High Blood Pressure And Seizures

Differences Between Seizures And Epilepsy

Some important differences between seizures and epileptic seizures include:

• Some medical conditions that cause nonepileptic seizures may be life threatening. A person could potentially die from dehydration, diabetes, or a brain injury.
• When an underlying medical condition causes seizures, a person may have other symptoms prior to the seizure, such as high blood pressure or malnourishment.
• Diagnosing epilepsy requires excluding other syndromes and diseases. When diagnosing some other conditions, a single test may offer clarity. For example, if a person has a seizure and very high blood glucose, a doctor may conclude that uncontrolled diabetes is the culprit.

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Neural Control Of Blood Pressure

The major determinant of oxygen and metabolite supply of tissues and organs is the blood perfusion which is regionally controlled by activity-dependent mechanisms. The overall perfusion of the body’s organs is secured by the systemic BP. Arterial BP is defined as the pressure exerted by the blood on the artery walls . By convention it is measured in millimeters of mercury above the surrounding atmospheric pressure. Mean arterial blood pressure is determined by the product of cardiac output and total peripheral resistance while CO is, in turn, the product of stroke volume and heart rate . The systemic BP shows a pulsatile profile due to the contraction of the cardiac cycle and the elastic behavior of the artery walls the maximal pressure during heart contraction is named systolic arterial pressure , the minimal pressure between two heart contractions as the diastolic arterial pressure . To secure appropriate energy and oxygen supply, systemic BP is constantly maintained within given limits by regulatory pathways involving the autonomic nervous system. Our current knowledge on the neural control of blood pressure comes from decades of experimental research in animals, clinicopathological correlations in humans, mostly with stroke or epilepsy, electrical stimulation studies in humans with epilepsy and functional imaging studies in humans .

Box 1. Selected Supratentorial Centers of BP Control

Insular Cortex

Medial Prefrontal Cortex

Amygdala

Seizures And Blood Pressure

Little is known about the impact of seizures on blood pressure, which is vital to maintaining an adequate quantity and supply of blood to the brain and the heart. New advances in non-invasive continuous measurement of blood pressure has made it feasible to record blood pressure around the time of seizures.

Bozorgi et al. reported a case of a woman with refractory epilepsy who had a generalized tonic-clonic seizure while undergoing video-EEG monitoring with simultaneous non-invasive blood pressure recording. Immediately after the seizure, she had a significant drop in systemic blood pressure lasting more than 1 minute.

More recently, Hempel et al. performed a prospective systematic assessment of blood pressure during and after seizures in 37 patients. They found that:

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What Are Generalized Seizures

Normally, the brains nerve cells communicate with one another by firing tiny electric signals that pass from cell to cell. The firing pattern of these electric signals reflects how busy the brain is. The location of these signals indicates what the brain is doing, such as thinking, seeing, feeling, hearing, controlling the movement of muscles, etc. A seizure occurs when the firing pattern of the brains electric signals suddenly becomes very abnormal and unusually intense, either in an isolated area of the brain or throughout the brain.

If the whole brain is involved, the electrical disturbance is called a generalized seizure. This type of seizure used to be called a grand mal seizure. The most easily recognizable symptom of a generalized seizure is the body stiffness and jerking limbs known as tonic-clonic motor activity.

Epilepsy is the condition of being prone to repeated seizures, but this can be any kind of seizures, not just generalized seizures. A person can have a seizure without having epilepsy. Today, seizure disorder is the term used more commonly than epilepsy.

A seizure can be provoked by any situation that seriously disturbs the physical or chemical environment of the brain. Some common triggers include:

If doctors can successfully treat the physical or chemical disturbance in the brain, the seizure problem often goes away. If not, seizures may return again and again, whenever the underlying problem flares up.

