Seizure disorders are characterized by explosive episodes of uncontrolled & excessive electrical activity in the brain, or seizure, & results in a sudden change in behavior and level of consciousness. The event is described as a lightning storm in the brain. A seizure may be subtle & consist of abnormal sensations, or it may produce overt involuntary repetitive movements & loss of consciousness.
According to the Epilepsy Foundation, seizures affect approximately 2.2 million people in the United States each year (1) & 10% of the population will experience a seizure in their lifetime (2). Onset usually occurs between the ages of 5 & 20, then after age 65. Epilepsy is a term used to describe recurrent seizures.
Most often, the underlying cause of seizures is unknown. Some cases are acquired & have been linked to head trauma, brain tumors, infections, high fever, cerebrovascular disturbances, chemical imbalances, withdrawal from certain drugs (medications & recreational drugs) or alcohol, & even stress.
The two main types of seizures are partial and generalized.
Partial seizures represent 60% of cases. Seizure activity is limited to a single area of the brain, & the person does not lose consciousness. However, the person often exhibits a lack of awareness, not knowing where they are, or how much time has passed.
Generalized seizures are seen in approximately 30% of cases & involve a more diffuse area of the brain. Two types of generalized seizures are absence & tonic-clonic. Absence seizures (petit mal) involve a brief loss of awareness & often some transient facial movements that last for up to 10 seconds. The previous activity is then resumed, & the person has no memory of what occurred during the seizure. Tonic–clonic seizures (grand mal) produce an intermittent contract/relax pattern in muscles & are associated with a loss of consciousness. The other 10% of seizures are unclassified.
Symptoms depend on which type of seizure is experienced. A partial seizure may be associated with repeated nonpurposeful automatic movements such as turning the head from side to side, lip smacking, leg twitching, picking at clothing, or with sensations such as ringing in the ears, sensations of light, tingling that begins in one area & spreads.
Absence seizures are often accompanied by transient facial movements such as eye twitching or blinking, the person may have a blank stare while being spoken to, or the person may just stare into space for a moment. Tonic–clonic seizures are the most intense. During the tonic phase, general tone increases & muscular contraction begins. A cry may be heard as the thoracic & abdominal muscles contract, forcing air out of the lungs. This phase lasts approximately 10 seconds. The clonic phase is the classic manifestation of alternating contraction & relaxation of muscles. The person may have increased salivation (foaming of the mouth); bowel & bladder incontinence may occur. These contractions gradually subside in several minutes; the person is then confused, weak, drowsy & has no memory of the event. The postseizure period is called the postictal state and can last from several minutes to several hours.
Anticonvulsant medications are used to reduce the frequency of seizures. These medications may be combined with mild sedatives. If the underlying cause is identified, it is treated as well. This treatment may include surgery to remove tumors or other brain lesions.
Massage Therapy & Seizure Disorders – The Epilepsy Society recommends massage therapy alongside any antiepileptic drugs as a way to reduce stress-induced seizures & to promote wellness (3). If a client has a history of seizure disorders, ask about any known triggers, & avoid them during the session. Certain odors can trigger a seizure; therefore aromatherapy may be contraindicated.
The Epilepsy Society recommends avoiding the following essential oils when working with people who have seizure disorders: rosemary, fennel, sage, eucalyptus, hyssop, camphor, & spike lavender (3). In addition, avoid using flashing lights or contrasting light & dark patterns in the massage room.
Check out this blog for a list of appropriate first aid measures for clients experiencing a seizure (more specifically, tonic–clonic seizures). Clients with seizure disorders are more likely to have a seizure if they stopped taking prescribed anticonvulsant medications.
Black J: Medical-surgical nursing: clinical management for positive outcomes, 8e, St Louis, 2009, Saunders
Articles and Journals Referenced:
- Epilepsy Statistics. http://www.epilepsy.com/learn/epilepsy-statistics
- Epilepsy & Seizure Facts. http://www.epilepsymichigan.org/page.php?id=358
- Complementary therapies. https://www.epilepsysociety.org.uk/complementary-therapies#.WHUtKH2Aaui
Susan Salvo is a board certified massage therapist with 30+ years of experience. Susan is passionate about massage therapy and massage education. You can contact her at firstname.lastname@example.org.