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The hallmarks of epilepsy are recurring seizures, which can be classified as partial or generalized (some patients may be affected by more than one type).
Partial seizures arise from a localized area of the brain, causing specific symptoms. In some patients, partial seizure activity may spread to the entire brain, causing a generalized seizure. Partial seizures include simple partial (jacksonian) and complex partial seizures (psychomotor or temporal lobe).
A simple partial motor-type seizure begins as a localized motor seizure characterized by a spread of abnormal activity to adjacent areas of the brain. It typically produces stiffening or jerking in one extremity, accompanied by a tingling sensation in the same area. For example, it may start in the thumb and spread to the entire hand and arm. The patient seldom loses consciousness, although the seizure may progress to a generalized seizure.
A simple partial sensory-type seizure involves perceptual distortion, which can include hallucinations.
The symptoms of a complex partial seizure vary but usually include purposeless behavior. The patient experiences an aura immediately before the seizure. An aura represents the beginning of abnormal electrical discharges within a focal area of the brain and may include a pungent smell, GI distress (nausea or indigestion), a rising or sinking feeling in the stomach, a dreamy feeling, an unusual taste, or a visual disturbance. Overt signs of a complex partial seizure include a glassy stare, picking at one’s clothes, aimless wandering, lip-smacking or chewing motions, and unintelligible speech; these signs may last for just a few seconds or as long as 20 minutes. Mental confusion may last several minutes after the seizure; as a result, an observer may mistakenly suspect intoxication with alcohol or drugs or psychosis.
Generalized seizures, as the term suggests, cause a generalized electrical abnormality within the brain and include several distinct types:
❑Absence (petit mal) seizures occur most commonly in children, although they may affect adults as well. They usually begin with a brief change in level of consciousness, indicated by blinking or rolling of the eyes, a blank stare, and slight mouth movements. There’s little or no tonic-clonic movement. The patient retains his posture and continues preseizure activity without difficulty. Typically, each seizure lasts from 1 to 10 seconds. If not properly treated, seizures can recur as often as 100 times per day. An absence seizure may progress to generalized tonic-clonic seizures.
❑A myoclonic (bilateral massive epileptic myoclonus) seizure is characterized by brief, involuntary muscular jerks of the body or extremities, which may occur in a rhythmic fashion and may precede generalized tonic-clonic seizures by months or years.
❑A generalized tonic-clonic (grand mal) seizure typically begins with a loud cry, precipitated by air rushing from the lungs through the vocal cords. The patient then falls to the ground, losing consciousness. The body stiffens (tonic phase) and then alternates between episodes of muscular spasm and relaxation (clonic phase). Tongue-biting, incontinence, labored breathing, apnea, and subsequent cyanosis may also occur. The seizure stops in 2 to 5 minutes, when abnormal electrical conduction of the neurons is completed. The patient then regains consciousness but is somewhat confused and may have difficulty talking. If he can talk, he may complain of drowsiness, fatigue, headache, muscle soreness, and arm or leg weakness. He may fall into deep sleep after the seizure. These seizures may start as facial seizures and spread to become generalized.
An akinetic seizure is characterized by a general loss of postural tone (the patient falls in a flaccid state) and a temporary loss of consciousness. It occurs in young children and is sometimes called a “drop attack” because it causes the child to fall.
Status epilepticus is a continuous seizure state that can occur in all seizure types. The most life-threatening example is generalized tonic-clonic status epilepticus, a continuous generalized tonic-clonic seizure without intervening return of consciousness. Status epilepticus is accompanied by respiratory distress. It can result from abrupt withdrawal of anticonvulsant medications, hypoxic encephalopathy, acute head trauma, metabolic encephalopathy, or septicemia secondary to encephalitis or meningitis.
Source: Professional Guide to Diseases (Eighth Edition), 2005
The hallmark of epilepsy is recurring seizures, which can be classified as partial, generalized, status epilepticus, or unclassified (some patients may be affected by more than one type).
