Epilepsy & Seizures

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    Absence (also called petit mal seizures) seizures are characterized by a brief altered state of consciousness and staring episodes. Typically, the person's posture is maintained during the seizure. The mouth or face may move or the eyes may blink. The seizure usually lasts no longer than 30 seconds. When the seizure is over, the person may not recall what just occurred and may go on with his/her activities, acting as though nothing happened. These seizures may occur several times a day. This type of seizure is sometimes mistaken for a learning problem or behavioral problem. Absence seizures almost always start between ages 4 and 12 years.
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    Focal seizures (or partial seizures) take place when abnormal electrical brain function occurs in one or more areas on one side of the brain. Two types of focal seizures include the following:
    • Simple partial seizures: The seizures typically last less than one minute. The person may show different symptoms depending upon which area of the brain is involved. If the abnormal electrical brain function is in the occipital lobe (the back part of the brain that is involved with vision), sight may be altered. If the abnormal brain function is in the frontal lobe (the front part of the brain that is involved with muscle or motor movement), the person's muscles are typically affected. The seizure activity is limited to an isolated muscle group, such as the fingers, or to larger muscles in the arms and legs. Consciousness is not lost in this type of seizure. The person may also experience sweating or nausea, or become pale.
    • Complex partial seizures: This type of seizure commonly occurs in the temporal lobe of the brain, the area of the brain that controls emotion and memory function. This seizure usually lasts between one to two minutes. Consciousness is usually lost during these seizures, and a variety of behaviors can occur. These behaviors may include gagging, lip smacking, running, screaming, crying, and/or laughing. When the person regains consciousness, he/she may complain of being tired or sleepy after the seizure. This is called the postictal period.
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    Complex partial seizures commonly occur in the temporal lobe of the brain, the area of the brain that controls emotion and memory function. This seizure usually lasts between one and two minutes. Consciousness is usually lost during these seizures and a variety of behaviors can occur. These behaviors may include gagging, lip smacking, running, screaming, crying, and/or laughing. When the person regains consciousness, he/she may complain of being tired or sleepy after the seizure. This is called the postictal period.
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    Simple partial seizures typically last less than one minute. The person may show different symptoms depending upon which area of the brain is involved. If the abnormal electrical brain function is in the occipital lobe (the back part of the brain that is involved with vision), sight may be altered. If the abnormal brain function is in the frontal lobe (the front part of the brain that is involved with muscle or motor movement), the person's muscles are typically affected. The seizure activity is limited to an isolated muscle group, such as the fingers, or to larger muscles in the arms and legs. Consciousness is not lost in this type of seizure. The person may also experience sweating or nausea, or become pale.
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    Seizures can be prevented or controlled by taking daily medications, known as anti-epileptics, avoiding certain triggers (like sleep deprivation)and by following your doctor's recommendations.

    Some patients may be seizure free for long periods of time (years) and only have a seizure, if they forget to take their medication, or if they are ill. Others may have more frequent seizure episodes despite taking their medications correctly.

