Brain Tumors and Seizures
What is a seizure?
A seizure is caused by a burst of abnormal electrical activity in the brain. It can cause a variety of things to occur depending on the type of seizure and where it occurs in the brain. In some cases, a person may have a seizure that leads to the diagnosis of a brain tumor but never have another seizure. Some people have many seizures over the course of their illness. Some people have a warning that a seizure is coming – this is called an “aura.” An aura can be many things such as a headache, a change in mood, a sensory change (smelling a certain smell), or a change in mood.
What are the types of seizures?
Seizures are grouped by a few factors – where the seizure starts, if the person is aware during the event, and whether movement is involved. The classifications are quite general. Two people can have the same type of seizure but experience very different things during the seizure. This is because the actual things a person experiences are based on what area of the brain is affected and what that area controls. Let’s look at the breakdown of these categories.
Where does the seizure start?
- Focal onset. The seizure starts in and only affects one part of the brain. This is determined by someone reporting what happened during the seizure. This type is most common in people with brain tumors.
- Focal to bilateral. The seizure starts in one part of the brain and spreads to other areas.
- Generalized onset. The seizure starts in and affects both sides of the brain at the same time. These generally start without a warning (or aura).
- Unknown onset. This term may be used if the seizure was not witnessed or the person was asleep.
How aware is the person during the seizure?
- Focal aware. Only a small part of the brain is affected, and the person is fully aware, even if they can’t speak. They can remember the seizure afterward, even if they cannot describe it.
- Focal impaired awareness. The seizure is still affecting only one side of the brain, but a little more of the brain is affected. You are confused or unaware of what is happening. You most likely will not remember the seizure afterward. You may feel tired after the seizure.
- Generalized seizures. Both sides of the brain are involved. You are likely unaware of what is happening. This type is not often related to brain tumors.
Is movement involved?
- Motor seizures. You have movement during the seizure. This can be things such as jerking or twitching movements, lip-smacking, picking at something, or muscles becoming very tense or suddenly weak.
- Non-motor or absence seizures. There is typically no movement during the seizure. Can include a change in heart rate or breathing, staring, problems talking, or understanding. You can still have sensory effects, such as visual hallucinations, smelling, feeling, or hearing something that isn’t there. One exception is that you can have small twitches in a specific part of the body, such as the eyelids twitching.
Now put it all together
These three factors are combined. This classification system has made the names used to describe a seizure provide more information than the previous classifications. The names include:
- Focal onset aware seizure.
- Focal onset impaired awareness seizure.
- Generalized onset absence seizure.
- Generalized onset motor seizure.
- Unknown onset motor seizure.
- Unknown onset absence seizure.
Are there things that can increase the chance of having a seizure?
If you have had seizures before, there are some things that can increase the risk of having a seizure. These include:
- Sleep deprivation / not getting enough sleep.
- Missing doses of seizure prevention medications.
- Drugs or alcohol.
- Infections or illnesses.
- Stress – both good and bad stressors.
- Hormonal changes.
How are seizures related to a brain tumor treated?
Your care team may prescribe an antiepileptic or antiseizure medication to prevent seizures. In some cases, a steroid medication is given for a period of time to reduce swelling in the brain that may be causing the seizures.
How can I help my provider to manage my seizures?
- Wear a medical alert bracelet indicating that you have seizures.
- If you experience an aura or warning sign, move to a safe place to reduce the risk of injury.
- If you experience seizures regularly, it can be helpful to keep a journal.
- Record when the seizure occurs, how long it lasts, and what happens during the seizure. This may help your provider adjust medications to better control the seizures.
- Talk to your provider about when you should contact them and what to do if a seizure happens at night or on a weekend.
How can I help someone with a brain tumor who is having a seizure?
The main goal is to keep them safe. A seizure can last for a few seconds to a few minutes.
- Stay calm, stay with the person, and wait for the seizure to pass.
- Try to move anything sharp or dangerous from the area, place pillows to prevent injury if they fall, or lower them to the ground to avoid a fall. Do not forcibly hold them down.
- Do not place anything in their mouth. If they are lying down, turn their head to the side.
- Make note of how long the seizure lasts and how long it is before they return to normal.
- It is not necessary to call 911 for most seizures related to a brain tumor. However, you should call 911 for help if the seizure lasts more than 5 minutes, if more than one seizure occurs back to back, if the person is having trouble breathing, is injured, or if the seizure occurs in water.
Being a Caregiver for Someone with a Brain Tumor
Being the caregiver of a person with a brain tumor is hard, and the added side effect of seizures can make it even more challenging. Seizures can be scary, and you may not be sure what to expect each time it happens. Try your best to stay calm and ensure the safety of your loved one during the seizure. Do not hesitate to ask for help or communicate your concerns with the care team. OncoLink has articles to support caregivers and to help during this challenging time.
The Brain Tumour Charity. Seizures, epilepsy and brain tumors. https://www.thebraintumourcharity.org/living-with-a-brain-tumour/side-effects/epilepsy-seizures-and-brain-tumours/
Epilepsy Foundation. Types of seizures. https://www.epilepsy.com/learn/types-seizures
Fisher, R. S. (2017). The new classification of seizures by the International League Against Epilepsy 2017. Current neurology and neuroscience reports, 17(6), 48.
McFaline-Figueroa, J. R., & Lee, E. Q. (2018). Brain tumors. The American journal of medicine, 131(8), 874-882.