Notes

Epilepsy

Epilepsy is a central nervous system (neurological) disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations, and sometimes loss of awareness.Anyone can develop epilepsy. Epilepsy affects both males and females of all races, ethnic backgrounds and ages.Seizure symptoms can vary widely. Some people with epilepsy simply stare blankly for a few seconds during a seizure, while others repeatedly twitch their arms or legs. Having a single seizure doesn't mean you have epilepsy. At least two unprovoked seizures are generally required for an epilepsy diagnosis.Treatment with medications or sometimes surgery can control seizures for the majority of people with epilepsy. Some people require lifelong treatment to control seizures, but for others, the seizures eventually go away. Some children with epilepsy may outgrow the condition with age.BrainEncyclopedia Entry for Epilepsy :Epilepsy - overview. Epilepsy occurs when changes in the brain cause it to be too excitable or irritable. As a result, the brain sends out abnormal signals. This leads to repeated, unpredictable seizures. (A single seizure that does not happen again is not epilepsy.) Brain structures Epilepsy may be due to a medical condition or injury that affects the brain. Or, the cause may be unknown (idiopathic). Common causes of epilepsy include: Stroke or transient ischemic attack ( TIA ) Dementia , such as Alzheimer disease Traumatic brain injury Infections, including brain abscess , meningitis , encephalitis , and HIV/AIDS Brain problems that are present at birth (congenital brain defect) Brain injury that occurs during or near birth Metabolism disorders present at birth (such as phenylketonuria ) Brain tumor Abnormal blood vessels in the brain Other illness that damages or destroys brain tissue Seizure disorders that run in families (hereditary epilepsy) Epileptic seizures usually begin between ages 5 and 20. There is also a higher chance of seizures in adults older than 60. But epileptic seizures can happen at any age. There may be a family history of seizures or epilepsy.Symptoms vary from person to person. Some people may have simple staring spells. Others have violent shaking and loss of alertness. The type of seizure depends on the part of the brain that is affected. Most of the time, the seizure is similar to the one before it. Some people with epilepsy have a strange sensation before each seizure. Sensations may be tingling, smelling an odor that is not actually there, or emotional changes. This is called an aura. Your doctor can tell you more about the specific type of seizure you may have: Absence (petit mal) seizure (staring spells) Generalized tonic-clonic (grand mal) seizure (involves the entire body, including aura, rigid muscles, and loss of alertness) Partial (focal) seizure (can involve any of the symptoms described above, depending on where in the brain the seizure starts).The doctor will perform a physical exam. This will include a detailed look at the brain and nervous system. An EEG (electroencephalogram) will be done to check the electrical activity in the brain. People with epilepsy often have abnormal electrical activity seen on this test. In some cases, the test shows the area in the brain where the seizures start. The brain may appear normal after a seizure or between seizures. To diagnose epilepsy or plan for epilepsy surgery, you may need to: Wear an EEG recorder for days or weeks as you go about your everyday life. Stay in a special hospital where brain activity can be recorded while video cameras capture what happens to you during the seizure. This is called video EEG. Tests that may be done include: Blood chemistry Blood sugar Complete blood count ( CBC ) Kidney function tests Liver function tests Lumbar puncture (spinal tap) Tests for infectious diseases Head CT or MRI scan is often done to find the cause and location of the problem in the brain.Treatment for epilepsy includes taking medicines, lifestyle changes, and sometimes surgery. If epilepsy is due to a tumor, abnormal blood vessels, or bleeding in the brain, surgery to treat these disorders may make the seizures stop. Medicines to prevent seizures, called anticonvulsants (or antiepileptic drugs), may reduce the number of future seizures: These drugs are taken by mouth. Which type you are prescribed depends on the type of seizures you have. Your dosage may need to be changed from time to time. You may need regular blood tests to check for side effects. Always take your medicine on time and as directed. Missing a dose can cause you to have a seizure. DO NOT stop taking or change medicines on your own. Talk to your doctor first. Many epilepsy medicines cause birth