What are seizures, why do they occur
and how are they managed after a brain tumour?

Notes taken by Glen Hunter (husband of Liz, GBM dx 12 1999) at a presentation by
Dr Philip McManus, Neurologist,
at the Sydney Neuro-Oncology Group
Brain Tumour Support Group meeting
at North Shore Private Hospital on Wednesday, 12 September 2001.

These audience notes, not Dr McManus's notes.
They are general notes and should not be taken in substitution of medical advice from your own Specialist.

One third of people with a brain tumour are likely to experience seizures. There are many different kinds fo seizure.

Seizures are more common with lower grade tumours.

In a 'focal seizure' only a part of the brain is affected.

A 'Generalised Seizure' involves loss of consciousness and usually no recall of the event.

A 'Simple Seizure' does not result in loss of consciousness.

A 'Complex Partial Seizure' results in unconsciousness or vagueness.

Most seizures have no warning and no trigger. Seizure symptoms can include chest and abdomen contracting strongly (groaning) and arms and legs contracting, teeth clenching (biting the tongue).

Contrary to popular belief, it is not possible for someone to swallow their tongue during a seizure. Therefore a carer should not try to get the person's tongue out of their mouth (you might get your fingers bitten off!)

Seizures usually involve quivering, jerking, shaking then symptoms slow down. Often the person loses control over bowels and bladder. The person will sometimes turn blue and not breathe properly, which can be OK if it is only a short seizure. Most seizures last a maximum of 3 minutes.

If prolonged may need to terminate the seizure somehow (medication). This cannot be done orally and requires medical attention.

After a seizure people often sleep deeply then awake confused after 10 - 15 minutes.

WHAT TO DO WHEN SOMEONE HAS A SEIZURE

- do not restrain
- do not try to open mouth
- gently move the person from harm's way
- as the seizure stops lay them on their side in the recovery position, bend the top leg up
- turn face down to avoid choking and allow them to dribble
- comfort and reassure
- call an ambulance if it lasts more than 5 minutes (this means you should check the clock when the seizure starts, it's very hard to keep track of time)
- if less than 5 minutes may not need to go to hospital (this can vary from person to person)

Partial seizures usually need no action (but tell your doctor) - rarely need emergency treatment.

People who suffer seizures usually cannot drive a car for at least 6 months after their last seizure.

Seizures can indicate tumour growth or growth of a cyst. Anti-seizure medication such as Epilim can cause weight gain, hair thinning, trembling / shaking of hands, as well as menstrual irregularities in women.

The Epilepsy Association also sent a speaker to talk briefly about the valuable services they offer to people and carers of those who suffer from seizures, including information brochures and home visits to talk to patients and carers with videos etc.

DISCLAIMER: As the reason, type and effects of seizures can vary individually these notes should be taken as a guide only. Specific instructions need to be obtained from your Specialist. For example in Liz's situation our Oncologist has recommended that if Liz ever suffers another seizure, after following the safety precautions (seeing she is safe and comfortable) we should call an ambulance immediately regardless of the length of the seizure.