seizure that comes and goes

Overview

A seizure is a sudden burst of electrical activity in the brain that can cause changes in movement, behavior, or awareness. When seizures come and go, it means they happen at different times, not all the time. This pattern is common in epilepsy, a condition where a person has repeated seizures without a clear trigger. But seizures can also occur due to other causes like high fever, head injury, or low blood sugar.

Seizures are fairly common. About 1 in 10 people will have at least one seizure in their lifetime. Epilepsy, where seizures keep coming back, affects about 1 in 100 people worldwide.

Seizures can affect people of all ages, from babies to older adults. They are especially common in young children and people over 60. Some people have a higher risk because of genetics, brain injuries, or other health conditions.

Symptoms

Common symptoms

• Sudden loss of awareness or staring into space (absence seizure)
• Uncontrollable jerking movements of arms or legs (convulsion)
• Feeling confused or dazed after the event
• Strange sensations like a rising feeling in the stomach, unusual smells, or tingling
• Falling down or losing muscle control
• Twitching or stiffening of muscles

Symptoms in children

• Brief staring spells that might look like daydreaming
• Sudden drops of the head or body
• Unusual fussiness or changes in mood before a seizure
• Not responding when spoken to during the episode
• Rapid blinking or chewing movements

Symptoms in older adults

• Confusion or memory loss after the seizure that lasts longer
• Falls that might be mistaken for dizziness or ageing
• Staring spells that get dismissed as 'spacing out'
• Sensations like déjà vu or vivid memories

Causes

Main causes

• Epilepsy – a brain disorder where seizures happen repeatedly without a direct trigger
• High fever (febrile seizures, especially in young children)
• Head injury or trauma to the brain
• Brain infection like meningitis or encephalitis
• Stroke or other blood vessel problems in the brain
• Low blood sugar or very low sodium levels
• Alcohol or drug withdrawal
• Certain medicines or toxins

Risk factors

• Family history of epilepsy or seizures
• Previous brain injury (from accidents, stroke, or surgery)
• Developmental conditions like autism or cerebral palsy
• Sleep deprivation or extreme stress
• Heavy alcohol use or sudden stop after heavy use
• Infections that affect the brain

When to see a doctor

See a doctor urgently if:

• First-ever seizure – even if you recover quickly
• Seizure that lasts more than 5 minutes
• Seizure with difficulty breathing or not waking up
• Repeated seizures without recovery between them
• Seizure after a head injury

Book a routine appointment if:

• You have had more than one seizure that you think might be related
• Episodes of staring or unusual feelings that worry you
• You have been diagnosed with epilepsy and your seizures are changing or getting worse
• You want to discuss options for managing seizures

Diagnosis

A doctor will take a detailed history of your episodes, ask about any triggers, and may do tests to check your brain's activity and structure. It helps to bring someone who has seen your seizures because you may not remember what happened.

Tests that may be done

• Electroencephalogram (EEG) – records your brain's electrical activity using small sensors on your scalp
• Blood tests – to check for infections, low sugar, or chemical imbalances
• Brain imaging (MRI or CT scan) – to look for tumours, strokes, or structural problems
• Lumbar puncture (spinal tap) – if infection is suspected
• Video monitoring – sometimes you stay in hospital to film your seizures and record brain waves at the same time

What to expect at your appointment

Most people can be diagnosed in an outpatient clinic. Tests are usually painless. You may be asked to stay awake overnight before an EEG to improve the chance of capturing a seizure. The doctor will explain the results and discuss next steps for treatment or monitoring.

Treatment

Treatment depends on the cause and how often seizures happen. For people with epilepsy, medications are the first line of treatment. Many people become seizure-free with the right medication. Other options include diet changes, nerve stimulation, or surgery. Your doctor will work with you to find the best plan.

Self-care at home

• Keep a seizure diary to note when episodes occur and possible triggers
• Get enough sleep – tiredness is a common trigger
• Avoid alcohol and recreational drugs
• Take any prescribed medicines exactly as directed, without skipping doses

Medical treatments

Doctors often prescribe anti-seizure medications (also called anticonvulsants) to prevent seizures. These are taken daily. The choice depends on the type of seizure, your age, and other health factors. If medications don't work well, options include a special high-fat diet (ketogenic diet), vagus nerve stimulation (a device implanted in the chest that sends signals to the brain), or surgery to remove the part of the brain causing seizures.

When is surgery considered?

Surgery may be an option for some people whose seizures start from a small, clearly defined area of the brain that can be safely removed. It is considered when medications fail to control seizures after trying several types.

Living with this condition

Living with seizures that come and go often means making small changes to stay safe and reduce worry. Most people can lead a full life – work, drive (if seizures are controlled), and enjoy hobbies. It helps to educate family, friends, and coworkers about what to do if a seizure happens.

Lifestyle tips

• Avoid activities that could be dangerous if a seizure occurs, such as swimming alone or climbing ladders
• Tell close friends, family, and colleagues about your condition and what first aid to give
• Wear a medical alert bracelet or carry an ID card with your diagnosis
• If you drive, check local laws – many places require you to be seizure-free for a period (like 6 to 12 months) before driving

Diet and exercise

A balanced diet is important for overall health. Some people find that certain foods or missing meals can trigger seizures, so eating regularly helps. Exercise is safe and beneficial – activities like walking, swimming with a buddy, or yoga can reduce stress. Avoid overheating or becoming very dehydrated.

Mental health and emotional wellbeing

Worrying about when the next seizure will come can be stressful. Anxiety, depression, and feeling different from others are common. It is important to talk about these feelings – with a doctor, counsellor, or support group. Managing mental health can actually help reduce seizures.

Prevention

For many causes, you cannot completely prevent seizures. But you can lower the chance of some types by managing triggers: getting enough sleep, avoiding stress, limiting alcohol, and taking your medicine as prescribed. Treating underlying conditions like infections or correcting chemical imbalances also helps.

Vaccines

Omit

Screening programmes

Omit

Complications

If left untreated

• Injury from falls or accidents during a seizure (like hitting your head)
• Status epilepticus – a prolonged seizure that can cause brain damage
• Sudden unexplained death in epilepsy (SUDEP) – rare but serious
• Poor quality of life due to anxiety, isolation, or loss of independence
• Driving accidents if seizures are uncontrolled

Long-term outlook

With proper treatment, most people with seizures that come and go can control them well. Many become seizure-free and live normal, active lives. Even if seizures are not completely stopped, modern care helps reduce their frequency and severity. Stay hopeful – research continues to bring new treatments.

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