Interictal Alterations Of Blood Pressure And Baroreflex In Epilepsy

According to previous surveys, the prevalence of arterial hypertension is similar in PwE as compared to the general population . This is in line with smaller scope studies reporting similar interictal BP values in people with FBTCS and healthy controls as well as in individuals with epilepsy who later died of SUDEP and two matched control groups with and without epilepsy . The authors of the latter study found, however, that DAP tended to be higher in SUDEP patients, suggesting that the sympathetic tone is elevated in this patient group . In fact, subtle signs of cardiovascular autonomic dysfunction such as altered HR variability at rest or in response to orthostasis and other autonomic tests are common in PwE, possibly augmented by anti-seizure drugs such as carbamazepine . For instance, attenuated HRV, which is an established risk factor for cardiovascular morbidity and mortality, is significantly decreased in PwE, indicating a shift of autonomic function toward a predominant sympathetic activity and lower vagal activity. This sympathovagal imbalance may be further reinforced due to the effect of anti-seizure drugs and during phases of sleep related apnea, both in people with focal and generalized epilepsy syndromes .

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Seizures Due To Hypoglycemia

Seizures in the setting of hypoglycemia are well described. The brain needs sugar to function and when the blood sugar falls too low, one of the things that can happen is that the patient may have a seizure . There is no one level of blood sugar below which one has a seizure . Let me explain that with an example. Lets assume you are a diabetic and you take your insulin shot but for once forget to take a meal . You have a convulsion while at work and are taken to the nearest ER. There your blood sugar at the time of presentation is recorded to be 60 mg/dl. There might be another similar patient whose blood sugar falls to 52mg/dl yet he does not have a convulsion. So there is no set limit below which the brain shall have a seizure but speaking in broader terms usually the brain does not tolerate blood sugar below 60mg/dl and below 40 mg/dl most patients shall be symptomatic . The good news though is that seizures due to hypoglycemia are readily treatable. In the ER we load the patient with glucose . The blood sugar quickly rises and the seizures stop. Patients who suffer from hypoglycemic seizures do not need to be on an anti-epileptic drug. These patients do not have epilepsy. If their blood sugar does not fall down again, they will not have another seizure. Rather a meticulous search should bContinue reading > >

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What Does A Typical Seizure Look Like

A dog with a generalized seizure often begins showing abnormal behaviors prior to the actual seizure. Dogs may hide, whine, act anxious, tremble, or salivate for anywhere from several seconds to several hours prior to a seizure. This period of time is called the pre-ictal phase, or aura.

In a generalized, or tonic-clonic seizure, the dog will typically be seen to suddenly fall on his side. The legs will first become stiff, and this stiffening is often followed by rhythmic/jerky paddling motions. The head is often held back, with the neck extended. Dogs may vocalize, will often have repeated chewing or chomping motions of the jaw, and often will salivate excessively. Typically, dogs will also urinate or defecate during seizures. Seizures typically last approximately one to two minutes, although prolonged seizures can occur and require treatment.

Once the seizure has ended, dogs will have a prolonged post-ictal recovery period. This period may last up to 24 hours, depending on the individual dog. During the post-ictal period, dogs are typically confused and disoriented. They may be observed to pace and wander aimlessly, while some dogs may show further signs such as blindness, increased thirst, and increased urination.

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High Blood Pressure May Double Epilepsy Risk

High blood pressure may double the risk of developing epilepsy in older age. This is according to a new study in the journal Epilepsia.

The US study by Dr Maria Stefanidou and colleagues looked at risk factors in the blood system that may predict if epilepsy develops in people aged 45 years and older.

Participants from the Framing Heart Study , who were at least 45 years old at the time, were included in the study. They also needed to have available blood system risk factor data and an epilepsy follow-up. Blood system risk factors included high blood pressure, diabetes, smoking and high level of fats in the blood.

