Epilepsy: signs, symptoms and complications

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Although seizures are the main symptom of all types of epilepsy , the full spectrum of symptoms and signs of epilepsy varies. Common symptoms include muscle spasms and contractions, momentary loss of consciousness or consciousness, weakness, anxiety, and gaze. However, the specific symptoms you have depend on your type of epilepsy . While there are many different types of seizures, your seizures will generally be similar each time.

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Frequent symptoms

If you have epilepsy, you may experience a variety of symptoms before, during, or after the seizure. Not everyone has all of these symptoms, and again, the ones you experience will depend on the type of seizure.

While it is important to understand the symptoms of their seizures, most people with epilepsy do not remember their seizures or what happened before they happened.

It is important to ask anyone who has seen one of your seizures how it developed and what was happening at the time. If you are comfortable, you can also invite this person to speak directly with their healthcare provider.

The most common symptoms include:

  • Muscle Contraction and Spasms: When people think of cramps, they are usually a type in which various muscles in the body contract and contract. However, involuntary muscle contractions can occur in certain parts of the body .
  • Loss of consciousness: Some seizures can cause a sudden loss of consciousness or consciousness that can last from a few seconds to hours. For some types of seizures, this may be the only sign of a seizure that is visible to other people. This may be due to automatism – repetitive, aimless movements performed without thinking.
  • Weakness – Weakness can occur anywhere on your body. For example, you may have weakness in one arm, one leg, or both. Usually with repeated seizures, there is weakness in the same part of the body. Weakness in one part of the body can be very similar to a stroke, but it goes away when the attack is over. However, sometimes a stroke can cause seizures , so it is not always possible to immediately discover the cause of this symptom .
  • Anxiety – Before an attack, often a focal seizure, some people experience anxiety. It can be a single symptom and / or a sign that an attack is coming (for example, an aura). Some people experience intense anxiety, fear, or a sense of impending doom.
  • Look : looking into space is a symptom when you have episodes of absence. You may feel like you are daydreaming for a short time or lost in thought, when you are actually having a seizure.

Various symptoms, including automatism and aura, can help determine which side of the brain is having seizures and possibly even the type of epilepsy.

Automatisms

The type of automation and its nature, whether complex or so simple that it can be overlooked, is very different. In epilepsy, automatisms can occur in the form of focal seizures of altered consciousness, as well as absences (particularly atypical). People tend to have the same automaticity over and over, but it may not be present in all of their seizures.

Some types of automatism are more likely with certain types of seizures. For example, pelvic tremors and bilateral automatic leg movements, such as pedaling or cycling, are more common in frontal lobe epilepsy than in temporal lobe epilepsy. On the other hand, hand and mouth automatism is more common in temporal lobe epilepsy.

The automatisms can also provide clues to determine if a seizure is occurring in the right or left hemisphere of your brain. For example, an automatism that occurs on one side of your body usually indicates that the seizure started on the same side of your brain.

People who witness your seizures may have important observations, including any automatisms you may have. The presence or absence and type of automatisms can help your healthcare provider determine the location and type of your seizures.

Aura

An epileptic aura is a special perception (visual, motor, sensory, or psychological) that you experience during a seizure. Sometimes the aura can occur only a few seconds before the attack, but it can also occur an hour before .

In people with focal epilepsy, auras can be an early warning sign because they often occur less than two minutes before fainting.

Sometimes auras appear without any other seizure symptoms. In these cases, the aura triggers an attack.

You can experience any of the many different types of auras, either alone or before an attack. They can be broken down into sensory auras , in which only sensation is present, and experiential auras , which are more complex .

The types of auras include:

  • Vision (visual): Visual auras can be simple, such as seeing bright flashes of light, dark spots, or tunnel vision, or they can be complex or empirical, such as blindness, visual hallucinations , illusions, and distorted landscapes such as macropsia where Everyone is what surrounds you seems bigger than usual.
  • Odor (olfactory): some odors, often unpleasant, can be felt with an aura.
  • Auditory (Auditory): Like visual auras, auditory auras can be simple, such as hearing ringing or buzzing, or complex (experiential), such as hearing distorted sounds or voices when speaking.
  • Somatosensory: These auras are associated with sensations and can be quite varied, such as tingling, a sensation of movement even when sitting still, or the need to move.
  • Taste (palatability): There may be unusual taste sensations (eg, Metallic) or those that are present without food.
  • Abdominal – Nausea, indigestion, or pressure in the stomach is a fairly common aura in temporal lobe seizures.
  • Motor: Repetitive movements, limbs, or weakness may occur.
  • Vegetative – For example, auras can occur, including chills and goose bumps.
  • Psychic: These auras can be very dramatic and can include sudden feelings of dread, feelings of impending doom, experiences of déjà vu, and the like.

