Strokes and seizures are both serious neurological events that significantly impact brain function, yet they differ in their underlying causes, symptoms, and long-term effects. A stroke occurs when blood flow to a part of the brain is blocked or a blood vessel ruptures, potentially causing permanent brain damage if not treated immediately. Seizures result from sudden, abnormal electrical activity in the brain and are often temporary, though they may signal underlying conditions such as epilepsy or brain injury. Recognising the subtle differences in symptoms, such as sudden one-sided weakness in strokes or staged episodes in seizures, is vital. Early identification and prompt medical attention can prevent complications, improve recovery outcomes, and preserve overall brain health.


Understanding strokes and seizures

A stroke occurs when blood flow to a portion of the brain is interrupted or reduced, depriving brain tissue of oxygen and nutrients. This can lead to permanent brain damage if not treated urgently. In contrast, a seizure is caused by sudden, abnormal electrical activity in the brain. While seizures are usually temporary and often non-damaging, they can sometimes signal serious underlying neurological conditions.

Knowing the differences can help you act quickly in emergencies and potentially save lives.


Symptoms of strokes and seizures

Although strokes and seizures can share certain symptoms, careful observation can help differentiate them.


Few shared symptoms

Some symptoms can appear in both conditions, including confusion, sudden falls, inability to control movements, and temporary unawareness or unresponsiveness. Severe cases of either condition may cause loss of consciousness.

Because these shared signs can be subtle, it is always safest to seek immediate medical help when someone shows sudden neurological changes.


Stroke symptoms

Stroke symptoms usually appear suddenly and often affect one side of the body. Key warning signs include:

• Numbness or weakness on one side of the body
• Facial drooping or uneven smile
• Trouble walking or sudden loss of coordination
• Slurred or incoherent speech
• Difficulty understanding spoken words
• Sudden changes in vision
• Severe, unexplained headache

A stroke is a medical emergency, and early treatment can dramatically reduce the risk of permanent disability or death. If you suspect a stroke, call emergency services immediately.


Seizure symptoms

Seizures typically progress through three stages: beginning (prodrome), middle (ictal), and end (postictal).

Beginning stage (Prodrome)

This stage can occur minutes to hours before a seizure. Signs may include:

• Visual disturbances or seeing unusual lights and colours
• Sensitivity to light
• Dizziness or unsteadiness
• Anxiety or sudden unease

Middle stage (Ictal Phase)

During the seizure itself, individuals may experience:

• Loss of consciousness or zoning out
• Muscle jerking, twitching, or stiffness
• Drooling or biting the tongue
• Repetitive movements or actions
• Temporary incontinence
• Hallucinations
• Difficulty hearing or seeing

Seizures can be partial (focal), affecting a specific brain area, or generalised, affecting the entire brain and usually causing loss of consciousness.


End stage (Postictal Phase)

After the seizure ends, symptoms can include:

• Confusion or memory lapses
• Sleepiness or fatigue
• Temporary weakness or paralysis on one side of the body
• Emotional distress or fear

First-time seizures are treated as emergencies, as they may indicate an underlying neurological disorder or serious medical issue.


Why stroke or seizure happens: Check below the causes

Understanding the underlying causes helps distinguish strokes from seizures.


Stroke causes

Strokes occur when blood supply to the brain is compromised, leading to tissue damage. There are two main types:

• Ischemic Stroke: Caused by a blockage in a blood vessel, often due to a blood clot. Clots may form within the brain’s arteries or travel from other parts of the body, such as the carotid arteries in the neck. This is the most common type of stroke.

• Haemorrhagic Stroke: Caused by a blood vessel bursting, which leads to bleeding in the brain. Chronic high blood pressure is a common risk factor, as it weakens blood vessel walls over time.

Seizure causes

Seizures arise from abnormal electrical activity in the brain. Causes include:

• Epilepsy: A chronic disorder that causes recurrent seizures
• Brain injuries or trauma
• Brain tumours
• Infections such as meningitis
• Alcohol withdrawal
• Certain medications
• Overheating or metabolic disturbances
• Seizures can also occur as a secondary effect of a stroke.

Risk factors: Who is most vulnerable


Stroke risk factors

Key factors that increase the risk of stroke include:

• High blood pressure
• Cardiovascular disease
• Abnormal heart rhythms (arrhythmias)
• Diabetes
• Carotid artery disease and atherosclerosis
• Smoking and unhealthy lifestyle habits
• Older age
• Family history of stroke

Some of these factors, such as high blood pressure and smoking, are modifiable, while others, like age and genetics, are not.

Seizure risk factors

Seizures are more likely if you have:

• Epilepsy or a family history of seizure disorders
• A history of head trauma or brain injury
• Brain infections or tumours
• Stroke or other brain abnormalities

Identifying risk factors early can guide prevention and prompt medical intervention.


How doctors determine the cause

Prompt diagnosis is critical for both strokes and seizures.

• Stroke diagnosis: Brain imaging tests such as CT or MRI scans confirm whether a stroke has occurred and help identify its type.
• Seizure diagnosis: An electroencephalogram (EEG) measures brain wave activity to detect abnormal electrical patterns. Additional tests may be needed to determine the underlying cause.

For first-time seizures or suspected strokes, immediate medical attention is essential. Early diagnosis can save brain tissue and improve recovery outcomes.