Fits Types, Causes, Symptoms And Treatment

A fits is a sudden, uncontrolled disturbance of electrical activity of the brain. A fits is defined as the transient paroxysm of uncontrolled, abnormal and excessive discharges of cortical neurons. It is a chronic neurological disorder. It affects people of all ages. It is not a contagious disease.

Types

There are two main types of fits depending upon the area of brain involved,

Generalized Fits

If the activation of both the hemisphere of the brain occurs simultaneously, then it is termed as generalized fits. It results in the impairment of consciousness. There are four main types of generalized fits,

1. Tonic clonic fits

This type is most common and is also termed as grand mal attack. The sign and symptoms of tonic clonic fits are,

• Body stiffens
• Falling
• Convulsion
• Labored breathing
• Salivation
• Cyanosis
• Tongue biting
• Incontinence

                      Sometimes periods of drowsiness, confusion, headache and sleep occur after attack.

2. Atonic fits

In this type, muscle tone is suddenly dropped and the person collapses. This type is very rare and recovery is fast after fits.

3. Myoclonic fits

These shocks are very abrupt and very brief. Shocks or jerks of the whole body or of arms or legs occur in this type. They usually occur after waking or early in the morning. Recovery is fast in this type.

4. Absence fits

This type is also known as petit mal attacks. This type is the rarest and mostly occurs in childhood and adolescence. The symptoms of absence fits is staring or blanking period, eyelids fluttering and head flopping.

Partial or focal fits

If the neuron discharge begins in a localized area of the brain, then the fits is termed as partial or focal. There are three main types of partial or focal fits,

1. Simple partial fits

This type is rare and progresses to the other types of focal fits. Level of consciousness is preserved in simple partial fits. The symptoms of fits depend upon the area of discharge and vary from person to person. Localized jerking, stiffness of one body part, abnormal sensation and numbness are the major symptoms of simple partial fits.

2. Complex partial fits

In this type, the neuronal discharge occurs in the frontal or temporal lobes of the brain. The signs and symptoms of complex partial fits are automatic behaviour, lip smacking, chewing movements, grimacing, undressing, plucking own clothes and confused state.

3. Secondarily generalized fits

The discharge of neurons spread to the entire brain. The clinical profile of secondarily generalized fits is similar to the tonic clonic fits.

Symptoms

The signs and symptoms of fits may range from mild to moderate depending upon the type and severity of disease. During the period of fits, the following symptoms appear,

• A gazing period
• Twitching into arms and legs
• Confused mental state
• Loss of consciousness
• Being unaware about who you are or where are you
• Unusual movements
• Tongue biting
• Shaking or stiffening of the body

Causes

The fits are caused by the abnormal discharge of neurons which affects the cortical layer of the brain. The genetic mutations also play an important role in some types of fits.

Epilepsy is the most common cause of fits or seizures. But not everyone suffering from seizure or fits has epilepsy. Other possible causes of fits are discussed below,

• High fever
• Lack of sleep
• Flashing lights
• Hypoxia
• Birth asphyxia
• Intracranial trauma during birth
• Hyponatremia
• Metabolic disturbances
• Congenital malformations of the brain
• Infection
• Head injury
• Alcohol abuse
• Cortical dysplasias
• Brain tumors
• Cerebrovascular diseases
• Complication of diabetes or pregnancy
• Stroke
• Drug abuse
• Alcohol withdrawal
• Autoimmune disorders, including systemic lupus erythematosus and multiple sclerosis

Treatment

The main aim of treatment is to control fits using only one drug. During fits, the person should be made comfortable. The preferable position is lying him down, loosening any tight dress or neckwear. Try not to move the patient during the convulsive state. There is no need to open the mouth of patients with fits. It could be dangerous and results in inhaling of broken teeth. Check the airways to find any blockage and support respiration. No drinks or extra antiepileptic drugs should be given after fits. Fits may be life threatening and it is very important to stay with patients during and after attack. If the convulsive state remains for more than 10 minutes, then intravenous or rectal administration of 10–20mg diazepam is effective. First line drugs for the treatment of fits are lorazepam or diazepam. If the patient does not respond to the first line drugs, then midazolam is preferred. If the fever is present with convulsions, then sponging and paracetamol is given. The first line drugs for the treatment of partial fits are carbamazepine, lamotrigine, oxcarbazepine and levetiracetam. The second line drugs for the treatment of partial fits include zonisamide, clobazam, topiramate valproate, pregabalin, phenytoin, gabapentin, lacosamide and eslicarbazepine. The first line drugs for the treatment of generalised fits are valproate sodium, carbamazepine, lamotrigine, clonazepam, clobazam, sodium valproate and ethosuximide. The second line drugs include lamotrigine, clobazam, phenobarbital, clonazepam, carbamazepine, phenytoin, acetazolamide and topiramate.