Epilepsy/Seizures

Home » Epilepsy/Seizures » Signs and Symptoms

Signs and Symptoms

Signs and symptoms depend on the area of the brain in which seizure activity occurs and on the type of seizure.

Simple Partial Seizures
Symptoms may be motor, sensory, psychic (states of consciousness), and/or autonomic (involuntary activity controlled by the autonomic nervous system). There is no impairment of consciousness in simple partial seizures.

Motor signs include the following:

• alternating contraction and relaxation of muscle groups
• eye movements and turning of the head to the same side
• asymmetrical posturing of the limbs
• speech arrest, vocalization

Sensory symptoms include the following:

• seeing flashes of lights or colors, illusions and hallucinations
• hearing humming, buzzing, hissing noises
• experiencing unpleasant odors and tastes
• dizziness, lightheadedness

Autonomic signs and symptoms include the following:

• borborygmi (rumbling noises produced by gas in the intestines)
• flushing
• incontinence
• nausea, vomiting
• piloerection (goose bumps)
• pupillary dilation
• sweating
• tachycardia (rapid heart rate)

Psychic symptoms include the following:

• detachment, depersonalization
• dreamy state
• memory distortion: flashback, deja vu (feeling that one has seen something before), deja entendu (feeling that one has heard something before), jamais vu (feeling that one has never seen something that is familiar), jamais entendu (feeling that one has never heard something that is familiar), panoramic vision (rapid recall of past events)
• time distortion
• unprovoked emotion: fear, pleasure, displeasure, depression, anger, elation, eroticism

Complex Partial Seizures
Loss of consciousness distinguishes complex partial seizures from simple partial seizures. While unconscious, the patient may have "vacant" or "frightened" look and may have signs and symptoms of a simple partial seizure. Automatisms may occur during unconsciousness.

There are five types of automatisms:

• Alimentary: chewing, increased salivation, borborygmi (rumbling noises caused by gas in the intestines)
• Mimetic: facial expressions of fear, bewilderment, discomfort, tranquility, laughter, crying
• Gestural: repetitive movements of the hands, fingers, sexual gestures
• Ambulatory: wandering, running
• Verbal: repeated short phrases or swearing

Patients who have had complex partial seizures over a period of years may develop drop attacks. When this occurs, they lose postural tone and fall with the sudden onset of unconsciousness.

Complications—Complex partial seizures are easily triggered by emotional stress. The limbic structures (i.e., hypothalamus, hippocampus, amygdala) of the brain may be damaged by seizure activity. The limbic system is concerned with emotion and motivation.

These patients may develop cognitive and behavioral difficulties, such as the following:

• Interictal personality: humorlessness, dependence, obsessions, anger, hypo- or hypersexuality, emotionality
• Memory loss: short-term memory loss attributable to dysfunction in the hippocampus, anomia (inability to recall words or names of objects)
• Poriomania: prolonged aimless wandering followed by amnesia
• Violent behavior: aggression and defensiveness when subjected to restraint during a seizure

Tonic-Clonic (Grand Mal) Seizures
Generalized tonic-clonic seizures may begin as simple or complex partial seizures. They may begin with aura, but patients often do not remember this phase. The tonic phase consists of the following:

• Fall
• Loss of consciousness
• Yell or "tonic cry"
• Extension of arms, legs, and/or face
• Fingers and jaw clenched
• Autonomic symptoms: increased blood pressure and heart rate, increased bladder pressure, flushing, sweating, increased salivation, increased bronchial secretion, apnea (cessation of breathing)

During the clonic phase, muscles relax completely, then muscle tone returns. This produces rhythmic jerks of the body and head. In the postictal phase drooling; biting of the tongue, cheek, or lip; and urinary incontinence are common.

When the jerking movements stop, the patient may remain unconscious for a period of time. The seizure usually lasts 5 to 20 minutes. Patients often awaken confused and may sleep or pass directly into sleep without awakening, and may experience prolonged weakness after the event.

Complications—A tonic-clonic seizure may involve injury, such as

• aspiration of secretions or vomited stomach contents
• skull or vertebral fractures
• tongue, lip, or cheek injuries caused by biting
• status epilepticus

Status epilepticus is a medical emergency in which seizures recur without the patient regaining consciousness between events. It is also defined as a single seizure that lasts 30 minutes or longer. This condition can develop in any type of seizure but is most common in tonic-clonic seizures. Status epilepticus may cause brain damage or cognitive dysfunction and may be fatal.

Subsequent seizures become briefer, more localized, and may be reduced to myoclonic activity. Events may include:

• aspiration
• cardiac arrhythmias
• dehydration
• fractures
• myocardial infarction (heart attack)
• oral and head trauma
• pulmonary edema (fluid build-up in the lungs)

Absence (Petit Mal) Seizures
This type affects children. Absence seizures are generalized seizures that have a rapid onset and are characterized by the following:

• automatisms (e.g., licking the lips, chewing, grimacing, scratching, fumbling with clothes)
• blank staring
• change in facial expression
• lack of awareness, responsiveness, memory
• jerking movements of the extremities
• postictal confusion, sense of "lost" time

Myoclonic Seizures
These brief seizures cause a sudden onset of muscle contractions that may occur throughout the body or may be limited to certain areas of the body (e.g., face, one or more extremities, individual or groups of muscles). The seizure is so brief that it is not known if consciousness is lost. The onset may be so sudden that the patient falls to the ground, or so subtle that the seizure looks like a tremor.

SUDEP
Sudden unexplained death in epilepsy (SUDEP) occurs in a small percentage of persons with epilepsy. For reasons that are poorly understood, an otherwise healthy person with epilepsy can die suddenly. While this also happens within the general population, persons with symptomatic epilepsy have a much greater risk.

Autopsies have not uncovered a physical cause of SUDEP. It is possible that pulmonary edema (fluid build-up in the lungs), suffocation, or cardiac arrhythmias (irregular heartbeat) may be responsible. Some people appear to be at a higher risk than others, such as young adults with generalized tonic-clonic seizures that are not fully controlled with medication and those who abuse alcohol and illicit drugs. Patients using two or more anticonvulsants may be at increased risk for SUDEP.

Epilepsy/Seizures, Signs and Symptoms reprinted with permission from neurologychannel.com
© 1998-2008 Healthcommunities.com, Inc. All Rights Reserved.

Epilepsy/Seizures Resources

	Join Our Epilepsy/Seizures Forum Do you have a question, want to share medical advice, or just need to discuss your situation with someone else having a similar experience? The healthchannels forum is a resource for everyone to share and discuss their health and medical needs with others.	Advertising Disclaimer
	Living with...Share your story Do you have a personal health story that you would like to share with others? As a source of free patient education, our goal is to provide our users with trustworthy information and support from others. That's why we've started our "Living with..." sections.
	Our "Living With..." support pages are a place to share experiences about living with a certain condition, disease, disorder, or illness and for loved ones of those dealing with health-related issues. Many people, especially when newly diagnosed, find comfort in knowing that others are having a similar experience. Help others by sharing your story. View stories already submitted.
	Stay Updated Sign up for our newsletter and receive important updates on the medical conditions that are most important to you.
Advertising Disclaimer To quickly access health information from your website's browser, download Healthcommunities.com's healthchannels toolbar. Advertising Disclaimer