Meaning of seizures (fits)

Normal functioning of the brain

Our brain is divided up into many different parts. These different brain parts have varied functions.

For example:

  • The brain parts in the front do most of the thinking.
  • The brain parts behind the ears store memories.
  • The brain parts just above the ears help us to move our hands and legs.
  • The brain parts at the very back help us to see things.

And so on…

These parts communicate with each other using minute electrical currents.

This electricity is strictly regulated. Our hand only moves when we want it to move. We remember something only when it is relevant, or we try to remember it. We see something only when our eyes send a electrical current to the brain parts in the back.

Thus, usually these things happen for a reason.

Patients with seizures can get olfactory (smell) hallucinations.

What causes a seizure?

A seizure is caused by a sudden uncontrolled surge of electricity in the brain.

If wires connecting two brain parts are not properly connected, electricity in that area can become un-regulated. This may occasionally cause cause a sudden surges of electricity. Frequently, this electrical surge is suppressed by our brain.

But sometimes, this local electrical surge becomes uncontrollable. It may spread to other areas of the brain, like an electrical storm.

A seizure is like an electrical storm inside our head.

When the electrical storm involves different brain parts, you experience symptoms related to that brain part. For example:

  1. If the electrical surge involves the brain part behind the ears, you may get a sudden surge of memories.
  2. If it involves the brain part above the ears, your hand may cramp up or start shaking
  3. If it involves the back of the brain, you may see things

and so on…

If the electrical storm spreads over the entire brain, your entire body shakes violently and you lose consciousness. At this stage, the electrical storm is called a “Generalized convulsion” or “Generalized Tonic-Clonic seizure”.

When the electrical storm spreads over the entire brain, the entire body may start shaking.

What happens during a seizure?

The symptoms during a seizure depend on which brain part is involved.

A few examples are given above.

Our brain produces ALL our experiences. Therefore, you can get any kind of experience during a seizure.

But some parts of the brain have seizures more frequently than others. Therefore, some symptoms are more common during seizures.

Each part of our brain has a specific, unique function.
Common symptoms which happen during a seizure
  1. A bad odor. It may be disgusting (for example of garbage) or sickeningly sweet.
  2. A bad taste. A metallic taste, or a bitter taste is very common. Some patients report tasting blood.
  3. Extreme fear or anxiety.
  4. A Deja-Vu feeling: An intense feeling of “This has happened to me before”.
  5. Difficulty in talking or understanding other people.
  6. Visual hallucinations: Seeing things that are not really in front of you.
  7. Tingling or numbness in the face, arm or legs
  8. Cramping or shaking of a hand, leg or the entire body.
  9. Involuntarily passing urine or stool.
  10. Blanking out and staring off into space

As noted, any experience can happen with a seizure. Here are some experiences/symptoms that occur with seizures, but less commonly.

Less common symptoms during a seizure
  1. Extreme anger
  2. Extreme happiness or sadness
  3. A feeling of floating away from your body and looking towards it from above (Autoscopy)
  4. A feeling of being one with nature, or with the surroundings (Depersonalization)
  5. Sudden nausea or urge to vomit
  6. Sudden urge to urinate
  7. Dizziness
  8. Hearing strange sounds such as ringing bells or people talking
  9. Repetitive eye blinking

In addition to these symptoms that happen during a seizure, there may be some complications due to a seizure:

  1. You may bite your tongue.
  2. In generalized convulsions (see above), some people may dislocate their shoulder.
  3. In generalized convulsions,  some people may get other injuries – such as bruises or head injuries.
  4. After a seizure, you may have trouble speaking, using a body part or thinking for some time.
You may bite your tongue during a seizure.

Warning signs of a seizure (Aura)

An Aura is the beginning of a seizure. Many patients interpret this as a warning sign of a seizure.

Auras are usually seen with Focal seizures (see below)

When the seizure is small, it produces minimal symptoms. It may produce a bad smell, or some memories, or some problems with eyesight. Later, when the seizure spreads over the entire brain, the patient gets a big seizure.

For example, a patient may smell something bad, and then get a large seizure with violent shaking of the entire body.

An aura is a small seizure that produces subtle symptoms.

