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Seizures are associated with the occurrence of disturbances in the electrical activity of the brain. They are very diverse - they can consist of both sudden loss of consciousness and trembling of the hand or the occurrence of convulsions of the whole body. What are the types of epileptic seizures?

An epileptic seizureis a transient state in which there is disturbance in brain function associated with sudden, chaotic electrical discharges in nerve cells.

Typically, epilepsy is associated with seizures, but in reality epilepsy definitely has more than one name - in fact, there are even about 40 forms of epilepsy.

The exact course of an epileptic seizure depends primarily on the part of the brain in which its electrical activity is disturbed.

Distinguishing between different types of epilepsy attacks is important both in terms of determining the patient's prognosis and in determining the treatment - the choice of medications recommended to a patient often depends on the exact type of seizures.

Focal (partial) seizures

Focal epileptic seizures (also known as partial seizures) occur when excessive discharges occur in one specific place in the brain and within one hemisphere.

The simplest division distinguishes between simple and complex focal seizures, within the above-mentioned categories there are further specific sub-types of these epileptic seizures.

  • Simple focal epileptic seizures

A characteristic feature of simple focal seizures is that they are not accompanied by disturbances of consciousness - during which the patient becomes aware of what he is experiencing. Simple focal seizures include:

  • motor seizures -they are associated with disturbances in electrical activity within the so-called the motor cortex of the brain. These seizures may include, for example, turning the eyeballs to one side or sudden trembling of the hand. Sometimes, after motor seizures, patients experience temporary paresis (lasting up to several hours).
  • sensory seizures -they are based on experiencing various disorders on the part of the sensory organs. During a sensory attack, the patient may experience pain but also feel numbnesssome part of the body. This type of seizure can be confused with hallucinations (hallucinations) as patients may, for example, hear non-existent sounds (e.g. whistling) or smell unusual, unnoticed by others.
  • mental (emotional) seizures -associated with rather unusual sensations, such as the feeling of being outside of your own body or receiving distorted images of objects around (e.g. the impression that something is definitely smaller than in reality). Some specialists believe that experiencing deja vu may also be related to psychiatric seizures.
  • vegetative seizures -this type of epileptic seizures is associated, for example, with a feeling of tightness in the chest, increased sweating, increased heart rate or increased salivation.
  • Compound focal epileptic seizures

Unlike simple focal seizures, in complex focal seizures patients experience a disturbance of consciousness and also do not remember having a seizure.

The disturbances of consciousness occurring in their course may have a different character - the patient's consciousness may be only slightly disturbed, and it may lead to a complete loss of it.

Complex focal seizures can take the form of a sudden immobility with inhibition of performing some activity.

There may also be a reverse situation, in which the patient will present automatisms, i.e. he will perform unintentionally, involuntarily, some completely pointless activities.

Examples of automatisms that can occur in complex epileptic seizures are:

  • swallowing
  • chewing
  • nibbling
  • and sometimes even walking or undressing

Epileptic seizure - how to help the patient?

Generalized seizures

Disorders of electrical activity, generally speaking, in both hemispheres of the brain lead to generalized epileptic seizures. The six main types of generalized seizures are the most common.

  • Tonic seizures

Tonic seizures consist of a rapid contraction of various, usually many, muscle groups.

  • Atonic seizures

Atonic seizures are associated with the opposite of the above phenomenon, i.e. with a sudden loss of muscle tone. Disorders in the case of atonic seizures most often affect the muscles of the upper and lower extremities, so that patients may experience -often leading to serious consequences - sudden falls.

  • Generalized epileptic seizures

As the name suggests, during these epileptic seizures, patients suddenly become unconscious. It happens suddenly, often even while performing some activity - the patient simply freezes at some point.

Attacks of unconsciousness usually last no more than half a minute. After the seizure has resolved, the patient often does not feel that he or she has experienced it.

This type of epileptic seizures is characteristic primarily for children and adolescents, another feature of absenteeism is that they can occur many times, even several dozen times a day.

  • Generalized myoclonic seizures

Myoclonic seizures are the occurrence of very short, one to five seconds long muscle jerks (jerks).

Myoclonic seizures can affect different muscle groups, for example, when the hands are affected, the patient may drop objects held in them.

Like absence seizures, myoclonic seizures are most common among children and adolescents. Patients remain aware of this type of generalized seizure.

  • Generalized tonic-clonic seizures (formerly grand mal)

Tonic-clonic seizures are the type of seizure that is probably most associated with this condition. In tonic-clonic seizures, patients become unconscious.

The first phase, usually lasting about a minute, is the tonic phase - during this phase, the patient experiences contraction of various muscle groups, leading, for example, to the flexion of the head and torso or to clenching the hands.

During the tonic phase, the patient may also not breathe, and sometimes, due to sudden muscle contraction, the tongue is bitten or the patient urinates involuntarily.

The tonic phase is followed by a clonic phase, which usually begins with a deep breath and consists of seizures that also last up to about a minute.

  • Seizure - first aid

In addition to those already mentioned, the following are also associated with tonic-clonic seizures:

  • increased heart rate
  • drooling
  • impaired pupillary reflexes (pupils do not react to light during an attack).

The tonic-clonic seizure ends after about two minutes with the patient entering a deep sleep phase.

Status epilepticus

Status epilepticus is one of the most dangerous phenomena associated with epilepsy.

It is diagnosed when a single seizure lasts more than 30 minutes, or when the patient experiences a series of seizures one after another without regaining consciousness between them.

Status epilepticus can lead, inter alia, to it is classified as a life-threatening condition and its occurrence requires urgent, specialist medical assistance.

Epileptic seizures: new classifications

The classification of epileptic seizures described above is based on the classification proposed quite a long time ago, in 1981, by the International League Against Epilepsy (ILAE).

It probably comes as no surprise that the original classification system has undergone numerous changes since then, and what's more - most likely there is still no perfect and complete classification of all possible types of seizures.

The last version of the ILAE classification is from 2022. In the latest edition, the authors focused, inter alia, on distinguishing from what problems an epileptic seizure begins. Therefore, the following are listed:

  • focal-on attacks
  • generalized onset seizures
  • attacks with unknown start

The differences also concern the division of focal seizures - these seizures are divided into focal seizures with disturbed consciousness and seizures with preserved consciousness.

These two categories include seizures with motor (movement) disorders and seizures without motor disorders (i.e. those with sensory, mental or vegetative disorders). The sense of the existence of such a division is explained by: in. the fact that an initially focal seizure may become a generalized seizure (in such a situation it is referred to as the occurrence of a secondary generalized seizure, usually in the form of a tonic-clonic seizure).

Seizures with unknown onset are important mainly because they require the most careful diagnosis in order to determine what type of seizures a given patient actually experiences.

More about the types of epilepsy:

  • Childhood epilepsy with absences (pycnolepsy, Friedman syndrome)
  • Roland's Epilepsy
  • West's Epilepsy Syndrome
  • Northern epilepsy
  • Alcoholic epilepsy
  • Psychogenic pseudo-epileptic seizures

About the treatment of epilepsy:

  • Treatment of epilepsypharmacological and treatment
  • Stimulation of the vagus nerve in the treatment of epilepsy
  • Telemedicine in the treatment of epilepsy
  • Epilepsy and pregnancy

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Category:

Neurology