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For people with Down syndrome, family members, caregivers and professionals.

Seizures

October 2018 | Aashima Ghai, DO - Family Medicine Resident, Adult Down Syndrome Center

Definition: Seizures are waves of abnormal electrical activity in the brain. The brain has multiple nerve cells that create and receive electrical impulses which help the cells communicate with each other. During a seizure, these electrical impulses are abnormal and often excessive which can cause abnormal behaviors, awareness, and movements.

Epilepsy definition: Epilepsy is the tendency to have recurrent seizures.

Seizures may be more common in people with Down syndrome (DS). There is a correlation between seizures and Alzheimer’s disease and people with DS have a higher incidence of Alzheimer’s disease. One study showed that as high as 84% of patients with DS and Alzheimer’s disease had seizures.

Causes of seizures:

  • Epilepsy: Brain dysfunction with intermittent abnormal electrical activity. May be related to a brain injury, stroke, or infection. May also be inherited.

  • Provoked seizures: May be caused by low blood sugar, electrolyte imbalances, or certain medications.

  • Nonepileptic seizures: Not caused by abnormal brain activity. May be from fainting, muscle disorders, or a psychologic condition.

  • There may be certain triggers for seizures to occur including but not limited to strong emotions, fevers, stress, intense loud music, or flashing lights.

  • Related to Alzheimer’s disease progression.

Symptoms of a seizure:

  • Patients may pass out at the start of a seizure.

  • Most common type of seizures include convulsions which are jerking movements and they may be followed by tonicity or stiffening of the patient’s muscles.

  • They may affect the entire body or only a part of the body like an arm or leg.

  • Most seizures last from a few seconds to minutes.

  • Most patients will experience a post-ictal state in which they are confused, may not have memory of the event, may have a throbbing headache, and possibly may have some residual weakness.

Diagnosis:

EEG – An electroencephalogram is a test that can be done to diagnose epilepsy. Electrodes are attached to the person’s scalp and connected to the EEG machine which monitors for abnormal activity in the brain. It is safe and painless. Other workup will likely be completed to find the cause of the seizures from the possibilities listed above which may include blood tests and other imaging studies.

Treatment:

  • Depending on cause of seizures, treat the cause.

  • Anti-convulsant medications may be prescribed for short-term or long-term prevention.

What to do when somebody is having a seizure:

  • Secure the environment for safety of the person and yourself.

  • If the person is not lying flat on the floor, help them down to the floor.

  • Place the person on his/her side to keep them from choking on drool or vomit.

  • Loosen any tight clothing, especially around the neck.

  • Place something under the person’s head.

  • Stay with the person until the seizure ends.

  • Do not put anything in their mouth including your fingers as the person may bite down during the seizure.

  • Do not restrain the person or try to stop the movements from the seizure.

When to call 911

  • Call if this is the first time they have had a seizure.

  • Call if the person hits his/her head or is injured.

  • Call if the seizure occurred in water.

  • Call if the shaking episodes lasted more than 5 minutes.

  • Call if a second seizure occurs right after the first.

  • Call if the person is unconscious for more than 5-10 minutes.

References:

Advocate Health Care. (n.d.) How to help someone with seizures. Health eNews. Retrieved from www.ahchealthenews.com/2014/01/16/how-to-help-someone-with-seizures/

Menendez, M. (2005). Down syndrome, Alzheimer’s disease, and seizures. Brain & Development, 27(4), 246-252. https://doi.org/10.1016/j.braindev.2004.07.008

UpToDate. (2018). Seizures: The basics. In C. Armsby (Ed.), UpToDate. Retrieved from www.uptodate.com/contents/seizures-the-basics?search=seizures&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

Wilfong, A. (2018). Seizures in children: Beyond the basics. In J.F. Dashe (Ed.), UpToDate. Retrieved from www.uptodate.com/contents/seizures-in-children-beyond-the-basics?search=seizures&source=search_result&selectedTitle=7~150&usage_type=default&display_rank=7

Please note: The information on this site is for educational purposes only and is not intended to serve as a substitute for a medical, psychiatric, mental health, or behavioral evaluation, diagnosis, or treatment plan by a qualified professional. We recommend you review the educational material with your health providers regarding the specifics of your health care needs.

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