defects. Women who plan to become pregnant should tell their doctor in advance in order to adjust medicines. Many epilepsy drugs may affect the health of your bones. Talk to your doctor about whether you need vitamins and other supplements. Epilepsy that does not get better after 2 or 3 anti-seizure drugs have been tried is called 'medically refractory epilepsy.' In this case, the doctor may recommend surgery to: Remove the abnormal brain cells causing the seizures. Place a vagal nerve stimulator (VNS). This device is similar to a heart pacemaker. It can help reduce the number of seizures. Role of the vagus nerve in epilepsy Some children are placed on a special diet to help prevent seizures. The most popular one is the ketogenic diet. A diet low in carbohydrates, such as the Atkins diet, may also be helpful in some adults. Be sure to discuss these options with your doctor before trying them. Lifestyle or medical changes can increase the risk for a seizure in adults and children with epilepsy. Talk with your doctor about: New prescribed drugs, vitamins, or supplements Emotional stress Illness, especially infection Lack of sleep Pregnancy Skipping doses of epilepsy medicines Use of alcohol or other recreational drugs Other considerations: People with epilepsy should wear medical alert jewelry so that prompt treatment can be obtained if a seizure occurs. People with poorly controlled epilepsy should not drive. Check your state's law about which people with a history of seizures are allowed to drive. DO NOT use machinery or do activities that can cause loss of awareness, such as climbing to high places, biking, and swimming alone.The stress of having epilepsy or being a caretaker of someone with epilepsy can often be helped by joining a support group. In these groups, members share common experiences and problems.Some people with epilepsy may be able to reduce or even stop their anti-seizure medicines after having no seizures for several years. Certain types of childhood epilepsy go away or improve with age, usually in the late teens or 20s. For many people, epilepsy is a lifelong condition. In these cases, anti-seizure drugs need to be continued. There is a very low risk for sudden death with epilepsy.Complications may include: Difficulty learning Breathing in food or saliva into the lungs during a seizure, which can cause aspiration pneumonia Injury from falls, bumps, self-inflicted bites, driving or operating machinery during a seizure Permanent brain damage (stroke or other damage) Side effects of medicines.Call your local emergency number (such as 911) if: This is the first time a person has a seizure A seizure occurs in someone who is not wearing a medical ID bracelet (which has instructions explaining what to do) In the case of someone who has had seizures before, call 911 for any of these emergency situations: This is a longer seizure than the person normally has, or an unusual number of seizures for the person Repeated seizures over a few minutes Repeated seizures in which consciousness or normal behavior is not regained between them (status epilepticus) Call your doctor if any new symptoms occur: Loss of hair Nausea or vomiting Rash Side effects of medicines, such as drowsiness, restlessness, confusion, sedation Tremors or abnormal movements, or problems with coordination.There is no known way to prevent epilepsy. Proper diet and sleep, and staying away from alcohol and illegal drugs may decrease the likelihood of triggering seizures in people with epilepsy. Reduce the risk for head injury by wearing a helmet during risky activities. This can lessen the likelihood of a brain injury that leads to seizures and epilepsy.Seizure disorder; Epileptic - epilepsy.Brain surgery - discharge Epilepsy in children - discharge Epilepsy or seizures - discharge Epilepsy - what to ask your doctor - adult Epilepsy - what to ask your doctor - child Febrile seizures - what to ask your doctor Stereotactic radiosurgery - discharge.Brain structures Brain structures Limbic system Limbic system Role of the vagus nerve in epilepsy Role of the vagus nerve in epilepsy Central nervous system and peripheral nervous system Central nervous system and peripheral nervous system First aid convulsions, part 1 Convulsions - first aid - series.Abou-Khalil BW, Gallagher MJ, Macdonald RL. Epilepsies.Encyclopedia Entry for Epilepsy :Epilepsy - resources. Resources - epilepsy.Epilepsy - what to ask your doctor - adult Epilepsy - what to ask your doctor - child.Central nervous system Central nervous system and peripheral nervous system.Encyclopedia Entry for Epilepsy :Epilepsy - what to ask your doctor - adult. Should I call you, or someone else, every time I have a