Epilepsy

Alternative Names

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 the same thing over and over, while some people have many different types of seizures that cause different symptoms each time. The type of seizure a person has depends on a variety of many things, such as the part of the brain affected and the underlying cause of the seizure.

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.

Note: Disorders that may cause symptoms resembling seizures include transient ischemic attacks (TIAs), rage or panic attacks, and other disorders that cause loss of consciousness.

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)

• Whole body, violent muscle contractions
• Rigid and stiff
• Affects a major part of the body
• Loss of consciousness
• Breathing stops temporarily, followed by sighing
• Incontinence of urine
• Tongue or cheek biting
• Confusion following the seizure
• Weakness following the seizure (Todd's paralysis)

SYMPTOMS OF PARTIAL SEIZURES (SIMPLE AND COMPLEX)

Partial seizures may be complex or simple. Partial seizures affect only a portion of the brain.

Symptoms of simple partial (focal) seizures may include:

• Muscle contractions of a specific body part
• Abnormal sensations
• Nausea
• Sweating
• Skin flushing
• Dilated pupils

Symptoms of partial complex seizures may include:

• Automatism (automatic performance of complex behaviors without conscious awareness)
• Abnormal sensations
• Nausea
• Sweating
• Skin flushing
• Dilated pupils
• Recalled or inappropriate emotions
• Changes in personality or alertness
• May or may not lose consciousness
• Problems with smell or taste -- if the epilepsy is focused in the temporal lobe of the brain

Exams 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:

• CBC
• Blood chemistry
• Blood glucose
• Liver function tests
• Kidney function tests
• Tests for infectious diseases
• CSF (cerebrospinal fluid) analysis

Tests for the cause and location of the problem may include:

• Head CT or MRI scan
• Lumbar puncture (spinal tap)