When this keeps happening repeatedly the patient recognizes that the bad smell is a warning. This warning is called an “Aura”.

Auras in Primary Generalized Seizures:

Primary generalized seizures (see below) usually don’t produce an aura. The occur without warning. This is because they occur over the entire brain at once.

However, newer research has show that even in these kind of seizures, some patients get a warning. This warning is felt before the big seizure. How this happens is not known.

Auras also occur in primary generalized seizures, but they may be difficut to describe.

Types of seizures

There are two main types of seizures. Focal seizures and Primary Generalized seizures.

Focal seizures:

Partial seizures start in one part of the brain’s surface.

Sometimes, a focal seizure may not spread and produce limited symptoms. At other times,  it may then spread to the entire brain and produce dramatic symptoms.

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Generalized seizures & Focal seizures

Primary Generalized seizures:

Generalized seizures start all over the brain, at once.

It is unclear where they start from. Many researchers believe that they start deep within the brain. These deep-seated brain parts are called the “Basal-Ganglia” & “Thalamus”.

These seizures had different names earlier. For example, focal seizures used to be called “Partial seizures”.

Even more confusingly, each one of these seizures is divided further into many types! Here is the current classification from the ILAE (International League Against Epilepsy):

ilae 2017 classification expanded 0 e1618815599205

How should you keep track of your seizures?

It is very easy to get confused by this complex and ever-changing terminology.

Therefore, I always insist that patients use their own words to describe and label their seizures.

It is easy to get confused by medical terms. It is better to describe seizures in your own words, and name them yourself – for example – “Only bad smell” seizures.

For example, a patient who gets 4 different types of seizures may describe them as below:

  1. “Only Bad smell” seizures
  2. “Right arm Cramping” seizures
  3. “Big whole body shaking” seizures
  4. “Blank staring” seizures

By labeling the seizures simply, it becomes easy to count them.

You can use a paper calendar, diary or your smartphone to record your seizures. There are are many apps.

A nice printable diary is available from the UK Epilepsy society: [Printable Seizure Diary – Click here]

Keeping a detailed log of your seizures helps immensely in titrating your medications.

For apps – I like the free “My Seizure Diary” app which is available both for Android and Apple.

Click here [My seizure diary app for Android & iPhone]

You could also try this alternative seizure tracking app. But this app is only available for Android.

Click here: [Epilepsy Journal app for Android]

Caution: This information is not a substitute for professional care. Do not change your medications/treatment without your doctor's permission.
Dr. Siddharth Kharkar

Dr. Siddharth Kharkar

Dr. Siddharth Kharkar has been recognized as one of the best neurologists in Mumbai by Outlook India magazine and India today Magazine. He is a board certified (American Board of Psychiatry & Neurology certified) Neurologist.

Dr. Siddharth Kharkar is a Epilepsy specialist in Mumbai & Parkinson's specialist in Mumbai, Maharashtra, India.

He has trained in the best institutions in India, US and UK including KEM hospital in Mumbai, Johns Hopkins University in Baltimore, University of California at San Francisco (UCSF), USA & Kings College in London.

Call 022-4897-1800

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NeuroPlus Epilepsy & Parkinson's Clinic - Dr. Kharkar IconNeuroPlus Epilepsy & Parkinson's Clinic - Dr. Kharkar

near LIC, Dr Balabhai Nanavati hospital, near LIC, Swami Vivekananda Road, LIC Colony, Vile Parle