The team found that out of the 2,986 people included in the study, 55 had epilepsy at the follow-up. High blood pressure appeared to double the risk of developing epilepsy. The team did a second analysis, where they excluded people with normal blood pressure who were receiving blood pressure medication. This changed the total number of people in this group to 2,613 and those who had epilepsy to 50. In this analysis, high blood pressure increased the risk by nearly two-and-a-half times.

The study authors concluded that their study added to evidence that high blood pressure increases the risk of developing epilepsy later in life. They stressed that this is a risk factor that can be reduced in the general population, through things like lifestyle changes and medicines.

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Blood Pressure And Seizures: Can Blood Pressure Trigger Seizures

Posted byRSC Diagnostics on Jul 23, 2021

Could your blood pressure be causing you to have more seizures? Some recent studies looked at the effects seizures have on respiratory and cardiac functions, and they have found that there is a potential for danger in certain circumstances. Through EEG with video monitoring, researchers discovered that focal seizures and generalized tonic-clonic seizures can lead to problems with breathing. It can also lead to instability of the cardiac muscles and slower reflexes.

Current data suggests there are autonomic and respiratory dysfunctions that occur after a seizure. This is especially the case with generalized tonic-clonic seizures. It could also be correlated with SUDEP or Sudden Unexpected Death in Epilepsy.

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What Can I Expect If I Have Seizures

Fewer than half of people who have a single unprovoked seizure will have another. If a second seizure happens, healthcare providers usually recommend starting anti-seizure medications.

Medications can help prevent seizures or reduce how often they happen. However, it sometimes takes trying multiple medications to find one that works best.

In some cases, people have refractory epilepsy, which resists medications. For people with refractory epilepsy, surgery, ketogenic diet or an implantable device are the next options to consider.

How long will I have this condition?

For provoked seizures, the risk of having another depends on what caused the first seizure and if that cause was treatable or curable. If it was treatable or curable, your risk of having another seizure is low .

Many people who had an unprovoked seizure will never have another for the rest of their lives. For those who do have a second seizure, epilepsy is a life-long condition because its not curable. However, its possible for this condition to go into remission and for seizures to stop happening.

Whats the outlook for this condition?

For people who’ve had one or more seizures, the prognosis and outlook depend on several factors. These include:

Sudden unexpected death in epilepsy

There is a small risk of sudden unexpected death in epilepsy for people with that condition. SUDEP happens for unknown reasons. Experts suspect it involves heart rhythm or breathing problems.

Key Points About Epilepsy And Seizures

• A seizure occurs when one or more parts of the brain has a burst of abnormal electrical signals that interrupt normal signals

• There are many types of seizures. Each can cause different kinds of symptoms. These range from slight body movements to loss of consciousness and convulsions.

• Epilepsy is when you have 2 or more seizures with no known cause.

• Epilepsy is treated with medicine. In some cases, it may be treated with VNS or surgery.

• Its important to avoid anything that triggers seizures. This includes lack of sleep.

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Dangerously High Blood Pressure During Seizure

Porkette said:Hi Mtilton472, Welcome to the Forum! I’ve had epilepsy for 48 yrs. and take my word a persons blood pressure can increase especially if the seizures are coming from the temporal or frontal lobe or it can be the seizure med the person takes. I’ve been on over 13 different seizure meds andnothing stopped my seizures it wasn’t until my Dr. did a DNA test on me and he found out I was drug resistant. My advice to you is when yousee your Dr. ask to have a DNA test done all they do is take some blood and some salvia from you and it goes to the lab the lab will see howmany enzymes you have in your liver along with your body chemistry and they can match that up to the best seizure med for you with the least side effect. I will tell you some Drs. will say “We don’t do this” but that’s nonsense because the Drs. are making money pushing the meds. I found the best thing that has ever helped me was the medical marijuana since I started using that my seizures have decreasedto the lowest in my life. I wish you the best of luck and May God Bless You! Sue

What To Do During A Seizure

Most of the time a seizure lasts less than 3 minutes, so by the time an emergency medication is ready to be given, the seizure is over. The most important thing during a seizure is for you to stay calm and protect the person having a seizure.