Auras vary considerably from person to person, but are generally roughly the same from seizure to seizure. Some auras are easy to describe, such as seeing zigzag lines, while others are much more difficult to explain, such as feeling detached from your body.

Although these are the symptoms most commonly associated with epilepsy, a variety of symptoms can be caused by abnormal activation of neurons in the brain, and some are particularly difficult to distinguish from mental and behavioral disorders.

From unusual thoughts to hearing and seeing things that are not there, to symptoms of flatulence and recurrent vomiting (abdominal epilepsy), the palate is practically the limit in terms of symptoms. That is why it is important to write down everything you notice before, during, or after the seizure.

Symptoms by type: generalized

Generalized seizures affect both hemispheres of the brain. Six different species have been identified, each with its own set of symptoms.

Absolute cramps

Absences, formerly called minor seizures, may not always be recognized as seizures at first and are more common in children .

Symptoms that last about 10 seconds include:

  • Sudden cessation of activity.
  • Seems to stare into space
  • Automatisms such as lip smacking, chewing, or eye rolling.

Although this is less common, atypical absences can occur . These seizures:

  • Lasts more than 10 seconds
  • Start and stop gradually, not abruptly
  • It is more likely to cause a fall.
  • It can include automatisms such as blinking, blinking, lip smacking, chewing, finger rubbing, or other repetitive hand movements.

Tonic seizures

Tonic seizures most often occur during sleep. Symptoms include:

  • Muscles in the arms, legs, and back suddenly tense up
  • Typical duration 20 seconds or less
  • Loss of consciousness and fall is possible

Atonic seizures

These seizures are called "drip seizures" and are the opposite of tonic seizures. When they arise:

  • The muscles become flabby.
  • The entire body or just the head, neck, and trunk may be affected.
  • You may fall off if you are standing up.
  • There may be some loss of consciousness.

With this type of epilepsy, there is a high probability of falling due to the high probability of injury. You may need to wear protective head gear.

Myoclonic seizures

They can happen one after another in no time, or just here and there. These seizures:

  • Induce short arm or leg spasms.
  • They are usually found on both sides of your body .
  • The last seconds

Clonic seizures

Clonic seizures are similar to myoclonic seizures, but they can last from a few seconds to a minute. They include:

  • Repeated short jerks with arms or legs
  • Both sides of the body (in some cases)

Clonic seizures are rare in their own right and usually occur in babies .

Tonic-clonic seizures

These seizures, formerly called grand seizures , have a definite course of events. They can last up to three minutes and include:

  • Loss of consciousness, which usually occurs suddenly.
  • Toning phase: the muscles of the arms, legs, back and chest become stiff
  • Clonic phase: muscle spasms and spasms

As your body begins to relax and you gradually regain consciousness, you may lose control of your bladder and / or bowels. You may wake up feeling sleepy, confused, irritable, or depressed.

Symptoms by type: focal

Focal seizures are the most common type of seizure disorder. They affect only one area or one side of your brain. They are of two types.

Suspicious focal seizures

This type of seizure is also known as an aura. During a focal seizure:

  • You are awake and aware.
  • You may not be able to answer.
  • You may have muscle spasms, stiffness, lethargy, or other symptoms.

The duration can be from a few seconds to a couple of minutes.

Focal seizures with impaired consciousness

This type of seizure includes many symptoms that differ depending on the area of the brain in which they occur. Symptoms, which can last a minute or two, can include:

  • Ignorance or loss of consciousness.
  • Pre-existing aura or focal lucid seizure (possibly)
  • Automatisms, including repetitive touches; fast blinking; repetition of words or phrases; moaning repetitive hand movements; pick up or play with clothing or objects; lip smacking, chewing, mumbling, swallowing; the complex acts as a deck of cards; dramatic actions such as laughing, crying, yelling, or taking off clothes

Complications / Indications for a subgroup

Possible complications of seizures depend on when and where you got them. They may include:

  • Drowning: The risk of drowning when swimming or bathing is 15 to 19 times higher when you have epilepsy, due to the possibility of a seizure in the water. This risk decreases the longer you stay between attacks.
  • Falls: A seizure can result in a blow to the head, broken bone, or other injury from a fall .
  • Car Accidents: Driving seizures can cause a car accident, so many states impose driving and time restrictions related to how long you have not been in a seizure. As with the risk of drowning, the risk of seizures while driving decreases as the time between seizures increases.
  • Emotional problems: Anxiety, depression, suicidal thoughts and behavior are common in people with epilepsy. It is estimated that one in three people with epilepsy will develop clinical depression at some point in their lives, which is often accompanied by an anxiety disorder. However, treating these problems can help.