seizure? What safety measures do I need to take at home to prevent injuries when I have a seizure? Is it OK for me to drive? Where can I call to find more information about driving and epilepsy? What should I discuss with my boss at work about my epilepsy? Are there work activities that I should avoid? Will I need to rest during the day? Will I need to take medicines during the work day? Are there any sports activities that I should not do? Do I need to wear a helmet for any type of activities? Do I need to wear a medical alert bracelet? Who else should know about my epilepsy? Is it ever OK for me to be alone? What do I need to know about my seizure medicines? What medicines am I taking? What are the side effects? Can I take antibiotics or other medicines also? How about acetaminophen (Tylenol), vitamins, herbal remedies? Will birth control pills still work if I am taking medicines for my seizures? What are the risks of these medicines if I were to get pregnant? How should I store the seizure medicines? What happens if I miss one or more doses? Can I ever stop taking a seizure medicine if there are side effects? Can I drink alcohol with my medicines? How often do I need to see the provider? When do I need blood tests? What should I do if I am having trouble sleeping at night? What are the signs that my epilepsy is becoming worse? What should others with me do when I am having a seizure? After the seizure is over, what should they do? When should they call the provider? When should we call 911?.What to ask your doctor about epilepsy - adult; Seizures - what to ask your doctor - adult; Seizure - what to ask your doctor.Abou-Khalil BW, Gallagher MJ, Macdonald RL. Epilepsies.Encyclopedia Entry for Epilepsy :Epilepsy - what to ask your doctor - child. What safety measures do I need to take at home to keep my child safe during a seizure? What should I discuss with my child's teachers about epilepsy? Will my child need to take medicines during the school day? Can my child participate in gym class and recess? Are there any sports activities that my child should not do? Does my child need to wear a helmet for any type of activities? Does my child need to wear a medical alert bracelet? Who else should know about my child's epilepsy? Is it ever OK to leave my child alone? What do we need to know about my child's seizure medicines? What medicines does my child take? What are the side effects? Can my child take antibiotics or other medicines also? How about acetaminophen (Tylenol), vitamins, or herbal remedies? How should I store the seizure medicines? What happens if my child misses one or more doses? Can my child ever stop taking a seizure medicine if there are side effects? How often does my child need to see the doctor? When does my child need blood tests? Will I always be able to tell my child is having a seizure? What are the signs that my child's epilepsy is becoming worse? What should I do when my child is having a seizure? When should I call 911? After the seizure is over, what should I do? When should I call the doctor?.What to ask your doctor about epilepsy - child; Seizures - what to ask your doctor - child.Abou-Khalil BW, Gallagher MJ, Macdonald RL. Epilepsies.Encyclopedia Entry for Epilepsy :Epilepsy in children - discharge. If the doctor sent your child home with medicines, it is to help prevent more seizures occurring in your child. The medicine can help your child avoid having seizures, but it does not guarantee that seizures will not occur. The doctor may need to change the dosage of your child's seizure drugs or use different medicines if seizures persist despite your child taking the medicines, or because your child is having side effects.Your child should get plenty of sleep and try to have as regular schedule as possible. Try to avoid too much stress. You should still set rules and limits, along with consequences, for a child with epilepsy. Make sure your home is safe to help prevent injuries when a seizure takes place: Keep bathroom and bedroom doors unlocked. Keep these doors from being blocked. Make sure your child stays safe in the bathroom. Younger children should not take a bath without someone present. DO NOT leave the bathroom without taking your child with you. Older children should only take showers. Put pads on sharp corners of furniture. Place a screen in front of the fireplace. Use nonslip flooring or cushioned floor covers. DO NOT use freestanding heaters. Avoid letting a child with epilepsy sleep on the top bunk. Replace all glass doors and any windows near the ground with either safety glass or plastic. Plastic cups should be used instead of glassware. The use of knives and scissors should be supervised. Supervise