What Can Cause Seizures?

Causes of seizures can vary by age. Causes of seizures in newborns, causes of seizures in infants and young children, causes of seizures in children, and adults, as well as seniors, are differences. The common causes of seizures in seniors are stroke, Alzheimer's, and trauma.

Seizures occur when there is a sudden surge of abnormal electrical activity in the brain that usually affects how a person appears or acts for a short time.

There are 3 major groups of seizures:

• Generalized onset seizures
  • Affect both sides of the brain at the same time
  • Includes seizure types like tonic-clonic, absence, or atonic 
• Focal onset seizures
  • Focal seizures can start in one area or in one side of the brain
  • Focal onset aware seizures occur when a person is awake and aware during a seizure (formerly called simple partial seizure)
  • Focal onset impaired awareness seizures occur when a person is confused or awareness is affected during a focal seizure (formerly called a complex partial seizure)
• Unknown onset seizures
  • Occur when the beginning of a seizure is not known, such as if it’s not witnessed by anyone
  • An unknown onset seizure may later be diagnosed as a focal or generalized seizure

Many different symptoms happen during a seizure. The new classification separates them into groups that involve movement.

Symptoms of generalized onset seizures include:

• Motor symptoms 
  • Sustained rhythmical jerking movements (clonic)
  • Muscle weakness or limpness (atonic) 
  • Tense or rigid muscles (tonic)
  • Brief muscle twitching (myoclonus)
  • Epileptic spasms (body flexes and extends repeatedly)
• Non-motor symptoms (absence seizures) 
  • Staring spells
  • Brief twitches that can affect a specific body part or just the eyelids

Symptoms of focal onset seizures include:

• Motor symptoms 
  • Jerking (clonic)
  • Muscle weakness or limpness (atonic) 
  • Tense or rigid muscles (tonic)
  • Brief muscle twitching (myoclonus)
  • Epileptic spasms (body flexes and extends repeatedly)
  • Repeated automatic movements (automatisms), such as clapping or rubbing of hands, lip-smacking, chewing, or running
• Non-motor symptoms
  • Changes in sensation
  • Mood changes
  • Changes in thinking or cognition
  • Changes in autonomic functions (such as gastrointestinal sensations, waves of heat or cold, goosebumps, heart racing, etc.)
  • Lack of movement (behavior arrest)

Symptoms of focal onset seizures include:

• Motor seizures: either tonic-clonic or epileptic spasms
• Non-motor seizures: behavior arrest

Causes of seizures can vary by age.  

Causes of seizures in newborns include:

• Malformations of the brain
• Lack of oxygen during birth
• Low levels of blood sugar, blood calcium, blood magnesium or other electrolyte problems
• Problems with metabolism
• Intracranial bleeding
• Maternal drug use 

Causes of seizures in infants and young children include:

• Infections
• Fever (febrile seizures)
• Brain tumor (rarely)

Causes of seizures in children and adults include:

• Congenital conditions 
  • Down's syndrome
  • Angelman's syndrome
  • Tuberous sclerosis
  • Neurofibromatosis
• Genetics
• Head trauma
• Progressive brain disease (rare)

Causes of seizures in seniors include:

• Stroke
• Alzheimer's disease
• Trauma

Common triggers that may precipitate seizures include:

• Fever or illness
• Lack of sleep
• Stress
• Flashing bright lights or patterns
• Alcohol or drug use
• Certain foods
• Excess caffeine 
• Certain times of day or night
• Menstrual cycle in women or other hormonal changes
• Poor diet 
• Low blood sugar
• Certain medications

Tests used to diagnose the cause of seizures include: 

• Electroencephalogram (EEG) checks for brain wave patterns consistent with seizure activity
• Blood tests to check for certain medical disorders
• Brain imaging to look for abnormal areas such as a tumor or infection
  • X-ray of the brain
  • Computerized tomography (CT) scan
  • Magnetic resonance imaging (MRI) scan 
• Lumbar puncture (also called a spinal tap)
• Electrocardiogram (EKG) to check the heart
• Sleep testing

Treatment for seizures usually involves medicines called anti-epileptic drugs (AEDs), such as:

• Brivaracetam
• Cannabidiol oral solution (Epidiolex)
• Carbamazepine (Carbatrol, Epitol, Tegretol, Tegretol XR
• Cenobamate (Xcopri)
• Clobazam (Onfi, Sympazan)
• Clonazepam (Epitril, Klonopin, Rivotril)
• Diazepam nasal
• Diazepam rectal (Diastat)
• Divalproex sodium (Depacon, Depakote, Depakote ER, Epival)
• Eslicarbazepine Acetate (Aptiom)
• Ethosuximide (Zarontin)
• Ezogabine (Potiga)
• Felbamate (Felbatol)
• Fenfluramine
• Gabapentin (Neurontin)
• Lacosamide (Vimpat)
• Lamotrigine (Lamictal)
• Levetiracetam (Keppra, Keppra XR, Roweepra)
• Lorazepam (Ativan)
• Midazolam nasal (Nayzilam)
• Oxcarbazepine (Oxtellar XR, Trileptal)
• Perampanel (Fycompa)
• Phenobarbital
• Phenytoin (Dilantin, Epanutin, Phenytek)
• Pregabalin (Lyrica)
• Primidone (Mysoline)
• Rufinamide (Banzel, Inovalon)
• Stiripentol (Diacomit)
• Tiagabine hydrochloride (Gabitril)
• Topiramate (Topamax, Qudexy XR, Trokendi XR)
• Valproic Acid (Convulex, Depakene, Depakine, Orfiril, Valporal, Valprosid)
• Vigabatrin (Sabril)
• Zonisamide (Zonegran)

Other treatments for seizures include: 

• Diet therapy, including the ketogenic diet
• Epilepsy surgery 
  • Removal of a small part of the brain that's causing the seizures 
  • Implantation of a small electrical device inside the body to help control seizures