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  • Avatar Paras Prabhu ★★★★★ 6 months ago
    Out patient is epileptic from about 10 years and her seizure gotten worse during the past year with the frequency of about 3-4 times a week.So we consulted … More Dr. Kharkar. He tried a few medicines, and within 1.5-2 months now the patient is feeling very well now. There are no seizures for 14 days currently.Dr. tried to keep medicines as minimum as possible. He also tried to keep the cost of the treatment minimum.When some of the medicines started showing side-effects, he was quick to switch the medicines to the better options.Overall I think we are getting a best of the available treatments. We thank you very much Dr. Kharkar.
  • Avatar Dr Shobha Sankhe ★★★★★ a month ago
    Dr Kharkar is gem of a doctor with tremendous patience, empathy, genuine concern for his patients .He guides them very methodically & scientifically … More for their neurological ill healthOur epilepsy patient is extremely happy with his treatment , Patient feels better by just visiting him too!May his selfless service to humanity flourish to reach all the needy patients!!
  • Avatar shrruti khanna ★★★★★ a month ago
    I consulted Dr Sidharth for my sister who has become very hyper and aggressive and we could not understand the issue. Keeping in mind she is someone with … More special needs Dr Sidharth was extremely understanding of the situation and did not put her through unnecessary investigation and avoided a very long stay at the hospital. He was infact more keen on her returning home to her natural environment. We highly appreciate Dr Sidharth for his effort and for looking into the matter with utmost care. It was a very difficult decision for my family to get my sister admitted but we are glad we did it under his care.Thankyou Doc.
  • Avatar Prashant Purohit ★★★★★ a month ago
    my name is prashant purohit. I m become completely bed ridden from last 9 months and was unable to walk. I couldnt find out the cause even after visiting … More many doctors and many hospital in Ahmedabad nd jodhpur.started losing hope. A good friend of mine suggested to visit a neurologist. After searching a lot, I came to know about Dr. Siddharth Kharkar and took his appointment in Nanavati Hospital. He examined and said that he suffered from \u201cPKD(PAROXYSMAL KNESIGENIC DYSKNESIA\u201c. He assured us to reverse this in 5 days time. And indeed this happened. I started recovering miraculously. today I am fully well fit I m walking as normal . Many Many thanks to Dr. Siddharth Kharkhar sir for giving me a new life.
  • Avatar Sanjay Pradhan ★★★★★ 7 months ago
    Dr. Kharkar is truly exceptional. He is extremely knowledgeable. But simultaneously, he is extremely patient and kind - taking the time and care to respond … More to all the questions. It is rare to come across a doctor who is not in a hurry to get on to the next patient, but instead, focuses on the one in front with full attention, expertise and compassion. A great experience.
  • Avatar N N ★★★★★ 11 months ago
    We visited Dr. Kharkhar for treatment regarding my mum - who is a multi-stroke patient and has aphasia. Certain medications were creating complications … More with her condition and Dr. Kharkhar was able to help mitigate the issue. We found him and his approach to be incredibly compassionate, considerate, individualized and patient-friendly. He advice is astute, up-to-date and empathetic. His treatment always comes from a deeply human place and is about seeing how to help the patient and their caregivers feel more at ease. Something that is quite rare and refreshing within the medical community.We feel that he genuinely cares about the patients that he is treating and is always kind and respectful in his communication. Moreover, his admin team is very efficient and prompt and it's a pleasure to deal with them.Would highly recommend Dr Kharkhar himself - though we must say our experience with Nanavati hospital itself has been less than ideal.Hope this helps.
  • Avatar Manish Ranjan ★★★★★ a year ago
    I have been visiting Dr Kharkar for treatment of my father. He is a very friendly doctor. He listens to our concerns with lot of patience. He also explains … More the issue in much greater details. He has really been of great help. My father is much better now.
  • Avatar Pinakin Shah ★★★★★ 9 months ago
    One of the best Dr. Gives complete attention and time to listen to patient's history, issues. Explains various options of treatment with pros and … More cons.
  • Avatar Lawrence Castellino ★★★★★ 11 months ago
    Exceptional experience with an expert,Dr. Kharkar is a knowledge house. It is rare nowadays to find doctors with patience, knowledge, and a flair for … More handling patient’s questions, besides Dr. Kharkar’s bedside manners are exemplary. I am privileged to be treated by such an amazing soul. I have told him and will repeat it here that “I am advancing my move back to India although I am a US Citizen, because I know I am in good hands and will be well taken care of. Thanks Dr. Kharkar for your selfless service!
  • Avatar Hemant Kansara ★★★★★ a year ago
    Great doctor!! Really appreciate.The doctor diagnosed to my sister correctly and start treatment, she has good improvement after taking medicine prescribed … More by doctor as no epilepsy attake. We have good experience with the doctor. Thank you

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