your child in the kitchen. Most children with seizures can lead an active lifestyle. You should still plan ahead for the possible dangers of certain activities. These activities should be avoided if a loss of consciousness or control would result in an injury. Safe activities include jogging, aerobics, moderate cross-country skiing, dancing, tennis, golf, hiking, and bowling. Games and playing in gym class or on the playground are generally OK. Supervise your child when swimming. To prevent head injury , your child should wear a helmet during bike riding, skateboarding, and similar activities. Children should have someone to help them climb on a jungle gym or perform gymnastics. Ask your child's doctor about your child participating in contact sports. Have your child carry and take seizure medicines at school. Teachers and others at schools should know about your child's seizures and seizure medicines. Your child should wear a medical alert bracelet. Tell family members, friends, teachers, school nurses, babysitters, swimming instructors, lifeguards, and coaches about your child's seizure disorder.DO NOT stop giving your child seizure medicines without talking with your child's doctor. DO NOT stop giving your child seizure medicines just because the seizures have stopped. Tips for taking seizure medicines: DO NOT skip a dose. Get refills before the medicine runs out. Keep seizure medicines in a safe place, away from young children. Store medicines in a dry place, in the bottle that they came in. Throw away all old bottles. If your child misses a dose: Have them take it as soon as you remember. If it is already time for the next dose, skip the dose that you forgot to give your child and go back to the schedule. DO NOT give a double dose. If your child misses more than one dose, talk with the child's health care provider. Drinking alcohol and taking illegal drugs can change the way seizure medicines work. Be aware of this possible problem in teenagers. The provider may need to check your child's blood level of the seizure drug on a regular basis. Seizure medicines have side effects. If your child started taking a new drug recently, or the doctor changed your child's dose, these side effects may go away. Always ask the child's doctor about any possible side effects. Also talk to your child's doctor about foods or other medicines that can change the blood level of an anti-seizure drug.Once a seizure starts, family members and caregivers can help make sure the child is safe from further injury and call for help, if needed. Your doctor may have prescribed a medicine that can be given during a prolonged seizure to make it stop sooner. Follow instructions on how to give the medicine to the child. When a seizure occurs, the main goal is to protect the child from injury and make sure the child can breathe well. Try to prevent a fall. Help the child to the ground in a safe area. Clear the area of furniture or other sharp objects. Turn the child on their side to make sure the child's airway does not get obstructed during the seizure. Cushion the child's head. Loosen tight clothing, especially around the child's neck. Turn the child on their side. If vomiting occurs, turning the child on their side helps make sure that they do not inhale vomit into their lungs. Stay with the child until they recover, or medical help arrives. Meanwhile, monitor the child's pulse and rate of breathing (vital signs). Things to avoid: DO NOT restrain (try to hold down) the child. DO NOT place anything between the child's teeth during a seizure (including your fingers). DO NOT move the child unless they are in danger or near something hazardous. DO NOT try to make the child stop convulsing. They have no control over the seizure and are not aware of what is happening at the time. DO NOT give the child anything by mouth until the convulsions have stopped and the child is fully awake and alert. DO NOT start CPR unless the child has clearly stopped having the seizure and is still not breathing and has no pulse.Call your child's doctor if your child has: Seizures that have been happening more often Side effects from medicines Unusual behavior that was not present before Weakness, problems with seeing, or balance problems that are new Call 911 if: A seizure lasts more than 2 to 5 minutes. Your child does not wake up or have normal behavior within a reasonable time after a seizure. Another seizure starts before your child returns to awareness after a seizure ends. Your child had a seizure in water or appears to have inhaled vomit or any other substance. The person is injured or has diabetes. There is anything different about this seizure compared to the child's usual