Seizures and Epilepsy
Posted on
January 26, 2024
Let's learn all the facts about a brain pattern called
Seizures and Epilepsy
!
Seizures and Epilepsy
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Focal onset seizures can be categorized into 4 major categories: focal to bilateral tonic clonic, hemispheric lateralization, lobar localization (frontal, temporal, parietal, occipital), or by the onset features (awareness, motor, non-motor).
The frontal lobe is the largest lobe; seizures will have features depending on where they arise from, are usually brief events (< 2 minutes), and include stereotyped features (vocalization, bizarre behavior, urinary incontinence, and head and eye deviation) with preserved awareness. Frontal lobe seizures may begin with a brief aura, even when seizures occur from sleep. They may be exclusively nocturnal and can occur in clusters.
Frontal lobe seizures may be mis-diagnosed as non-epileptic especially when the features include bilateral motor phenomena with preserved awareness. The ictal EEG may not show ictal patterns or may be obscured by movement artifact.
Primary motor cortex
Motor features are prominent and range from focal hyperkinetic seizures with pelvic thrusting and bipedal kicking or pedaling to focal bilateral motor seizures with asymmetric tonic posturing.
Primary sensorimotor cortex
Seizures are focal motor seizures characterized by localized clonic, tonic-clonic, tonic or myoclonic activity. May have a Jacksonian march where unilateral tonic-clonic movements start in one muscle group and spread systematically to adjacent groups reflecting the spread of ictal activity through the motor cortex according to the homunculus. There may be focal somatosensory features alone, such as unilateral tingling, or in combination with motor features.
An atypical absence seizure is a generalized non-motor onset seizure. An atypical absence seizure has less abrupt onset and offset of loss of awareness and often associated with other features such as loss of muscle tone of the head, trunk or limbs (often a gradual slump) and subtle myoclonic jerks. Atypical absence seizures can occur in individuals with intellectual impairment.