Fits: Symptoms, Causes, Diagnosis, and Treatment

“Fits,” commonly known as seizures, are sudden, uncontrolled electrical disturbances in the brain that can cause changes in behavior, movements, feelings, or levels of consciousness. Seizures can be a one-time occurrence due to an acute illness or an ongoing condition such as epilepsy. Understanding the symptoms, causes, diagnosis, and treatment of fits is crucial for managing this condition effectively.

Symptoms of Fits

The symptoms of fits vary depending on the type of seizure and which part of the brain is affected. The primary types of seizures are generalized and focal.

1. Generalized Seizures:
   • Tonic-Clonic Seizures (Grand Mal): Characterized by loss of consciousness, body stiffening (tonic phase), followed by jerking movements (clonic phase), and sometimes loss of bladder control or biting of the tongue.
   • Absence Seizures (Petit Mal): Brief episodes of staring, often mistaken for daydreaming, lasting only a few seconds with no recollection of the event.
   • Myoclonic Seizures: Sudden, brief jerks or twitches of the arms or legs.
   • Atonic Seizures: Sudden loss of muscle tone, causing the person to collapse or fall.
   • Tonic Seizures: Sudden stiffening of the muscles, often affecting the back, legs, and arms.
   • Clonic Seizures: Repeated jerking movements that are rhythmic.
2. Focal Seizures (Partial Seizures):
   • Simple Focal Seizures: Affect a small part of the brain and can cause twitching, changes in sensation (e.g., strange taste or smell), or a sense of déjà vu.
   • Complex Focal Seizures: Can cause confusion, unresponsiveness, and repetitive movements such as hand-rubbing or walking in circles.
   • Secondary Generalized Seizures: Focal seizures that evolve into generalized seizures, leading to loss of consciousness.

Causes of Fits

Seizures can be caused by various factors, and in some cases, the cause remains unknown. Common causes include:

1. Epilepsy: A neurological disorder where the brain’s electrical activity becomes abnormal, causing recurrent seizures.
2. Infections: Meningitis, encephalitis, and other infections that affect the brain can trigger seizures.
3. Head Injury: Traumatic brain injuries can cause seizures, sometimes developing years after the injury.
4. Stroke: A leading cause of seizures in older adults, strokes disrupt the brain’s blood supply, leading to brain damage and seizures.
5. Brain Tumors: Abnormal growths in the brain can disrupt electrical activity, leading to seizures.
6. Genetic Factors: Some forms of epilepsy are hereditary, meaning they are passed down through families.
7. Metabolic Imbalances: Imbalances in blood sugar, sodium, calcium, or other electrolytes can lead to seizures.
8. Drug or Alcohol Withdrawal: Sudden withdrawal from alcohol, certain medications, or drugs can trigger seizures.
9. Fevers (Febrile Seizures): High fevers, particularly in young children, can cause seizures.
10. Prenatal Injury: Brain damage before birth due to infection, poor nutrition, or oxygen deprivation can lead to epilepsy.

Diagnosis of Fits

Diagnosing the cause and type of seizure is crucial for proper treatment. The diagnostic process typically involves:

1. Medical History:
   • Detailed Account: A detailed history of the seizure, including its onset, duration, and characteristics, is vital.
   • Family History: Any family history of epilepsy or other neurological disorders.
2. Physical and Neurological Examination:
   • Physical Exam: Checking for signs of injury or underlying conditions that might be causing seizures.
   • Neurological Exam: Evaluating brain function, including motor skills, sensory perception, reflexes, and mental status.
3. Electroencephalogram (EEG):
   • EEG Test: This test measures electrical activity in the brain and can identify abnormal patterns associated with seizures.
4. Imaging Tests:
   • MRI or CT Scan: Imaging tests help detect brain abnormalities like tumors, cysts, or structural issues.
   • Functional MRI or PET Scan: Advanced imaging techniques can identify the specific brain areas responsible for seizures.
5. Blood Tests:
   • Metabolic Testing: Blood tests can identify metabolic or genetic conditions that may be causing seizures.
   • Toxicology Screen: Checking for drugs or toxins that might have triggered a seizure.
6. Lumbar Puncture:
   • Spinal Tap: This procedure may be performed to rule out infections or other central nervous system issues.
7. Video EEG Monitoring:
   • Video Monitoring: Combines EEG with video recording to capture and analyze seizures as they happen, helping to pinpoint their origin.

Treatment of Fits

The treatment for fits varies based on the underlying cause, frequency, and severity of the seizures. Treatment options include:

1. Medications:
   • Anti-Epileptic Drugs (AEDs): The most common treatment for epilepsy and seizures. AEDs work by stabilizing electrical activity in the brain.
   • Common AEDs: Include phenytoin, carbamazepine, valproic acid, and levetiracetam. The choice of drug depends on the type of seizures and the patient’s overall health.
2. Surgical Treatment:
   • Resective Surgery: Involves removing the part of the brain where seizures originate.
   • Laser Ablation: A minimally invasive procedure using a laser to target and destroy the seizure focus.
   • Corpus Callosotomy: Cutting the connections between the two hemispheres of the brain to prevent seizures from spreading.
   • Vagus Nerve Stimulation (VNS): A device implanted under the skin sends electrical impulses to the vagus nerve to reduce seizure frequency.
3. Lifestyle Modifications:
   • Stress Management: Stress is a common trigger for seizures, so stress-reducing activities like yoga or meditation can be beneficial.
   • Sleep Hygiene: Ensuring adequate sleep is crucial as sleep deprivation can trigger seizures.
   • Dietary Changes: The ketogenic diet, high in fats and low in carbohydrates, has been effective in reducing seizures in some people.
4. Alternative Treatments:
   • CBD Oil: Cannabidiol (CBD) has shown promise in reducing seizures, especially in drug-resistant epilepsy.
   • Biofeedback: A technique that teaches individuals to control physiological functions, potentially reducing seizure frequency.
5. Emergency Treatment:
   • First Aid: If someone is having a seizure, keeping them safe, ensuring their airway is clear, and avoiding restraint are critical.
   • Emergency Medication: Diazepam or lorazepam may be administered in cases of prolonged seizures (status epilepticus).
6. Psychosocial Support:
   • Counseling: Living with epilepsy can be challenging, and counseling or support groups can help individuals and families cope.
   • Education: Educating patients and their families about seizure triggers, medication adherence, and safety measures.

Conclusion

Fits, or seizures, are complex and can significantly impact a person’s life. Understanding the symptoms, causes, and diagnosis is crucial for effective management. With appropriate treatment, many people with seizures can lead fulfilling lives. Early diagnosis and intervention are key to controlling seizures and improving quality of life. If you or a loved one experience seizures, seeking medical advice promptly is essential to managing this condition effectively.