seizures.Seizure disorder in children - discharge.Camfield PR, Camfield CS. Pediatric epilepsy: an overview.Encyclopedia Entry for Epilepsy :Epilepsy in children. Epilepsy may be due to a medical condition or injury that affects the brain. Or the cause may be unknown. Common causes of epilepsy include: Traumatic brain injury Damage or scarring after infections of the brain Birth defects that involve the brain Brain injury that occurs during or near birth Metabolic disorders present at birth (such as phenylketonuria ) Benign brain tumor, often very small Abnormal blood vessels in the brain Stroke Other illnesses that damage or destroy brain tissue Epileptic seizures usually start between ages 5 and 20. But they can happen at any age. There may be a family history of seizures or epilepsy. A febrile seizure is a convulsion in a child triggered by a fever. Most of the time, a febrile seizure is not a sign that the child has epilepsy.Symptoms vary from child to child. Some children may simply stare. Others may shake violently and lose alertness. The movements or symptoms of a seizure may depend on the part of the brain that is affected. Your child's health care provider can tell you more about the specific type of seizure your child may have: Absence (petit mal) seizure : Staring spells Generalized tonic-clonic (grand mal) seizure : Involves the entire body, including aura, rigid muscles, and loss of alertness Partial (focal) seizure : Can involve any of the symptoms described above, depending on where in the brain the seizure starts Most of the time, the seizure is similar to the one before it. Some children have a strange sensation before a seizure. Sensations may be tingling, smelling an odor that is not actually there, feeling fear or anxiety for no reason or having a sense of d j vu (feeling that something has happened before). This is called an aura.The provider will: Ask about your child's medical and family history in detail Ask about the seizure episode Do a physical exam of your child, including a detailed look at the brain and nervous system The provider will order an EEG (electroencephalogram) to check the electrical activity in the brain. This test often shows any abnormal electrical activity in the brain. In some cases, the test shows the area in the brain where the seizures start. The brain may appear normal after a seizure or between seizures. To diagnose epilepsy or plan for epilepsy surgery, your child may need to: Wear an EEG recorder for few days during day-to-day activities Stay in the hospital where brain activity can be watched on video cameras (video EEG) The provider also may order other tests, including: Blood chemistry Blood sugar Complete blood count (CBC) Kidney function tests Liver function tests Lumbar puncture (spinal tap) Tests for infectious diseases Head CT or MRI scan are often done to find the cause and location of the problem in the brain. Much less often, PET scan of the brain is needed to help plan surgery.Treatment for epilepsy includes: Medicines Lifestyle changes Surgery If your child's epilepsy is due to a tumor, abnormal blood vessels, or bleeding in the brain, surgery may be needed. Medicines to prevent seizures are called anticonvulsants or antiepileptic drugs. These may reduce the number of future seizures. These medicines are taken by mouth. The type of medicine prescribed depends on the type of seizure your child has. The dosage may need to be changed from time to time. The provider may order regular blood tests to check for side effects. Always make sure your child takes the medicine on time and as directed. Missing a dose can cause your child to have a seizure. Do NOT stop or change medicines on your own. Talk to the provider first. Many epilepsy drugs may affect your child's bone health. Talk to your child's provider about whether your child needs vitamins and other supplements. Epilepsy that is not well controlled after trying a number of antiseizure drugs is called 'medically refractory epilepsy.' In this case, the doctor may recommend surgery to: Remove the abnormal brain cells causing the seizures. Place a vagal nerve stimulator (VNS). This device is similar to a heart pacemaker. It can help reduce the number of seizures. Some children are placed on a special diet to help prevent seizures. The most popular one is the ketogenic diet. A diet low in carbohydrates, such as the Atkins diet, also may be helpful. Be sure to discuss these options with your child's provider before trying them. Epilepsy is often a lifelong or chronic illness. Important management issues include: Taking medicines Staying safe, such as never swimming alone, fall-proofing your home and so on Managing stress