The following guidelines apply to tonic-clonic seizures or complex partial seizures.

Cushion the head. Banging the head against a hard surface during a seizure may lead to head trauma. Use any available soft object, and, if needed, use your foot.

Loosen tight neckwear to ease breathing.

Turn the person onto his/her side. This position helps the tongue fall to the side of the mouth, leaving the airway clear for normal breathing.

Do not insert any object into the persons mouth. An object in the mouth will not prevent tongue biting, nor will a person swallow his/her tongue, as some people think. In fact, if an object is placed into the mouth, you may cause more harm by breaking teeth or losing the object in the throat, causing choking.

Do not restrain a person during a seizure unless there is a danger. They may become aggressive if you do so. Allow them to do what they want to do. Talk to them in a soft voice to reassure them.

Afterward, tell the person that he/she has had a seizure and make sure theyre breathing normally. Check the persons awareness by asking a few questions, such as, Where are you? or What is the day today? If a tonic-clonic seizure has occurred, inform the doctor.

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Blood Pressure During Focal Seizures

In our recent study with continuous non-invasive BP recordings in 37 patients with focal epilepsy undergoing video-EEG monitoring, MAP, SAP, and DAP increased by 2030% on average during 35 FS and returned to baseline within 10 min after seizures cessation . Peri-ictal alterations of BP had a similar time course as the concomitant increase in HR and did not depend on oxygen saturation. FS with impaired awareness showed a stronger increase in BP than those without impaired awareness . Notably, peri-ictal BP modulation was stereotypic in those patients with recordings of more than one seizure of the same type. The most frequent pattern was a concomitant increase of BP and HR, which is in line with previously published case reports . In some patients with FS, however, BP decreased whilst HR increased . Jaychandran and colleagues also found, on average, a seizure-related increase in BP in 42 patients with 57 FS . They reported that ictal hypertension was observed in 26.3% of the patients, whereas ictal hypotension occurred in 8.7%.

What Should I Do If Someone Im With Has A Seizure

If you’re with someone who’s having a seizure, there are several things you can do as part of seizure first aid. Some Dos and Donts include:

Dos

Dont

• Dont restrain them. You could hurt the person or get hurt yourself.
• Dont put anything in their mouth. There are many myths about seizures and epilepsy. One myth is that putting something in a persons mouth like a belt or spoon can keep them from swallowing or biting their tongue. ++Dont do this.++ You shouldnt put anything into the mouth of someone having a seizure. You could hurt them or get hurt yourself.
• Dont panic. Stay calm. If others around you are panicking, reassure them as best you can. Nearly 98% of seizures don’t last more than five minutes.

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How Do You Help Someone Who Is Having A Seizure

Clear the area around a person whos having a seizure to prevent possible injury. If possible, place them on their side and provide cushioning for their head.

Stay with the person. Call 911 or local emergency services as soon as possible if any of these apply:

• The seizure lasts longer than 5 minutes.
• The person doesnt wake up after the seizure.
• The person is experiencing repeat seizures.
• The seizure occurs in someone who is pregnant.
• The seizure occurs in someone who has never had a seizure before.

Its important to remain calm. While theres no way to stop a seizure once its begun, you can provide help. The recommends the following:

• Stay with the person having the seizure until it ends, or until they are fully awake again.
• Check to see whether the person is wearing a medical bracelet.
• If the person is wearing glasses or anything around their neck, remove them if possible.
• If the person having the seizure is standing, you can prevent them from falling or injuring themselves by holding them in a hug or gently guiding them to the floor.
• If the person having the seizure is on the ground, try to position them on their side so that saliva or vomit leaks out of their mouth instead of down their windpipe.
• If possible, place something soft under their head.
• Do not try to hold the person down while theyre having a seizure.
• Do not put anything in the persons mouth.