Seizures

Focal Seizures ◽

Generalized Seizures ◽

Seizures are transient neurological events caused by abnormal excessive or synchronous neuronal activity in the brain. This can arise from a localized brain region, causing focal seizures, or simultaneously from both hemispheres, leading to generalized seizures. Epilepsy is the tendency to develop recurrent seizures and is usually diagnosed after two or more unprovoked seizures. This chapter covers simple partial seizures (sometimes called aura), complex partial seizures, and focal (or partial) seizures, their differential diagnosis, context, approach to diagnosis, key diagnostic tests, therapy, and prognosis, as well as dealing with uncertainty in a diagnosis.

Brain Mechanisms of Altered Consciousness in Focal Seizures

Behavioural Neurology ◽

10.1155/2011/520276 ◽

2011 ◽

Vol 24 (1) ◽

pp. 35-41 ◽

Cited By ~ 10

Author(s):

Andrew P. Bagshaw ◽

Andrea E. Cavanna

Keyword(s):

Brain Function ◽

Fundamental Issue ◽

Partial Seizures ◽

Altered Consciousness ◽

Main Criterion ◽

Central Concept ◽

Focal Seizures ◽

Generalized Seizures ◽

Consciousness is a central concept in epileptology, relevant to the understanding of both focal and generalized seizures. Within focal seizures, impairment of consciousness has long been considered as the main criterion differentiating complex partial seizures (CPS) from simple partial seizures With the development of improved tools for investigating human brain function, new insights into the brain mechanisms of altered consciousness in CPS have become available. This paper reviews the existing literature on how the currently available methods can be used to address the fundamental issue of how CPS alter consciousness.

Etiology of epilepsy a prospective study of 210 cases

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x1991000300003 ◽

1991 ◽

Vol 49 (3) ◽

pp. 251-254 ◽

Cited By ~ 20

Author(s):

Walter Oleschko Arruda

Keyword(s):

Ct Scan ◽

Neurological Examination ◽

Epileptic Seizures ◽

Partial Seizures ◽

Blood Tests ◽

Generalized Seizures ◽

A Prospective Study ◽

Csf Examination

The objective of this study was to establish the etiology of epilepsy in 210 chronic epileptics (110 female, 100 male), aged 14-82 years (34.2±13.3). Patients less than 10 years-old and alcoholism were excluded. All underwent neurological examination, routine blood tests, EEG and CT-scan. Twenty patients (10.5%) were submitted to spinal tap for CSF examination. Neurological examination was abnormal in 26 (12.4%), the EEG in 68 (45.5%), and CT-scan in 93 (44.3%). According to the International Classification of Epileptic Seizures (1981), 101 (48.1%) have generalized seizures, 66 (31.4%) partial seizures secondarily generalized, 25 (11.8%) simple partial and complex partial seizures, and 14 (6.6%) generalized and partial seizures. Four patients (2.0%) could not be classified. In 125 (59.5%) patients the etiology was unknown. Neurocysticercosis accounted for 57 (27.1%) of cases, followed by cerebrovascular disease 8 (3.8%), perinatal damage 5 (2.4%), familial epilepsy 4 (1.9%), head injury 4 (1.9%), infective 1 (0.5%), and miscelanea 6 (2.8%).

Cyclic Vomiting and Recurrent Abdominal Pains as Migraine or Epileptic Equivalents*

Cephalalgia ◽

10.1046/j.1468-2982.1983.0302115.x ◽

1983 ◽

Vol 3 (2) ◽

pp. 115-118 ◽

Cited By ~ 34

Author(s):

G. Lanzi ◽

U. Balottin ◽

A. Ottolini ◽

F. Rosano Burgio ◽

E. Fazzi ◽

...

Keyword(s):

The Other ◽

Periodic Syndrome ◽

Age Group ◽

Pediatric Age ◽

Partial Seizures ◽

Pediatric Age Group ◽

Generalized Seizures ◽

Epileptic Disorder ◽

Cyclic Vomiting

A retrospective method was used to estimate the incidence of recurring motion-sickness, cyclic vomiting and abdominal pain considered as different manifestations of a so-called periodic syndrome in 100 migraine sufferers, 100 epileptics and 100 control subjects in the pediatric age group. Such recurrent symptoms are significantly more frequent in those suffering from migraine than in the other two groups. Examination of subgroups of patients affected by particular forms of migraine (classical and common) and of epilepsy (generalized seizures, simple partial seizures, complex partial seizures) contributed little new to our understanding of the nature of periodic syndrome. It is concluded that the above symptoms of periodic syndrome should generally be considered as manifestations of a migrainous rather than of an epileptic disorder.

