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Epilepsy with Partial Seizures

epilepsy partial

What is a seizure?

A seizure is a short episode of symptoms which is caused by a burst of abnormal electrical activity in the brain. Typically, a seizure lasts from a few seconds to a few minutes. The brain contains millions of nerve cells (neurons). Different parts of the brain control different parts and functions of the body. Therefore, the symptoms that occur during a seizure depend on where the abnormal burst of electrical activity occurs.

There are different types of seizures but they are broadly divided into two main types - generalised and partial.

What is a partial seizure?

With a partial seizure, the burst of electrical activity stays in one part of the brain. Therefore, you tend to have localized (focal) symptoms. Different parts of the brain control different functions and so symptoms depend on which part of the brain is affected.

Simple partial seizures

In this type of seizure you may have muscular jerks or strange sensations in one arm or leg. You may feel, hear, see, smell, or taste odd sensations. Some people develop pins and needles in one part of the body. However, you do not lose consciousness or awareness. A simple partial seizure usually lasts just a few seconds or minutes.

Complex partial seizures

During this type of partial seizure, you are not aware of your surroundings, or of what you are doing. In effect, you have a partial loss of consciousness. This type of seizure can arise from any part of the brain but most commonly arises from a temporal lobe (a part of the brain). Therefore, this type is sometimes called temporal lobe seizure. You may have strange feelings, sensations, and emotions during a complex partial seizure. It may feel like being in a dream. Your surroundings may appear strange or oddly familiar. It may be difficult to explain the feelings or sensations that occur. To an onlooker, you may appear to be in a trance or behave strangely for a few seconds or minutes.

What is epilepsy?

If you have epilepsy, it means that you have had repeated seizures. If you have a single seizure, it does not necessarily mean that you have epilepsy. Epileptic seizures arise from within the brain. A seizure can also be caused by external factors which may affect the brain. For example, a high fever may cause a febrile convulsion. Other causes of seizures include: lack of oxygen, a low blood sugar level, certain drugs, poisons, and a lot of alcohol.

What causes epilepsy?

Unknown cause

Symptomatic epilepsy

In some cases, an underlying brain condition or brain damage causes epilepsy. Some conditions are present at birth. Some conditions develop later in life. For example: a patch of scar tissue in a part of the brain, a head injury, stroke, cerebral palsy, some genetic syndromes, tumours of the brain, previous infections of the brain, such as meningitis or encephalitis.

What triggers a seizure?

There is often no apparent reason why a seizure occurs at one time and not at another. Possible triggers may include:

  1. Stress or anxiety.
  2. Heavy drinking.
  3. Street drugs.
  4. Some medicines such as antidepressants, antipsychotic medication.
  5. Lack of sleep, or tiredness.
  6. Irregular meals which cause a low blood sugar level.
  7. Flickering lights, such as from strobe lighting.
  8. Menstruation (periods).
  9. Illnesses which cause fever, such as flu or other infections.

How is epilepsy diagnosed?

You should see your doctor if you have had a possible seizure or similar event. It is important that a doctor should have a clear description of what happened during the event. Preferably this is from the person affected, and also from an eyewitness.

A brain scan - usually a magnetic resonance imaging (MRI) or computed tomography (CT) scan - can show the structure of different parts of the brain.

EEG. This test records the electrical activity of the brain. Some types of seizure produce typical EEG patterns. However, a normal recording does not rule out epilepsy, and not all EEG abnormalities are related to epilepsy.

Blood tests and other tests may be advised to check on your general well-being. They may also look for other possible causes of the event.

How can I help someone having a partial seizure?

As partial seizures can take many different forms, bystanders need to take a common sense approach. Nearly all partial seizures stop within a few minutes by themselves. Gentle and quiet reassurance may be all that is needed until the seizure ends. If the affected person appears confused or is wandering, try to guide them away from any danger.Sometimes a partial seizure develops into a convulsive one, so be aware of this.

What are the treatments for epilepsy?

Medication

Epilepsy cannot be cured with medication. However, various medicines can prevent seizures. They work by stabilizing the electrical activity of the brain.  The decision to start medication should be made by weighing up all the pros and cons of starting, or not starting, the medicine. A common option is to wait and see after a first seizure. If you have a second seizure within a few months, more are likely. Medication is commonly started after a second seizure that occurs within 12 months of the first.

Other treatments

Surgery to remove a small part of the brain, which is the underlying cause of the epilepsy. Surgery is only suitable for a minority of people with epilepsy and may be considered when medication fails to prevent seizures, especially partial seizures.

Vagal nerve stimulation is a treatment for epilepsy where a small generator is implanted under the skin below the left collar bone. The vagus nerve is stimulated to reduce the frequency and intensity of seizures.

The ketogenic diet is very high in fat, low in protein, and almost carbohydrate-free. This can be effective in the treatment of difficult-to-control seizures in some children.

What is the outlook (prognosis) for people with epilepsy?

The success in preventing seizures by medication varies depending on the type of epilepsy. The overall outlook is good.


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