Status epilepticus
A status epilepticus is described as such if a seizure lasts longer than ten minutes or if there is a series of seizures between which no complete recovery can take place. In addition, the series must last longer than half an hour. The status epilepticus is a life-threatening event and an emergency doctor must be called immediately.
Causes of epileptic seizures
The exact cellular (cell-related) disorders that trigger an epileptic seizure have not yet been fully clarified. A sudden discharge of the neurons at the sheaths of the grey cells plays a major role. This means that the important channels responsible for the transport of sodium, potassium and calcium have a functional disorder (dysfunction).
These non-functional channels cause a deficiency of the inhibitory neurotransmitter GABA (gamma-amino-butter acid), which has a preventive effect on seizures. In addition to the deficiency of these transmitters, there appears to be an excess of the neuron-activating transmitters glutamate and aspartate. They are seizure-promoting substances. In addition to these factors, genetic malformations or external influences (drop in blood sugar, severe infections, etc.) can also be a reason for the occurrence of an epileptic seizure.
What are the typical triggers?
Epileptic seizures and other seizures can be caused by a variety of triggers. Frequently, those affected already have an increased susceptibility to seizures for various reasons (increased epileptogenicity, lowered seizure threshold), but the triggers listed here can also trigger seizures in healthy individuals, so-called occasional seizures. However, people with increased susceptibility and epileptic disorders are more frequently affected.
Under certain circumstances, however, the susceptibility is also increased only in relation to certain triggers. The most common cause in adulthood is alcohol withdrawal, the most common cause in childhood is fever. In addition to alcohol withdrawal, there are also other substance-dependent triggers such as drug withdrawal, the use of drugs (especially ecstasy and cocaine), and certain drugs that can trigger seizures as part of side effects (e.g. penicillin, neuroleptics, amitriptyline (antidepressant)). In addition to fever, other conditions can also trigger seizures in the context of illnesses, such as eclampsia in pregnant women, a shift in the electrolytes in the blood (e.g. in kidney diseases) and a massive, unphysiological reduction in blood sugar (hypoglycaemia, especially due to insulin overdoses). In addition, certain situations, especially in people with increased susceptibility, can trigger epileptic seizures, including above all sleep deprivation, intense physical exertion and stroboscopic light (rapid alternation of light and dark).