What is a convulsion?

Heidi Moawad, MD

If you or someone you know has had a convulsion, you likely have many questions about what that means and what you should expect.

Convulsions are often unexpected and generally cause concern for everyone involved. If you experience or witness a convulsion, it can be difficult to

identify it and to decide what you should do.

What is a convulsion?

A convulsion describes an episode characterized by erratic, usually involuntary physical movements, which may be accompanied by changes in consciousness.

A convulsion can be a manifestation of a number of different medical conditions.

Some convulsions involve what appears to be the whole body, and some involve only one area of the body, such as an arm or a leg. Convulsions may be brief in duration, lasting for only seconds, or may continue for a long period of time, sometimes without ending until medication is given.

What should you do if you experience or witness a convulsion?

If you witness a convulsion, the first thing you should try to do is to ensure that the person who is having or has had a convulsion is not left alone while medical care arrives. Someone should call for medical attention as soon as possible. If you are alone with someone who is having a convulsion, the best course of action is to call for emergency help while you remain with the person who is having a convulsive episode.

If you are present while someone is having a convulsion, there is no need for you to physically intervene.

 If possible, keep sharp objects away and protect from ledges or elevated spots that could allow falling.

Once medical help arrives, describe what you saw to healthcare professionals in as much detail as you can, particularly in regards to how the episode started. Be sure to report any falls or injuries that you are aware of.

If you know that any substances were used, such as medications or drugs, be as honest and specific in reporting this as you can, because these details can speed up appropriate medical treatment, which can potentially prevent long lasting health consequences.

If you think that you may have experienced a convulsion, you should call for medical attention as soon as it is possible for you to do so, and describe your experience in as much detail as possible.

What can cause a convulsion?

There are many medical problems that can manifest as a convulsion. The most common causes of convulsions include:

Convulsive seizure

Medication reaction

Severe infection, sepsis (infection that spreads through the blood)

Very high fever

Severe vomiting and/or diarrhea

Diabetic crisis (extremely high or low blood sugar levels)

Hydration abnormalities—severe dehydration or over-hydration

Severe malnutrition

Excessive blood loss

Organ failure

Severe allergic reaction

Drug overdose

Drug withdrawal

Heat stroke

Many of these medical conditions can cause extreme changes in the body, which may result in a convulsive reaction. Some of these conditions can produce fluid imbalances and/or electrolyte abnormalities that may lead to a convulsion.

Electrolytes, such as sodium, potassium, and calcium must be maintained within a very specific concentration in the body in order to support normal physical functions. Fluid and electrolyte imbalances can interfere with normal brain functions, causing changes in consciousness and physical convulsions.

How is a convulsion treated?

Because the causes of a convulsion are so varied, the treatment for a convulsion is initially focused on stabilizing your medical condition, which means that your medical team may need to initiate treatment even before the cause of the convulsion is identified.

However, your team will also work quickly to identify the cause of your convulsion.

This process involves checking for abnormal fluid and electrolyte levels, drugs, infections and neurological conditions such as stroke.

Once the emergency is under control, your doctor will proceed with a thorough evaluation to determine whether you have a medical problem that could predispose you to having a convulsion, such as epilepsy or organ failure. Treatment will then be tailored to managing the specific cause of your convulsion for the long term.

What kinds of diagnostic tests will you need after a convulsion?

Diagnostic testing for a convulsion includes a physical examination and a history from whoever may have witnessed the episode. Additionally, a urine toxicology screening and possibly a blood toxicology screening are often checked. Blood electrolyte and glucose (sugar) levels, and red and white blood cell counts may also be needed to evaluate the cause of a convulsion. In some instances, electroencephalogram (EEG), X-rays, or brain imaging tests may be necessary.

If you have experienced a convulsion, you probably will not need to have all of these diagnostic tests, and you will only need the tests that your doctor considers necessary after examining you and listening to your medical history. Once the results of these tests reveal what type of medical condition could have led to the convulsion, a long-term treatment plan may be necessary to manage your illness and to prevent another convulsion.

What medical conditions could be confused with a convulsion?

There are a number of conditions that may be confused with a convulsion because they manifest with similar characteristics, which may include sudden, jerky, or involuntary movements. The most common conditions that may be confused with convulsions are:

Seizure/epilepsy – Some seizures manifest as convulsions, while some do not. Similarly, some convulsions are seizures, while some are not.

Psychotic episode

Myoclonus

Tics/ Tourette's

Spasms

Deliberately disruptive behavior

Creutzfeldt-Jakob disease

A convulsion requires urgent medical attention. If you experience a convulsion or if you witness a convulsion, seek professional medical help promptly, as some of the causes of a convulsion can cause permanent consequences if they are not treated promptly.

A convulsion may be an important sign of a medical condition that requires attention. A convulsion may be the sign of epilepsy, but that is not necessarily the case. If you or a loved one has experienced a convulsion, there is a strong chance that your doctors will be able to identify the cause of your convulsion and administer short term and long term medical treatment.

Sometimes, a convulsion is caused by a one-time event, such as heat stroke or severe dehydration. In these instances, once you are medically stabilized, you should not be excessively concerned about having further convulsions. In fact, many people who experience a convulsion do not ever experience another one again in their lives.

Sources: verywell