and sleep Avoiding alcohol and drug abuse Keeping up in school Managing other illnesses Managing these lifestyle or medical issues at home can be a challenge. Be sure to talk with your child's provider if you have concerns.The stress of being a caretaker of a child with epilepsy can often be helped by joining a support group. In these groups, members share common experiences and problems.Most children with epilepsy live a normal life. Certain types of childhood epilepsy go away or improve with age, usually in the late teens or 20s. If your child does not have seizures for a few years, the provider may stop medicines. For many children, epilepsy is a lifelong condition. In these cases, the medicines need to be continued. Children who have developmental disorders in addition to epilepsy may face challenges throughout their life. Knowing more about the condition will help you take better care of your child's epilepsy.Complications may include: Difficulty learning Breathing in food or saliva into the lungs during a seizure, which can cause aspiration pneumonia Irregular heartbeat Injury from falls, bumps, or self-caused bites during a seizure Permanent brain damage (stroke or other damage) Side effects of medicines.Call your local emergency number (such as 911) if: This is the first time your child has a seizure A seizure occurs in a child who is not wearing a medical ID bracelet (which has instructions explaining what to do) If your child has had seizures before, call 911 for any of these emergency situations: The seizure is longer than the child normally has or the child has an unusual number of seizures The child has repeated seizures over a few minutes The child has repeated seizures in which consciousness or normal behavior is not regained between them (status epilepticus) The child gets injured during the seizure The child has difficulty breathing Call the provider if your child has new symptoms: Nausea or vomiting Rash Side effects of medicines, such as drowsiness, restlessness, or confusion Tremors or abnormal movements, or problems with coordination Contact the provider even if your child is normal after the seizure has stopped.There is no known way to prevent epilepsy. Proper diet and sleep may decrease the chances of seizures in children with epilepsy. Reduce the risk of head injury during risky activities. This can decrease the likelihood of a brain injury that leads to seizures and epilepsy.Seizure disorder - children; Convulsion - childhood epilepsy; Medically refractory childhood epilepsy; Anticonvulsant - childhood epilepsy; Antiepileptic drug - childhood epilepsy; AED - childhood epilepsy.Ghatan S, McGoldrick PE, Kokoszka MA, Wolf SM. Pediatric epilepsy surgery.Encyclopedia Entry for Epilepsy :Epilepsy or seizures - discharge. Your doctor sent you home with medicines to help keep you from having more seizures. This is because the doctor concluded you were at risk of having more seizures. After you get home, your doctor may still need to change the dosage of your seizure drugs or add new medicines. This may be because your seizures are not controlled, or you are having side effects.You should get plenty of sleep and try to keep as regular a schedule as possible. Try to avoid too much stress. Make sure your home is safe to help prevent injuries if a seizure takes place: Keep your bathroom and bedroom doors unlocked. Keep these doors from being blocked. Take showers only. DO NOT take baths because of the risk of drowning during a seizure. When cooking, turn pot and pan handles toward the back of the stove. Fill your plate or bowl near the stove instead of taking all of the food to the table. If possible, replace all glass doors either with safety glass or plastic. Most people with seizures can have a very active lifestyle. You should still plan ahead for the possible dangers of a certain activity. DO NOT do any activity during which loss of consciousness would be dangerous. Wait until it is clear that seizures are unlikely to occur. Safe activities include: Jogging Aerobics Cross-country skiing Tennis Golf Hiking Bowling There should always be a lifeguard or buddy present when you go swimming. Wear a helmet during bike riding, skiing, and similar activities. Ask your doctor if it is OK for you to play contact sports. Avoid activities during which having a seizure would put you or someone else in danger. Wear a medical alert bracelet. Tell family, friends, and the people you work with about your seizure disorder. Driving your own car is generally safe and legal once the seizures are controlled. State laws vary. You can get information about your state law from your doctor and the Department of Motor Vehicles (DMV).Never