Arising from a localized area of the brain, partial seizures cause focal symptoms. These seizures are classified by their effect on consciousness and whether they spread throughout the motor strip, causing a generalized seizure. When simple or complex seizures evolve to both sides of the brain, they’re termed secondary generalized seizures.
A simple partial seizure begins locally and generally doesn’t cause an alteration in consciousness. It isn’t uncommon for this type to present with sensory symptoms (lights flashing, smells, hearing hallucinations), autonomic symptoms (sweating, flushing, pupil dilation), and psychic symptoms (dream states, anger, fear). The seizure lasts for a few seconds and occurs without preceding or provoking events.
A complex partial seizure involves impairment in consciousness. Amnesia for the events that occur during and immediately after the seizure is a differentiating characteristic. During the seizure, the patient may follow simple commands. This type of partial seizure generally lasts for 1 to 3 minutes.
As the term suggests, generalized seizures cause a generalized electrical abnormality within the brain. They can be convulsive or nonconvulsive and include several types.
❑ Absence seizures occur most commonly in children, although they may affect adults. They usually begin with a brief change in level of consciousness, indicated by blinking or rolling of the eyes, a blank stare, and slight mouth movements. The patient retains his posture and continues preseizure activity without difficulty. Typically, each seizure lasts from 1 to 10 seconds. If not properly treated, seizures can recur as often as 100 times per day. An
absence seizure is a nonconvulsive seizure, but it may progress to a generalized tonic-clonic seizure.
❑ Myoclonic seizures (bilateral massive epileptic myoclonus) are characterized by brief, involuntary muscular jerks of the body or extremities, which may occur in a rhythmic manner. Consciousness isn’t usually affected.
❑ Generalized tonic-clonic seizures typically begin with a loud cry, precipitated by air rushing from the lungs through the vocal cords. The patient then loses consciousness and falls to the ground. The body stiffens (tonic phase) and then alternates between episodes of muscle spasm and relaxation (clonic phase). Tongue biting, incontinence, labored breathing, apnea, and subsequent cyanosis may also occur.
The seizure stops in 2 to 5 minutes, when abnormal electrical conduction of the neurons is completed. The patient then regains consciousness but is confused and may have difficulty talking. If he can talk, he may complain of drowsiness, fatigue, headache, muscle soreness, and arm or leg weakness. He may fall into a deep sleep after the seizure.
❑ Atonic seizures are characterized by a general loss of postural tone and a temporary loss of consciousness. They occur in young children and are sometimes called “drop attacks” because they cause the child to fall.
Status epilepticus is a continuous seizure state that can occur in all seizure types. The most life-threatening example is generalized tonic-clonic status epilepticus, a continuous generalized tonic-clonic seizure without intervening return of consciousness.
Status epilepticus is accompanied by respiratory distress. It can result from abrupt withdrawal of anticonvulsant medications, hypoxic encephalopathy, acute head trauma, metabolic encephalopathy, or septicemia secondary to encephalitis or meningitis.
This category is reserved for seizures that don’t fit the characteristics of partial or generalized seizures or status epilepticus. Included as unclassified are events that lack the data to make a more definitive diagnosis.
Source: Handbook of Diseases, 2003
Onset of Juvenile myoclonic epilepsy: early adolescence
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The symptom information on this page attempts to provide a list of some possible signs and symptoms of Juvenile myoclonic epilepsy. This signs and symptoms information for Juvenile myoclonic epilepsy has been gathered from various sources, may not be fully accurate, and may not be the full list of Juvenile myoclonic epilepsy signs or Juvenile myoclonic epilepsy symptoms. Furthermore, signs and symptoms of Juvenile myoclonic epilepsy may vary on an individual basis for each patient. Only your doctor can provide adequate diagnosis of any signs or symptoms and whether they are indeed Juvenile myoclonic epilepsy symptoms.
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