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Epilepsy

Alternative Names:
Seizure disorder

Symptoms:

The severity of symptoms can vary greatly from simple staring spells to loss of consciousness and violent convulsions. For many patients, the event is stereotyped (the same thing over and over) while some patients have many different types of seizures that cause different symptoms each time.

The type of seizure a person experiences depends on a variety of factors, such as the part of the brain affected, the cause, and individual response.

An aura consisting of a strange sensation (such as tingling, smell, or emotional changes) occurs in some people prior to each seizure. Seizures may occur repeatedly without explanation.

SYMPTOMS OF GENERALIZED SEIZURES

Generalized seizures affect all or most of the brain. They include petit mal and grand mal seizures.

Petit mal seizures:

  • Minimal or no movements (usually, except for "eye blinking") -- may appear like a blank stare
  • Brief sudden loss of awareness or conscious activity -- may only last seconds
  • Recurs many times
  • Occurs most often during childhood
  • Decreased learning (child often thought to be day-dreaming)
Tonic-clonic (grand mal) seizures:
  • Whole body, violent muscle contractions
  • Rigid and stiff
  • Affects a major portion of the body
  • Loss of consciousness
  • Breathing stops temporarily, then "sighing"
  • Incontinence of urine
  • Tongue or cheek biting
  • Confusion following the seizure
  • Weakness following the seizure (Todd's paralysis)

SYMPTOMS OF PARTIAL SEIZURES

Partial seizures affect only a portion of the brain.

Simple partial (focal) seizures:

Partial complex seizures:
  • Automatism (automatic performance of complex behaviors without conscious awareness)
  • Abnormal sensations
  • May have nausea, sweating, skin flushing and dilated pupils
  • May have other focal (localized) symptoms
  • Recalled or inappropriate emotions
  • Changes in personality or alertness
  • May or may not lose consciousness
  • Olfactory (smell) or gustatory (taste) hallucinations or impairments -- if the epilepsy is focused in the temporal lobe of the brain.


Signs and tests:
The diagnosis of epilepsy and seizure disorders requires a history of recurrent seizures of any type. A physical examination (including a detailed neuromuscular examination) may be normal, or it may show abnormal brain function related to specific areas of the brain.

An electroencephalograph (EEG), a reading of the electrical activity in the brain, may confirm the presence of various types of seizures. It may, in some cases, indicate the location of the lesion causing the seizure. EEGs can often be normal in between seizures, so it may be necessary to do prolonged EEG monitoring.

Tests may include various blood tests to rule out other temporary and reversible causes of seizures, including:

Tests for the cause and location of the problem may include procedures such as: Disorders that may cause symptoms resembling seizures include transient ischemic attacks, rage or panic attacks, and other disorders that cause loss of consciousness.

Review Date: 11/5/2002
Reviewed By: Joseph V. Campellone, M.D., Division of Neurology, Cooper Hospital/University Medical Center, Camden, NJ. Review provided by VeriMed Healthcare Network.

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