stop taking seizure medicines without talking with your doctor. DO NOT stop taking your seizure medicines just because your seizures have stopped. Tips for taking your seizure medicines: DO NOT skip a dose. Get refills before you run out. Keep seizure medicines in a safe place, away from children. Store medicines in a dry place, in the bottle that they came in. Throw away all old bottles. If you miss a dose: Take it as soon as you remember. Check with your doctor about what to do if you miss a dose for more than a few hours. There are many seizure medicines with different dosing schedules. If you miss more than one dose, talk with your doctor or nurse. Mistakes are unavoidable and you may miss several doses at some point. So it may be useful to have this discussion ahead of time rather than when it happens. Drinking alcohol or doing illegal drugs can cause seizures. DO NOT drink alcohol if you take seizure medicines. Using alcohol or illegal drugs will change the way your seizure medicines work in your body. This may increase the risk of seizures or side effects. Your health care provider will tell you when you need to check the blood level of your seizure drug. Seizure drugs have side effects. If you started taking a new drug recently, or your doctor changed the dosage of your seizure drug, these side effects may go away. Always ask your doctor about the side effects you may have and how to manage them. Many seizure medicines can weaken the strength of your bones ( osteoporosis ). Ask your doctor about how to reduce the risk of osteoporosis through exercise and vitamin and mineral supplements. For women during childbearing years: If you are planning on becoming pregnant, talk to your doctor about your seizure medicines beforehand. If you get pregnant while taking seizure medicines, talk to your doctor right away. Ask your doctor if there are certain vitamins and supplements you should take in addition to your prenatal vitamin to prevent birth defects. Never stop taking your seizure medicines without talking to your doctor first.Once a seizure starts, there is no way to stop it. Family members and caregivers can only help make sure you are safe from further injury. They can also call for help, if needed. When a seizure starts, family members or caregivers should try to keep you from falling. They should help you to the ground, in a safe area. They should clear the area of furniture or other sharp objects. Caregivers should also: Cushion your head. Loosen tight clothing, especially around your neck. Turn you on your side. If vomiting occurs, turning you on your side helps make sure you do not inhale vomit into your lungs. Stay with you until you recover or medical help arrives. Meanwhile, caregivers should monitor your pulse and rate of breathing (vital signs). Things your friends and family members should not do: DO NOT restrain you (try to hold you down). DO NOT place anything between your teeth during a seizure (including their fingers). DO NOT move you unless you are in danger or near something hazardous. DO NOT try to make you stop convulsing. You have no control over your seizures and are not aware of what is happening at the time. DO NOT give you anything by mouth until the convulsions have stopped and you are fully awake and alert. DO NOT start CPR unless the seizure has clearly stopped and you are not breathing or have no pulse.Call your doctor if you have: More frequent seizures than usual, or seizures starting again after being well controlled for a long period. Side effects from medicines Unusual behavior that was not present before Weakness, problems with seeing, or balance problems that are new Call 911 if: This is the first time the person has had a seizure. A seizure lasts more than 2 to 5 minutes. The person does not wake up or have normal behavior after a seizure. Another seizure starts before the person has fully returned to a state of awareness, after a previous seizure. The person had a seizure in water. The person is pregnant, injured, or has diabetes. The person does not have a medical ID bracelet (instructions explaining what to do). There is anything different about this seizure compared to the person's usual seizures.Focal seizure - discharge; Jacksonian seizure - discharge; Seizure - partial (focal) - discharge; TLE - discharge; Seizure - temporal lobe - discharge; Seizure - tonic-clonic - discharge; Seizure - grand mal - discharge; Grand mal seizure - discharge; Seizure - generalized - discharge.Abou-Khalil BW, Gallagher MJ, Macdonald RL. Epilepsies.Encyclopedia Entry for Epilepsy :Epilepsy. Can be caused by the B variant of Human Herpesvirus 6 virus (HHV-6B) and Human Papillomavirus infection of the brain.