A generalised seizure is a disturbance in the brain’s electrical activity which manifests externally as a loss of consciousness and/or a fixed stare, accompanied by uncontrolled muscle movements throughout the body (generalised convulsion). These manifestations are known as convulsions.
Causes
- Seizures can have many causes, including:
- head injury or its after-effects;
- certain conditions leading to brain damage (infections, tumours, strokes);
- the absorption of certain poisons or toxic substances; • hypoglycaemia;
- a lack of oxygen to the brain, particularly in the first few seconds of a cardiac arrest;
- a condition known as ‘epilepsy’, characterised by recurrent seizures, which is usually managed with medication.
Children, particularly infants, may experience convulsions caused by a sudden change in temperature (fever).
Risks & Consequences
The onset of a seizure may be caused by:
- injuries sustained during a fall or uncontrolled movements;
- airway obstruction in an unconscious casualty if they are left lying on their back or if they vomit (respiratory distress).
Signs
A seizure may be preceded by warning signs. The person may experience an unusual sensation or feeling (such as a visual or olfactory hallucination). When it occurs, a generalised seizure is easily identifiable during a life-saving emergency assessment. It is characterised by:
- initially, by the victim suddenly losing consciousness and falling;
- followed by stiffness in the victim and involuntary rhythmic muscle spasms, occurring in a rhythmic pattern, affecting one or more limbs, accompanied by rolling of the eyes, irregular or absent breathing, excessive salivation and clenching of the jaw muscles; This phase generally lasts less than five minutes, during which time the victim may bite their tongue;
- Finally, after the convulsions, the victim remains unconscious for several minutes. Their breathing may be laboured. They may also lose control of their bladder; less commonly, they may lose control of their bowels.
As the victim gradually regains consciousness, they may appear dazed, have a fixed stare or behave strangely, and remember nothing (amnesia regarding the circumstances).
In some cases, a person may experience a series of seizures, with or without regaining consciousness between them. This is known as status epilepticus, which requires urgent medical attention.
In infants, a convulsive seizure is usually triggered by a fever resulting from an infectious illness or excessive exposure to heat. It is accompanied by:
- an eye-rolling reaction;
- hypotonia;
- eyelid twitching;
- pallor or cyanosis, in the event of respiratory arrest.
Principle of emergency response
The lifeguard’s actions must ensure that:
- to prevent the victim from injuring themselves;
- to prevent the onset of respiratory distress.