Convulsions

Convulsions are episodes caused by abnormal electrical activity in the brain that produce sudden, often rhythmic movements, changes in sensation, or altered levels of awareness. They are a symptom that may occur with seizures, but the term convulsions describes the motor or behavioral expression seen in some seizures, particularly generalized convulsions. Convulsions can be generalized, affecting the whole body, or focal, involving one region.

Causes vary widely. Febrile convulsions occur in young children with fever. Epilepsy involves recurrent unprovoked seizures. Other provoked convulsions result from infections, metabolic disturbances (such as low glucose or abnormal sodium levels), head injury, stroke, brain tumors, alcohol or drug withdrawal, or autoimmune conditions. In some cases, no clear cause is found.

Diagnosis relies on a detailed history and eyewitness description, along with a neurological examination. Diagnostic tools may include electroencephalography (EEG) to characterize seizure type, neuroimaging (MRI or CT) if there are focal signs or new onset seizures, and laboratory tests to check glucose, electrolytes, infection markers, and other metabolic factors.

First aid during a convulsion involves staying calm and ensuring safety: protect the person from injury, cushion the head, loosen restrictive clothing, and remove nearby hazards. Do not place objects in the mouth. Time the seizure, and seek urgent help if it lasts longer than about five minutes, if it is the person’s first seizure, if there is injury, or if consciousness does not return after the seizure ends. Afterward, place the person on their side to aid breathing.

Management depends on the context. Prolonged convulsions may require emergency treatment with benzodiazepines. Long-term management may include antiseizure medications for epilepsy and treatment of any underlying cause. Febrile convulsions in children are usually benign and warrant routine medical follow-up.