Notes: January 7th & 8th

I have had two grand mals in two days. The first was not so severe But the one today was pretty lasting. I have a great deal of confusion on 7th (post-ictal), then today there was quite a bit of confusion just afterward - but I seemed to recover faster today than I did yesterday.

Types of Seizures

I thought that I would keep this post here so that I could look back and have a handy reference if I'm having trouble remembering the terminology for the various types of seizures when I talk about them.

Seizures in General

Seizures come in two main forms - "Primary Generalized Seizures" and "Partial Seizures". Primary Generalized Seizures essentially begin as widespread seizure activity in large area within the brain and on both sides of the brain at the same time as opposed to seizures that begin in only a small part of the brain or within one side of the brain only. Seizures which begin in only a small portion of the brain or within one side of the brain are called Partial Seizures.

There is a kind of seizure which encompasses both Generalized Seizures and Partial Seizures and this kind of seizure is called a "Secondarily Generalized Seizure". It begins in only a small portion of the brain or within one half of the brain and spreads to the entire brain, evolving from a Partial Seizure to a Generalized or "widespread" seizure.


Kinds of Primary Generalized Seizures


Absence Seizure - An absence seizure is a short seizure in which the affected person essentially appears to stare into space, having no memory of the seizure. The person is generally unresponsive for the duration of the seizure. These seizures only last for about 10 to 20 seconds and are very uncommon in people over the age of 14.

Atypical Absence Seizure - In an atypical absence seizure, the affected person's seizure is much the same as a typical absence seizure only with the difference of the person being somewhat able to respond to external stimuli within the duration of the seizure. Like a typical absence seizure, atypical absence seizures are most common in children under the age of 14.

Myoclonic Seizure - Myoclonic seizures manifest in the form of sudden uncontrollable "jerks" in any part of the body, but usually affecting both sides of the body simultaneously. These "jerks" may involve the arms, legs and head as well as any other muscle groups within the body. These seizures affect people of all ages.

Atonic Seizure - The seizures are commonly referred to as "drop seizures". The muscles lose their rigidity and the person "goes limp"; this, in turn, causes the person to fall. Consciousness is usually maintained. In an atonic seizure, the body simply goes limp and the seizure is over as opposed to tonic-clonic seizures or "grand mals" in which the body becomes rigid and violent muscle contractions immediately follow. People of all ages may have atonic seizures.

Tonic Seizure - In a tonic seizure, the muscles suddenly become rigid and this often causes the person to fall if standing. Consciousness is usually maintained. This kind of seizure affects people of all ages.

Clonic Seizure - A clonic seizure is a seizure which manifests as sudden violent "jerking", or contractions, of the muscles in one or both sides of the body. This kind of seizure, on its own, is rare. Clonic seizues are most commonly preceded by tonic seizures, from which the term "tonic-clonic seizure" is derived for the condition in which the body first stiffens and then begins to "jerk" violently. Clonic seizures, though rare, may occur in people of any age.

Tonic-Clonic Seizure - This kind of seizure may also be referred to as a "grand mal seizure". During a tonic-clonic seizure, the affected person's body becomes rigid as the muscles contract. This period is known as the "tonic" phase of the seizure. The tonic phase is then followed by the clonic phase in which the muscles on one or both sides of the body begin to contract violently, giving the appearance of the "jerking movements". This kind of seizure usually lasts, on average, about 1 to 2 minutes. People of any age may experience tonic-clonic seizures.


Kinds of Partial Seizures


Simple Partial Seizure - Simple partial seizures are seizures which originate in one small portion of the brain and on one side of the brain. The person does not lose consciousness during this kind of seizure. Auras themselves are actually simple partial seizures. Simple partial seizures may or may not spread to other parts of the brain. They can affect people of any age and may be further categorized:

• Simple Partial Motor Seizure - This kind of seizure may involve jerking movements of a finger, hand, arm, leg or muscle or group of muscles. Other examples are sudden weakness including slurred speech, spontaneous laughter and repeated or automatic movements.

• Simple Partial Sensory Seizure - These seizures affect a person's senses and may be seen as manifesting themselves in the form of "hallucinations". The affected person may see, hear, smell or feel things which are not actually there. These seizures may also causes feelings of numbness, pins and needles or spontaneous sensations of pain.

• Simple Partial Autonomic Seizure - These seizures affect the part of the nervous system which controls bodily functions. During an autonomic seizure, the person may experience a change in heartrate, breathing or sweating and they may experience strange or unpleasant sensations in the stomach, chest or abdomen. They may also experience goosebumps.

• Simple Partial Psychic Seizure - These seizures may affect a person's thinking, feeling or experiences of things. A person may experience an inability to recall words or how to carry out mundane tasks. They may also have difficulty with speech, reading or writing. These seizures may also manifest themselves in the form of panic attacks and as sudden unprovoked feelings of euphoria, fear or depression. During the duration of a psychic seizure, the person may feel detached from his or her body or may experience déja vu as well as jamais vu.

Complex Partial Seizure - These seizures, like simple partial seizures, begin in only one portion of the brain. They may or may not spread and occur in people of all ages. However, contrary to simple partial seizures, in complex partial seizures, the person's awareness and consciousness is altered. These seizures may resemble absence seizures as they often involve the person staring blankly or being otherwise cognitively impaired. However, unlike absence seizures, complex partial seizures often involve movement (usually automatisms, or repeated automatic movements such as pelvic thrusting, picking at the air or moving the lips or mouth amongst other things) . The affected person may even walk into traffic without being aware of remove their clothing. Sometimes the person will speak, laugh, cry, scream or otherwise vocalize spontaneously.

Secondarily Generalized Seizure - In this kind of seizure, the affected person experiences a partial seizure, a seizure limited to only one portion or side of the brain, followed by a generalized seizure or a seizure which affects both sides of the brain simultaneously. An example of a secondarily generalized seizure would be a seizure which begins as a panic attack or simple jerking hand motion which worsens and leads to a tonic-clonic seizure.