source UHC.com

Also known as:

Seizures - Inpatient
Seizures
Fits
Epilepsy


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