    Unfortunately, a seizure disorder cannot be predicted, and therefore, cannot be prevented. However there are certain risk factors, which are associated with increased odds of developing a seizure disorder. These include moderate to severe head injury, ischemic or hemorrhagic strokes, brain tumors, and central nervous system infections.
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    Generalized tonic-clonic seizures (GTC or also called grand mal seizures) are characterized by five distinct phases that occur. The body, arms, and legs will flex (contract), extend (straighten out), and tremor (shake), followed by a clonic period (contraction and relaxation of the muscles) and the postictal period. During the postictal period (when the person regains consciousness), the person may be sleepy, have problems with vision or speech, and may have a bad headache, fatigue, or body aches.
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    A Neurology, answered on behalf of
    An epileptic seizure is caused by excessive activity of nerve cells in the brain. Often, when the seizure is over these cells are exhausted and require time to recover. An epileptic seizure is also called an ictus so the postictal state refers to any dysfunction that occurs after a seizure while the brain is recovering from the ictus. For generalized tonic-clonic seizures, where the entire brain is eventually involved, the postictal state can consist of complete unresponsiveness with gradual recovery associated with confusion and other symptoms that can take hours, while brief absences have no postictal symptoms at all. Dysfunction can occur after focal seizures, and the feature of the postictal symptoms depend on the area of the brain involved in the seizure. Most commonly, focal motor seizures, for instance involving clonic movements of one hand and arm, can be followed by weakness of the same hand and arm for minutes or sometimes a day or more. Postictal visual deficits and memory problems also often occur. The types of postictal symptoms experienced by patients with epilepsy are as varied as the seizures themselves and, for some patients, disability may be caused more by the postictal symptoms than by the seizures.
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    Secondarily generalized seizures begin in one part of the brain, either as a simple partial seizure (last less than one minute and the person may show different symptoms depending upon which area of the brain is involved) or complex partial (commonly occur in the temporal lobe of the brain), and then spread to involve both sides of the brain where consciousness is lost. Clinically, it looks exactly like a generalized tonic clonic seizure (when a burst of electrical energy sweeps through the whole brain at once, causing a loss of consciousness, falls, and convulsions).
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    When seizures occur on both sides of the brain, they are called generalized seizures.

    There are many types of generalized seizures. They include:
    • Absence seizures. These typically occur in children. The person very briefly loses consciousness. It is as if the child is staring into space, though his or her muscles may twitch and his or her eyelids may flutter. These are very short seizures, lasting just for a few seconds, before the child resumes activity.
    • Clonic seizures. These seizures cause convulsions, which are jerking movements on both sides of the body.
    • Myoclonic seizures. These kinds of seizures involve jerking of the upper body and the limbs. It may appear as if the person has been shocked.
    • Tonic seizures. These seizures, which are more common in sleep, result in sudden stiffness in the muscles.
    • Atonic seizures. These seizures cause a person to droop or fall because of a loss of muscle control. They often are quick, but because they cause someone to fall, they sometimes result in further injury.
    • Tonic-clonic seizures. These seizures cause a person to quickly stiffen, lose consciousness and then convulse with repeated jerking of the legs and arms. These kinds of seizures involve a combination of the symptoms for tonic and clonic seizures.
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    Generalized seizures involve both sides of the brain. There is loss of consciousness after the seizure occurs. Types of generalized seizures include the following:

    • Absence seizures (also called petit mal seizures): These seizures are characterized by a brief altered state of consciousness and staring episodes. Typically, the person's posture is maintained during the seizure. The mouth or face may move or the eyes may blink. The seizure usually lasts no longer than 30 seconds. When the seizure is over, the person may not recall what just occurred and may go on with his/her activities, acting as though nothing happened. These seizures may occur several times a day. This type of seizure is sometimes mistaken for a learning problem or behavioral problem. Absence seizures almost always start between ages 4 and 12 years.
    • Atonic (also called drop attacks): With atonic seizures, there is a sudden loss of muscle tone and the person may fall from a standing position or suddenly drop his/her head. During the seizure, the person is limp and unresponsive.
    • Tonic: Stiffening or contraction in a fixed posture, often with abduction of the shoulders and partial flexion of the elbows; usual duration 10 to 20 seconds, but often cluster; electroencephalography (EEG) pattern of rapid, diffuse polyspikes, often following a slow wave.
    • Generalized tonic-clonic seizures (GTC or also called grand mal seizures): This seizure is characterized by five distinct phases that occur. The body, arms, and legs will flex (contract), extend (straighten out), and tremor (shake), followed by a clonic period (contraction and relaxation of the muscles) and the postictal period. During the postictal period, the person may be sleepy, have problems with vision or speech, and may have a bad headache, fatigue, or body aches.
    • Myoclonic seizures: This type of seizure refers to quick movements or sudden jerking of a group of muscles. These seizures tend to occur in clusters, meaning that they may occur several times a day, or for several days in a row.