Understanding Fits and Seizures: Dr A Santosh Sriram
This is a transcript from an educational video interview by telecast on TV5 News by Dr. A Santosh Sriram, Consultant Neurologist at Apollo Hospital, Hyderguda, Hyderabad, where he discusses about seizures, its types, triggers, diet, precautions, medication and busts myths.
Fits, or seizures, are caused by abnormal electrical activity in the brain and can affect individuals of all ages. Early diagnosis, proper medication, and lifestyle management help control seizures in nearly 70% of patients. Advanced epilepsy care ensures improved quality of life and long-term seizure control.
What Are Fits (Seizures)?
Fits occur due to excessive, uncontrolled electrical activity in the brain, leading to symptoms such as body jerking, upward rolling of the eyes, and teeth clenching. This condition is medically referred to as seizures.
Types of Seizures
Seizures are broadly classified into:
- Generalized seizures – involving the entire body
- Focal seizures – involving a specific part of the brain
Focal seizures include subtypes such as temporal lobe epilepsy, where individuals may stare blankly, perform automatic movements, or show facial expressions without awareness. Awareness during focal seizures varies depending on the brain region involved.
Causes and Triggers of Fits by Age
Infants & Young Children
Common causes include:
- Lack of oxygen during birth
- Low blood glucose levels
- Febrile seizures during high fever (typically between 6 months and 6 years)
Febrile seizures usually resolve once fever is controlled. However, children with recurrent febrile seizures have a higher risk of developing temporal lobe epilepsy later in life.
Children & Teenagers
- Sleep deprivation is one of the most common triggers
- Emotional stress can provoke seizures in susceptible individuals
- Some experience monthly seizures, while others may have multiple episodes daily
Juvenile Myoclonic Epilepsy (JME) is commonly seen in adolescents and requires long-term management.
Adults
- Middle-aged adults may develop seizures due to brain infections or head injuries
- Post-traumatic epilepsy can occur due to scarring in brain tissue
Elderly
- Stroke, brain tumors, and metabolic disturbances (low sugar or sodium levels)
- Careful sugar and electrolyte management is essential in older adults
Fits and Hypoglycemia
Low blood sugar (hypoglycemia) can cause seizures, especially in individuals with diabetes, alcohol dependence, or poor nutritional intake. These are considered symptomatic seizures and may not always indicate epilepsy.
Fits and Alcohol Consumption
Chronic alcohol consumption increases the risk of seizures, particularly during withdrawal. Such individuals may initially need short-term treatment but can later develop epilepsy requiring long-term care.
Diagnosis and Evaluation
- Detailed patient history and eyewitness accounts
- EEG to assess brain electrical activity
- MRI brain with epilepsy protocol to identify structural causes
Approximately 70% of patients achieve seizure control with medications alone.
Treatment Options
- Medications are the first-line treatment
- Different epilepsy syndromes require specific drugs
- About 30% of patients with drug-resistant epilepsy may require surgery
Newer anti-epileptic drugs are safer and better tolerated.
Epilepsy in Women
Hormonal fluctuations can influence seizure frequency, particularly during menstruation.
Special considerations include:
- Medication adjustments during menstrual cycles
- Planned pregnancy with safer medications
- Mandatory folic acid supplementation
Proper planning significantly reduces risks to both mother and baby.
Medication Side Effects
Possible side effects include:
- Dizziness
- Balance issues
- Weight gain
- Bone softening
Most side effects are dose-related and manageable with monitoring.
Emergency Situations
- Status epilepticus (continuous seizures) is life-threatening
- Requires immediate medical intervention
- Emotional stress, sleep deprivation, and anger can worsen seizure control
Diet, Lifestyle & Weight
- Regular healthy diet has minimal impact on seizures
- Weight gain can require higher medication doses
- In select cases, a ketogenic diet may help
Myths and Misconceptions About Fits
Pouring water into the mouth during a seizure is dangerous and should be avoided.
Tying the tongue does not prevent seizures and can cause injury.
Making a person smell onions does not stop a seizure and has no medical benefit.
The person should be gently turned to the side and kept safe until the seizure ends.
Medical Expert Advice
- Do not stop medications abruptly
- Dose reduction is possible after years of seizure control
- Women planning pregnancy must consult a neurologist early
If you or your loved one is experiencing seizures, consult Dr A Santosh Sriram, leading epilepsy specialist in Hyderabad. At Dr Sriram Neuro, we offer advanced diagnosis, epilepsy treatment, and surgical options. Book an appointment today with the best neurologist for fits treatment in Hyderabad.