focal seizure

focal seizure 



  Seizures


    Causes
    Focal convulsions
    Simple partial crises
    Complex focal crises
    Generalized epileptic seizures
    What is the cause of convulsions?
    What to do? Therapy
    What is the prognosis?

Epileptic seizures consist of sudden increases in electrical activity in the brain.
Epileptic seizures are divided into two main types:

    Focal convulsions (also called partial convulsions) or unilateral (if they originate from a single brain hemisphere),
    Generalized epileptic seizures.

Epileptic seizures always begin in the brain.
The brain is divided into two parts called hemispheres.
Each hemisphere has four sections called lobes.
Each lobe is responsible for different functions, such as sight, speech and emotions.

Epileptic seizures, electroencephalogram, epilepsy
Most seizures occur suddenly (without any warning) can be daily or rare.
They can have a short duration (a few seconds or minutes) and stop alone.
Epileptic seizures are different from person to person, some people have more than one type of epileptic seizure.
In most cases, convulsions are repeated in the same way: they are the consequence of the same events, but they do not know how often they happen.
Not all epileptic seizures occur with spasms or tremors. Some people have lost their eyes or are confused.
Some people have convulsions when they are awake, others when they sleep.
Injuries may occur during convulsions but in most cases there is no need to go to the hospital or consult a doctor.
The doctor must rule out panic attacks in the differential diagnosis.

Causes of epileptic seizures

The causes of epileptic seizures are the same as those of epilepsy, for example:

    After a stroke or a head injury
    It can be caused by a congenital alteration
    As a consequence of a brain tumor (for example a glioblastoma)
    Post-operative (for example after brain surgery)
    They could be idiopathic, the cause is unknown

CRANIAL TRAUMA, epilepsy, epileptic seizures
Focal convulsions (partial)

In focal convulsions, the epileptic attack begins and involves only part of the brain (called focus). It could cover much of a hemisphere or just a small area in a lobe.

In focal epileptic seizures, convulsions start from a small part of one of the brain lobes.
The person is conscious (aware and alert).
The patient realizes that something is happening in the brain and will remember the epileptic attack.
Some people can not describe partial convulsions in words, but they feel 'strange'.

Classification of simple partial crises

The simple focal crises of the temporal lobe (for example the hooked ones that originate from temporal ouncus) cause:

    Mood swings
    Tinnitus, scampanii or noises are heard
    Redness, pallor, sweat

Simple focal crises of the frontal lobe cause:

    Vocalization with repetitive word output
    Movements of the head or eyes on one side
    Lack of response or difficulty speaking
    Abnormal body posture (for example a stretched arm and another inflection)
    Redness, pallor, sweat
    These CFSs last around 15 to 30 seconds.

Simple focal crises of the frontal lobe include:

    Nighttime epilepsy of the frontal lobe causes seizures during sleep (morpheque epileptic seizures)
    Versatile crises characterized by the rotation of the head and eyes towards the same side and the lifting of the corresponding arm

Simple focal crises of the parietal lobe cause these symptoms:

    Numbness
    tingling,

Simple focal crises of the occipital lobe cause:

    Visual disturbances (colored or flashing lights),
    Hallucinations (see something that does not exist).



Frontal, temporal, parietal lobe

Complex focal crises

Complex focal seizures (CFS) occur in a larger part of the hemisphere compared to a simple focal epileptic seizure.
People may lose consciousness or may have mental confusion.
You can make strange and repetitive movements (automatisms).

People can move confusedly and behave strangely.
They are not aware of what they do.
Individuals could speak but often they do not understand what they say.
They do not react as they normally would.
When speaking aloud, the person with a crisis may think that he is in danger and may react aggressively.
In most cases CFS occurs in temporal lobes but can occur in other parts of the brain.

The complex focal crisis of the lobe causes:

    Nausea
    Unusual behavior as it collects objects without any reason, fiddling with clothing, etc.
    Repeated chewing
    Altered perception of the surrounding world (for example, objects may seem closer or farther away)
    Altered perception of the body (the person feels an arm or a leg bigger or smaller than the reality)
    Déjà vu (feeling similar to "I've been here before") or Jamais vu (familiar things seem new)
    Unusual movements of the lips
    Unusual movements of the hands
    Whisper and repeat meaningless words
    Walking in a confused way, without a destination
    Olfactory hallucinations like hearing unpleasant smells
    Auditory hallucinations (music can be heard).

CFS can start with a simple focal epileptic seizure and last about three to four minutes.

After a complex focal convulsion, the person may be confused for some time, this is the 'post-convulsion' confusion.
It can be difficult to determine when the epileptic crisis ends. The person may feel tired and may not remember the epileptic seizure.