A Case of Complex Partial Seizures Presenting as Acute and Transient Psychotic Disorder

Case Reports in Psychiatry ◽

10.1155/2019/1901254 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4

Author(s):

Sadia Sultan ◽

Ebtihaj Omar Fallata

Keyword(s):

Psychotic Disorder ◽

Aggressive Behaviour ◽

Financial Constraints ◽

Temporal Region ◽

Partial Seizures ◽

Impaired Consciousness ◽

High Clinical Suspicion ◽

Oral Olanzapine ◽

Introduction. Complex partial seizures are focal (CPS) (i.e., start in one area of the brain) and associated with impairment in consciousness. Most of them arise in the temporal region and are characterized by aura, impaired consciousness, and automatisms. CPS that arise in temporal region are most often misdiagnosed as primary psychiatric illness. Case Report. A 25-year-old male presented with fluctuations in consciousness, aggressive behaviour, hallucination, and delusions of grandeur lasting a few hours. He was diagnosed with acute and transient psychotic disorder according to ICD10 criteria and was treated with intramuscular haloperidol 10mg BID followed by oral olanzapine 10mg. Computed tomography of brain and electroencephalogram were normal. After 15 days he presented again to the outpatient department with complaints of aggressive behaviour and sensory misinterpretations. Video electroencephalogram was recommended, which was not done due to financial constraints. The diagnosis was reconsidered and he was started on oral carbamazepine due to high clinical suspicion, of complex partial seizures, in spite of lack of EEG evidence. He responded well to antiepileptic and symptom remission has maintained well. Conclusion. Patients presenting with psychosis need careful diagnostic evaluation for other possibilities.

Seizure Types and Frequency in Patients Who “Fail” Temporal Lobectomy for Intractable Epilepsy

Neurosurgery ◽

10.1227/neu.0000000000000120 ◽

2013 ◽

Vol 73 (5) ◽

pp. 838-844 ◽

Cited By ~ 20

Author(s):

Dario J. Englot ◽

Anthony T. Lee ◽

Catherine Tsai ◽

Cathra Halabi ◽

Nicholas M. Barbaro ◽

...

Keyword(s):

Intractable Epilepsy ◽

Temporal Lobectomy ◽

Seizure Type ◽

Seizure Outcome ◽

Seizure Freedom ◽

Partial Seizures ◽

Generalized Seizures ◽

Number Of Patients ◽

Before And After

Abstract BACKGROUND: Temporal lobectomy can lead to favorable seizure outcomes in medically-refractory temporal lobe epilepsy (TLE). Although most studies focus on seizure freedom after temporal lobectomy, less is known about seizure semiology in patients who “fail” surgery. Morbidity differs between seizure types that impair or spare consciousness. Among TLE patients with seizures after surgery, how does temporal lobectomy influence seizure type and frequency? OBJECTIVE: To characterize seizure types and frequencies before and after temporal lobectomy for TLE, including consciousness-sparing or consciousness-impairing seizures. METHODS: We performed a retrospective longitudinal cohort study examining patients undergoing temporal lobectomy for epilepsy at our institution from January 1995 to August 2010. RESULTS: Among 241 TLE patients who received temporal lobectomy, 174 (72.2%) patients achieved Engel class I outcome (free of disabling seizures), including 141 (58.5%) with complete seizure freedom. Overall seizure frequency in patients with persistent postoperative seizures decreased by 70% (P < .01), with larger reductions in consciousness-impairing seizures. While the number of patients experiencing consciousness-sparing simple partial seizures decreased by only 19% after surgery, the number of individuals having consciousness-impairing complex partial seizures and generalized tonic-clonic seizures diminished by 70% and 68%, respectively (P < .001). Simple partial seizure was the predominant seizure type in 19.1% vs 37.0% of patients preoperatively and postoperatively, respectively (P < .001). Favorable seizure outcome was predicted by a lack of generalized seizures preoperatively (odds ratio 1.74, 95% confidence interval 1.06-2.86, P < .5). CONCLUSION: Given important clinical and mechanistic differences between seizures with or without impairment of consciousness, seizure type and frequency remain important considerations in epilepsy surgery.

