HJAR Jan/Feb 2023

HEALTHCARE JOURNAL OF ARKANSAS I  JAN / FEB 2023 49 Ali Krisht, MD Director CHI St. Vincent Arkansas Neuroscience Institute WHEN an adult experiences a seizure, it must be treated as an emergency. It is often the first manifestation of a larger problem, but first they, their family members, and healthcare providers need to recognize the wide range of seizure symptoms for what they are in order to quickly address the greater threat to their health. RECOGNIZING LESS COMMON SIGNS OF SEIZURES While epilepsy can lead to the typical convulsions where the entire brain experi- ences a seizure causing the body to stiffen with powerful jerking muscle movements, nonconvulsive seizures can be triggered by a wide range of causes and do not necessar- ily present the same convulsive symptoms. Depending on the area of the brain impact- ed and the cause of the seizure, symptoms can appear quite different. For instance, someone may experience visual seizures where they begin to see lights, sometimes referred to as an “aura,” or other visual changes. When a seizure im- pacts the area of the brain associated with speech, it could result in slurred speech, drooling, or difficulty finding the right words. In other instances, a patient may complain of a bad smell that only they can sense or experience profound déjà vu. All of these instances suggest a different part of the brain being impacted and provide valu- able clues to healthcare professionals if ac- curately reported. A key challenge we face is that even when someone recognizes the danger and seeks medical care, these symptoms can frequently dissipate by the time they reach an emergency room. In some cases, the pa- tients themselves may be left unaware of the experience associated with the seizure and feel confused when others try to ex- plain their behavior. This is when a patient’s support system proves critical. They can help the patient document the symptoms when a seizure occurs so that their doctors can better diagnose the real cause. UNDERSTANDING CAUSES OF SEIZURES IN ADULTS Brain trauma (new or old), scar tissue, hemorrhages, aneurysms, brain bleeds, or even infections affecting the brain can all cause seizures in adults. Drug use or alcoholism can additionally alter the environment of the brain over time in a way that causes serious injury with lasting implications. Even fever, stress, or sleep deprivation can contribute to a seizure, even though they may not be the primary cause. The causes that lead to nonepileptic seizures vary widely, but the details of how the seizure presents outwardly can offer valuable clues to doctors. We find that brain tumors are also a frequent cause of adult seizures. In fact, 80% of brain tumors are located in areas that could trigger seizures, and even a benign (noncancerous) tumor can lead to severe or frequent headaches, seizures, balance issues, and changes in speech or hearing. A tumor near the area of the brain responsible for vision can lead to the visual seizures and associated vision changes mentioned earlier. The same is true for seizures that present as bad smells. While these are clear clues, they can also prove misleading as well. For example, a tumor in one part of the brain can cause weakness in the arms and a feeling of heavy hands, easily misdiagnosed by family members as a stroke. That’s why it’s important to seek immediate medical help and provide healthcare professionals with as much additional information as possible so they can work to make an accurate diagnosis. TREATING THE ROOT CAUSES OF ADULT SEIZURES Unlike seizures in children, where epi- leptic incidences cause the seizures and are difficult to control, seizures in adults can be more easily managed with proper treat- ment, and patients can even become sei- zure free. Aneurysms, tumors, and similar causes can be addressed with neurosurgery, and our team at the Arkansas Neuroscience Institute has perfected methods to safely perform surgery in some of the most diffi- cult areas of the brain to reach. Advancements in treatments today mean adults suffering nonepileptic seizures have more opportunity than ever before to con- tinue living a full, vibrant life. They will, however, need the full support of their friends, families, and healthcare providers to ensure their seizures are quickly identi- fied for what they are and that patients re- ceive the proper care they deserve. n