Complex secondarily generalized epileptic seizures
Secondarily generalized seizures are partial epileptic seizures that evolve in generalized seizures.
In most cases they become tonic-clonic convulsions. Initially, partial seizures are limited to a cerebral hemisphere, subsequently comprising the entire brain.
This causes a generalized epileptic attack.
The beginning of a secondarily generalized epileptic seizure is not very different from the beginning of partial epileptic seizures.
Secondarily generalized seizures have a frequency of 16% in children and 9% in adults.



Generalized epileptic seizures

Generalized seizures occur simultaneously on both sides of the brain. They can occur without warning. The person is unconscious (except in myoclonic crises) even for a few seconds. In most cases individuals do not remember what happened during the epileptic seizure.

Cluster epileptic seizures (severe)
This type is defined as a series of repeated and close crises occurring after a short period of time, or without interruptions.
The "state of evil" is an epileptic syndrome that causes long crises, from 10 minutes to about half an hour and causes death in 20% of cases.
These crises can also be partial.

Absences (small evil crisis)
Absences are more frequent in children than adults. During an absence, the person becomes unconscious for a short time.
People may seem empty, with their eyes lost and their eyelids open and close irregularly.
If the small evil crisis occurs during the journey, the individual can continue to walk, but is not aware of what he is doing.
Absences can be confused with "daydreams". The difference is that during an absence you do not regain consciousness when someone calls attention with the voice.
Moreover, absences can occur during a conversation or the execution of an activity, this never happens in the daydream.
In typical absences, the person loses consciousness and does not respond for a few seconds.
When crises are so short, they can not be noticed.
The atypical absences last a little longer than the typical absences. They often have some movement like a brief nod.

Tonic convulsions
In tonic convulsions, muscles suddenly stiffen.
If people are standing, they fall backwards and could be injured.
Tonic convulsions are very short and occur without warning.

Atonic convulsions
In atonic convulsions the muscles suddenly relax and the person falls to the ground.
In most cases, individuals fall forward and can injure their face and forehead.

Myoclonic convulsions
This type of attack causes snap muscle contractions in the arms, legs or upper body.
The shock lasts a fraction of a second and the person remains conscious during the crisis, the attacks are milder or lighter.
In most cases, myoclonic shots occur in the first hours after awakening and can occur together with other types of epileptic seizures.

Tonic-clonic seizures (great evil crisis)
These convulsions are those that are frequently associated with an epileptic seizure.

At the beginning of the epileptic seizure the symptoms may be:

    Unconsciousness,
    Rigidity,
    Falling backwards,
    Shout,
    Bite your tongue or cheek.

During convulsions:
Individuals are agitated. The muscles relax and stiffen rhythmically. This could affect breathing; the skin can change color and become pale or bluish.
In some cases you can lose control of the sphincters.

After the epileptic attack:
Breathing and skin color return to normal,
The person may feel tired, confused or have a headache

Clonic convulsions
Clonic seizures are similar to tonic-clonic attacks, but the body does not stiffen at first.

Progressive myoclonic epilepsies
Progressive myoclonic epilepsies are a combination of myoclonic and tonic-clonic seizures. These occur in people with difficulty in balance, muscle stiffness and mental retardation.

Progressive myoclonic epilepsy is not a pathology, but includes several syndromes.
The main syndromes are shown in the following list:

    Severe myoclonic epilepsy of childhood (Dravet's syndrome)
    Unverricht-Lundborg disease
    Lafora disease
    Mitochondrial encephalopathy

What is the cause of convulsions?

Convulsions can be caused by certain situations. The trigger (Trigger) is different from person to person. The most frequent triggers are the following:

    Lack of sleep
    Stress
    Temperature
    Alcohol
    Intermittent lights (called photosensitive epilepsy)

If the person knows what "triggers" the convulsions must avoid the stimulus.

What to do? Therapy for epileptic seizures

To prevent seizures, you need to treat epilepsy with medications or other therapies, but during convulsions you need to:
1. Do not move your tongue because you risk getting hurt and damaging your teeth.
2. You have to open tight clothes on the neck (shirt and tie)
3. The patient must stand on one side

There are no natural remedies that can cure epilepsy, but some essential oils or herbal products can relax the patient, for example Valerian.

What is the prognosis of the patient with epileptic seizures?

In most cases, the prognosis is unfavorable. Convulsions are controlled with difficulty. Patients often lose thinking and motor control. However, the course of syndromes changes from person to person.

Presentations and auras
People with epilepsy may have a feeling or warning that an epileptic seizure is going to occur. These warning signs are known as aura, but in reality they are partial epileptic seizures.

The auras are different from person to person, the most frequent are:

    Presence of a strange smell or taste,
    Feeling of a déjà vu,
    To believe in living a dream or in an unreal world,
    Fear or anxiety.