Complex partial seizures: Clinical characteristics and differential diagnosis

Neurology ◽

10.1212/wnl.33.9.11515 ◽

1983 ◽

Vol 33 (9) ◽

pp. 11515-11515 ◽

Cited By ~ 110

Author(s):

W. H. Theodore ◽

R. J. Porter ◽

J. K. Penry

Keyword(s):

Differential Diagnosis ◽

Clinical Characteristics ◽

Partial Seizures ◽

Complex Partial Seizures

Classification of Epilepsy

10.1093/med/9780197512166.003.0081 ◽

2021 ◽

pp. 705-718

Author(s):

Jamal F. Khattak ◽

David B. Burkholder

Keyword(s):

Differential Diagnosis ◽

Neuronal Activity ◽

Initial Approach ◽

Key Characteristics ◽

An understanding of the definitions, classification, and key characteristics of seizures and epilepsy is vital in the initial approach to a patient presenting with seizures. Classifying seizures appropriately helps narrow the differential diagnosis and guide further testing, treatment, and prognosis. This chapter reviews the basic definitions and classifications of seizures and epilepsy and summarizes select epilepsy syndromes. A seizure is a transient occurrence of signs or symptoms due to abnormal, excessive, or synchronous neuronal activity in the brain.

Difficulty in differential diagnosis of atypical absence seizures and complex partial seizures in childhood

Psychiatry and Clinical Neurosciences ◽

10.1111/j.1440-1819.1995.tb02217.x ◽

1995 ◽

Vol 49 (3) ◽

pp. S300-S301

Author(s):

JIRO ONO ◽

TOSHIYUKI MANO ◽

TOMOKO IKEDA ◽

TAKESHI MURAMATSU ◽

HIROSHI ARAI ◽

...

Keyword(s):

Differential Diagnosis ◽

Partial Seizures ◽

Absence Seizures ◽

Atypical Absence

Nocturnal Plasma Prolactin and Cortisol Levels in Epileptics With Complex Partial Seizures and Primary Generalized Seizures

Archives of Neurology ◽

10.1001/archneur.1987.00520190011008 ◽

1987 ◽

Vol 44 (7) ◽

pp. 699-702 ◽

Cited By ~ 25

Author(s):

M. Molaie ◽

A. Culebras ◽

M. Miller

Keyword(s):

Plasma Prolactin ◽

Partial Seizures ◽

Generalized Seizures ◽

Cortisol Levels

Transnasal endoscopic removal of hypothalamic hamartoma (case reports)

Russian journal of neurosurgery ◽

10.17650/1683-3295-2019-21-1-72-82 ◽

2019 ◽

Vol 21 (1) ◽

pp. 72-82 ◽

Cited By ~ 1

Author(s):

A. Yu. Grigoriev ◽

I. S. Trifonov ◽

M. V. Sinkin ◽

E. V. Grigorieva ◽

I. L. Kaimovskiy ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Disease Duration ◽

Epileptic Seizures ◽

Effective Control ◽

Resonance Imaging ◽

Partial Seizures ◽

Generalized Complex ◽

The study objective is to report 2 cases of endoscopic transsphenoidal removal of hypothalamic hamartomas (HH). This surgical method has not been previously considered in both Russian and foreign publications. Materials and methods. A 16-year-old male patient (R.) was admitted to hospital with complaints of epileptic seizures occurring once every 5–6 days; the disease duration was 9 years. A 23-year-old female patient (M.) was also admitted to hospital with complaints of epileptic seizures occurring once a week; the disease duration was 16 years. Results. Magnetic resonance imaging of the brain of patient R. revealed a HH (1.5 cm × 1.4 cm × 1.4 cm) and focal cortical dysplasia in the right occipital lobe. During a 3-day video electroencephalogram monitoring, we registered 3 secondary generalized complex partial seizures. Patient R. underwent endoscopic transsphenoidal removal of the HH. After surgery, he experienced no epileptic seizures during the next 18 months, even though he continued to receive the same doses of antiepileptic drugs. Magnetic resonance imaging of the brain of patient M. demonstrated a HH (2.44 cm × 2.79 cm × 2.68 cm). During a 4-day video electroencephalogram monitoring, we registered 2 secondary generalized complex partial seizures. The patient underwent transsphenoidal removal of the HH. During the next 8 months, the patient experienced no seizures. Conclusion. Our results suggest that transnasal removal of HH is a highly effective and safe procedure for patients with drug-resistant epilepsy. Surgical removal of HHs ensures effective control of the disease, which was previously resistant to pharmacotherapy.