When Mayra* started having 10- 20-second episodes of staring out into space, her friends and family brushed it off as daydreaming. But when her staring episodes became more frequent, and began to take place during periods of physical activity, Mayra’s parents consulted their family doctor.

After performing an EEG to test her brain activity, the doctor determined that Mayra was experiencing a type of seizure called an absence seizure.

Seizures are defined as a sudden behavioral change because of abnormal electrical activity in the brain. When most people think of seizures, they often picture the grand mal or convulsive type of seizure in which a person loses consciousness and has severe muscle contractions. However, seizures can come in all shapes and sizes depending upon which parts of the brain are involved.

Some seizures, such as grand mal, are more obvious because they can cause a loss of awareness and uncontrollable twitching or shaking of various body parts. However, at other times, seizures can be hard to notice because they can consist of a behavior that seems commonplace, such as Mayra’s experience with staring.

According to Christianne Heck, M.D., assistant professor of clinical neurology at the Keck School of Medicine of USC, “Many events are initially so subtle they go unnoticed or ignored for months or even years.”

She says that some patients may experience odd sensations such as a strange and unexplainable smell or taste that no one else is experiencing. Events of repeated déjà vu are also common.

“These events may represent small seizures or auras and may go undiagnosed until a patient has a major convulsive seizure,” says Heck. “Then in retrospect, we find that they may have been having such auras for a long period of time prior to the convulsion.”

Epilepsy, a condition defined by repeated, unprovoked seizures, affects about 2.5 million Americans, according to the Centers for Disease Control and Prevention. While no one definite cause has been found, it is believed that genetics or injuries at birth may play a role for some people.

In addition, a number of medical issues may contribute to the formation of epilepsy, including traumatic brain injury, severe infections, brain tumors, stroke, drug and alcohol use, and other diseases or conditions such as diabetes or liver failure.

When seizures involve only a small part of the brain, they are called “focal” or “partial.” Further, focal seizures can be “simple,” meaning there is no change in memory or awareness, or “complex” with a change in memory or awareness. This includes the absence type of seizure that Mayra experienced.

If seizures involve the whole brain, they are called “generalized.” Generalized seizures—such as grand mal seizures—can affect the whole body or just parts of the body, and are defined by complete loss of consciousness. They are often accompanied by falls and severe injury, such as fractured bones.

There is a wide range of seizure symptoms; however, most patients experience one or more of the following:

• A disturbance in motor skills, including alternating contraction and relaxation of muscle groups; turning of the head to one side; inability to speak.

• Sensory signs including dizziness; unpleasant odors and tastes; seeing flashing lights, colors or hallucinations; or hearing humming, buzzing or hissing noises.

• Physical symptoms including sweating; nausea; vomiting; incontinence; flushing; goose bumps; dilation of the pupils; and rapid heart rate.

• Emotional symptoms including detachment; memory distortion; and time distortion.

According to the National Institute of Neurological Disorders and Stroke, for 80 percent of those diagnosed with epilepsy, seizures can be controlled with modern medicines and surgical techniques.
“Patients must be their own best advocate,” says Heck. “Many general physicians are not fully aware of or comfortable with diagnosing and treating epilepsy.”

She says that patients should do their best to seek the care of a neurologist if they experience any symptoms of seizure, particularly if they are missing moments of their day, or are unable to account for time in the day.

“These symptoms suggest they may be suffering from partial seizures that they are unaware of. Most cases of epilepsy are easily treated, but to ensure a person’s safety and long term good outcome, the epilepsy should be treated early,” says Heck.

For more information on epileptic seizures, visit the National Institute of Neurological Disorders and Stroke at www.ninds.nih.gov/disorders/epilepsy/epilepsy.htm.

To make an appointment with a USC doctor, visit www.doctorsofusc.com or call 1-800-USC-CARE.

(* Name changed to protect privacy)