How Serious Are Seizures?

Most people don’t understand how serious seizures can be. They either think that seizures are not a problem or that everyone may die from them. The truth lies somewhere in between. The types of problems people may have ranged from injuries, the effect of repeated seizures on the brain, seizure emergencies, and death.

This is a scary topic to read and talk about. But it’s important to know the facts so you know what questions to ask your doctor and health care team. Also, knowing your risks, or those of your loved ones, may help you learn what to do to lessen these risks!

Some seizures rarely cause problems for people. Overall, the chance of injury is higher for people with uncontrolled seizures. The type of injuries a person may get depends on the type of seizure, how long the seizure lasts, where the seizure occurs, and if it develops into an emergency.

Some common injuries may include:

  • Bruises
  • Cuts
  • Burns
  • Falls

More serious problems, such as broken bones, concussions, head injury with bleeding into the brain, or breathing problems, usually are seen in people who have generalized seizures with falls, long seizures, or repeated or clusters of seizures.

The overall risk of dying is 1.6 to 3 times higher in people with epilepsy than in the general population (IOM Report, 2013Forsgren et al, 2005). The risk of dying among children with epilepsy may be a bit higher since most children without epilepsy have very low risks.

  • People whose epilepsy is caused by things like a stroke or a brain tumor or other problem in the brain may die sooner from the cause of the epilepsy and not the seizures.
  • How frequent and severe a person’s seizures are affects their risk for dying.
  • People with seizures with no known cause may die only 2 years earlier than expected.
  • People with seizures with a known cause may die 10 years earlier than expected.

A long convulsive seizure (called “tonic-clonic or convulsive status epilepticus“) is a medical emergency. Generally speaking, a generalized tonic-clonic seizure lasting 5 minutes or longer is a medical emergency.

  • If seizures can’t be stopped or repeated seizures occur one right after another, permanent injury or death can occur.
  • People with epilepsy can also die from problems that occur during or after a seizure, such as inhaling vomit. This problem can be prevented if the person is turned onto one side as soon as possible. This allows saliva, vomit, or other fluids to drain out of the mouth and not go back into the lungs. Learn more seizure first aid.
  • Despite the risks, it’s important for people to remember that it is not common for people to die from seizures.

People who are not seizure-free need to be careful about possible accidents during a seizure:

  • Death from drowning is more common among people with epilepsy.
  • Drowning can even occur in a tub with only a few inches of water. Therefore, people who have seizures probably should stick to showers instead of baths.
  • If you have epilepsy, your doctor – and the agency in your state or province responsible for licensing drivers – will help you decide whether it is safe and legal for you to drive.
  • You should also be careful on train or subway platforms and when walking near busy streets.
  • With some planning, you should be able to lead an active and safe life.

SUDEP is likely the most common disease-related cause of death in people with epilepsy. SUDEP is thought to occur when a person with epilepsy who is in their usual state of health dies unexpectedly. The death is not related to an accident and no other cause of death can be found if an autopsy is done.

SUDEP is not frequent, but it’s a very real problem.

  • It occurs in 1 out of every 1,000 people with epilepsy.
  • It occurs more often in people with poorly controlled epilepsy. For example, 9 out of 1,000 people being considered for epilepsy surgery die of SUDEP.
  • SUDEP rarely occurs in children.
  • The person is often found dead in bed and doesn’t appear to have had a convulsive seizure. They are often found lying face down.
  • About a third of SUDEP cases show evidence of a seizure close to the time of death.
  • No one is sure about the cause of death in SUDEP. Some researchers think that a seizure causes an irregular heart rhythm, breathing problems, or other problems in the brain or other body areas.

Help is on the way. The Epilepsy Foundation has established the SUDEP Institute to:

  • Spread the word about death in epilepsy
  • Help people learn ways to prevent it
  • Get help to people who have lost a loved one to SUDEP
  • Speed up research on the causes and prevention of SUDEP
  • If your seizures are not controlled, seek out the help of an epilepsy specialist  or visit an epilepsy center to explore treatment options.

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