Life-threatening complications of epilepsy are rare, but include:

  • Status epilepticus: This is when you have a seizure that lasts longer than five minutes, or you have multiple seizures without fully waking up in between. This condition can lead to brain damage or death .
  • Sudden and unexpected death: This occurs in about 0.1 percent of people with epilepsy and no one knows the exact cause. You may be at increased risk of sudden and unexpected death if your seizures are not controlled with medicine or if you use tonics frequently. -clonic seizures.

Women with epilepsy

Women with epilepsy face some peculiarities of menstruation, contraception and pregnancy, as hormonal fluctuations can affect seizure activity. In particular, health professionals believe that estrogen can improve seizure activity, while progesterone appears to have the opposite effect.

Menstruation

During puberty, a woman's body produces estrogen and progesterone. Due to this increase in hormone levels, girls with epilepsy may experience more seizures at this stage of development.

Some women may also experience more frequent attacks during their menstrual cycle. Epilepsy, known as menstrual epilepsy , is a cramp that occurs during a woman's menstrual cycle and may need additional treatment. Health professionals believe that exposure to estrogen and progesterone in the brain increases the frequency of seizures.

Use of contraceptives

Some epilepsy medications can counteract the effects of birth control pills, which means that you can get pregnant even if you are taking them. In contrast, oral contraceptive pills can reduce the effectiveness of your anticonvulsants, which can lead to breakthrough attacks. This is especially true for lamictal (lamotrigine).

The pregnancy

Every woman with epilepsy reacts differently to pregnancy. Most women experience the same number of seizures during pregnancy as before, although some may have fewer or more.

Cramps during pregnancy are dangerous for your baby and can lead to miscarriage, premature labor, and preterm labor, so it's important to keep them under control as much as possible. Talk to your doctor if you are pregnant or planning to become pregnant, as your medication may need to be adjusted to reduce seizures and protect your baby.

Your healthcare provider may also recommend that you take a high dose of folic acid, which helps prevent brain and spinal cord abnormalities in the fetus, several months before you plan to become pregnant, as certain anticonvulsants can affect the way you that your body metabolizes this vitamin. ..

Seizures do not usually occur during labor, so you can have your baby normally and without complications. If you have a seizure during labor, your doctor may try to stop it with IV medication. For women who have frequent cramps during pregnancy, especially in the last trimester, a C-section may be recommended, but your healthcare provider will work with you on the safest delivery methods for you.

If you want to breastfeed your baby, talk to your doctor. Breastfeeding shouldn't be a problem, but your healthcare provider may want to change your medicine or ask you to take it at a different time than usual.

If you have epilepsy, your child's risk of developing epilepsy increases slightly, to about 5 percent . If you have epilepsy, your child's risk of developing epilepsy increases slightly, to about 5 percent .

If your epilepsy has a genetic or hereditary component, your risk is higher. You can speak with a genetic counselor if you are concerned about passing epilepsy to your child.

When to contact a healthcare provider

The first seizure means you should see your doctor, even if you are not sure if it was a seizure. You will need to determine the cause and rule out any underlying medical conditions, and possibly begin taking anticonvulsants . Use the discussion guide below with your doctor to start a conversation with your doctor.

Epilepsy Physician Discussion Guide

Get our printable guide to your next doctor's appointment to help you ask the right questions.

If you have already been diagnosed with epilepsy , you should see your doctor whenever you have a change in the nature, frequency, or activity of your seizures.

The goal of treatment is to control seizures with the least amount of medication, so you may need to adjust your dose, add a different medication, switch to a different type, or a completely different type of treatment.

If you are experiencing status epilepticus, you need urgent help as it may be life-threatening. You will also need emergency help if:

  • You have seizures and are pregnant.
  • Seizure in water
  • Don't wake up after a seizure
  • Has another seizure right away
  • You have a high fever
  • Diabetes
  • Traumatized during a seizure

The symptoms of epilepsy can be life-altering, but you have a variety of treatment options that can help reduce or eliminate the impact. Stay in touch with your healthcare provider so you can find the best epilepsy control treatments.

Frequently asked questions

  • Yes, epilepsy can occur in anyone at any age, but most of the time it occurs in children under 1 year of age, and then the frequency gradually decreases until about 10 years of age. New cases increase again in people 55 and older.

  • According to the CDC, about 5.1 million people in the US have epilepsy and 3.4 million have active epilepsy, making the condition very common.

  • Epilepsy is usually treated with anticonvulsants or sometimes surgery if the area of the brain responsible for the seizures can be isolated and removed. There are also some alternative treatments when medicine and surgery don't work. These include vagus nerve stimulation, where an implanted device sends an electrical current to a nerve in the neck to control seizures, and a ketogenic diet, which can help control seizures.

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