Partial seizure: signs, symptoms and treatment

With epilepsy, metabolic processes are disturbed in the patient’s brain, and this leads to epileptic seizures. Attacks are divided into generalized and partial. They differ in the clinic and the development mechanism. An attack occurs when pathological arousal in the brain dominates inhibition processes. Generalized epileptic seizure differs from partial seizure by the presence of an abnormal process in both hemispheres. In partial seizures, the focus of excitation is formed in only one area of ​​the brain, spreading to neighboring tissues. The treatment of the disease depends on the type and nature of the attack.

What is epilepsy?

Partial - this is a type of epilepsy in which a particular part of the brain is damaged, neurons give pathological signals with impaired intensity and spread to all abnormal cells. The result is an attack. Classification of partial epilepsy at the location of the affected lesion is as follows:

• temporal lobe - is one of the most common types of epilepsy; it is detected in almost half of all patients who came to the doctor;
• frontal - observed in a third of patients;
• occipital - only 10% of cases;
• parietal - is rare and is detected in less than 1% of patients.

Particularity of partial epilepsy is that the disease is formed in a separate part of the brain, all other parts of it remain intact. Most often, partial epilepsy occurs in children due to intrauterine abnormalities in the development of the fetus or those born after prolonged oxygen starvation as a result of complex births. In adults, epilepsy can occur as a secondary ailment after a past illness or brain injury. In this case, epilepsy is called symptomatic.

The causes of the disease

Symptomatic epilepsy develops as a result of acquired or congenital diseases. It occurs for the following reasons:

• hematomas;
• stroke;
• malignant and benign neoplasms;
• circulatory disorders in the cerebral cortex;
• staphylococcal, streptococcal and meningococcal infections;
• abscess;
• herpes virus;
• encephalitis and meningitis;
• postpartum injuries;
• congenital pathological changes;
• body reaction to prolonged use of drugs;
• traumatic brain injuries.

In addition, metabolic disorders in the body, various endocrine diseases, syphilis, tuberculosis, measles rubella, and prolonged use of alcoholic beverages and drugs can contribute to epilepsy. Can provoke a disease:

• wrong lifestyle;
• pathological pregnancy;
• severe stressful situation.

Symptoms of partial epilepsy

The symptomatology manifested in partial seizures depends on the area of ​​the brain lesion. It is expressed as follows:

• Temporal - this lobe of the brain is responsible for emotional processes. The patient may experience anxiety, euphoria, or anger. There is a violation of the perception of sound, the memory is distorted. An individual hears music or certain sounds. He is able to recall long-forgotten events.
• Frontal - directs motor processes. During a partial seizure, the patient makes stereotypical movements with his tongue or lips. His limbs involuntarily twitch, his hands and fingers move. On the face, changes in facial expressions occur, eyeballs move from side to side.
• Occipital - visual signals are processed in it. The patient sees colored spots during an attack, flies appear in front of his eyes, flashing lights appear. In addition, he may not see part of objects and phenomena, they simply disappear from sight. After a partial seizure, the patient suffers from severe headaches that resemble migraines.
• Parietal - causes sensory seizures. A person feels heat, cold, or tingling in some part of the body. Often there is a feeling that part of the patient’s body is separating or increasing in size.

Sometimes after partial epilepsy generalized can immediately begin. The patient develops cramps, paralysis occurs, muscle tone is lost.

Diagnosis of the disease

To make a diagnosis, the doctor conducts the following activities:

• He hears the story of a witness who was present during the seizure of the victim. The patient himself with complex partial convulsions often does not remember the attack. In simple cases, the patient himself can tell about his health during a seizure.
• A neurological examination is performed. The patient is checked for coordination of movements, finger-nose test, questions are asked to check the intelligence, the simplest logical tasks are solved.
• MRI - is necessary for the diagnosis of epilepsy with congenital pathologies of the structure and various brain tumors, cystic formations, diseases of the vessels of the head, multiple sclerosis.
• EEG (electroencephalogram) - determine the location of the focus and the form of epilepsy. In some cases, an examination is carried out several times.

Given all the data that was obtained during the study, as well as the causes and symptoms of partial epilepsy, the doctor builds the patient’s treatment tactics.

Disease therapy

In the treatment of symptomatic epilepsy, an integrated approach is used. To do this:

• timely and accurate diagnosis of the disease;
• monotherapy - one effective drug is used;
• experimental way of drug selection;
• the dose of the drug is increased until the symptoms of the disease disappear;
• selection of another medication in the absence of effect.

Partial epilepsy treatment then stops, signs and symptoms when a long period of time cease to appear. Therapy is carried out on an outpatient or inpatient basis depending on the severity of the symptoms. During treatment, the following goals are pursued:

• prevent new attacks;
• reduce the duration and frequency of seizures;
• reduce side effects from drugs;
• achieve drug withdrawal.

For treatment use:

• nootropics - affect the nerve impulse of the brain;
• anticonvulsants - reduce the duration of the attack;
• psychotropic drugs - neutralize the effects of neurological disorders.

In some cases, prolonged use of drugs does not give a positive effect, then surgery is performed. It is shown with:

• tumors;
• cysts;
• an abscess
• hemorrhage;
• aneurysm.

With the help of the operation, a section connecting the hemispheres is dissected, cysts and tumors are removed, and sometimes one of the hemispheres is removed. The prognosis of surgery is positive, most patients get rid of the symptoms of focal epilepsy.

What are partial seizures?

Focal or partial seizures are characterized by localization in one part of the brain. The location of the focus can be assumed by the symptoms that are present during the attack. They happen with loss of consciousness and without it. With a simple partial attack, the individual does not lose consciousness, he is inherent in various emotions and sensations. Suddenly, he feels joy, sadness, or anger. He feels various tastes and smells, hears and sees that which is not in reality. With a complex partial seizure, the patient changes or completely loses consciousness.

The condition is accompanied by convulsions, a convulsive curvature of the lips occurs, frequent blinking begins, he can walk in a circle. In this case, the patient continues to perform the same actions that were started before the attack. Sometimes, especially a complex attack, begins with an aura. This is a characteristic of a particular individual sensation: an unpleasant smell or fear. Aura is a warning to the patient about the occurrence of an attack. Therefore, he or his relatives are quite capable of taking certain actions aimed at reducing the likelihood of injury. Each time the attack appears approximately the same.

Types of Partial Seizures

All seizures are divided into:

1. Simple. The patient during these attacks does not lose consciousness. The following paroxysms belong to this group:

• Motor - are characterized by muscle cramps, various twitches, body and head rotation, lack of speech or pronunciation of sounds, chewing movements, licking lips, smacking are possible.
• Sensory - manifested by a tingling sensation, the presence of goosebumps or numbness of some part of the body, a feeling of an unpleasant aftertaste in the mouth, a disgusting smell, visual impairment: flashes in front of the eyes.
• Vegetative - there is a change in skin color: redness or blanching, there is a rapid heartbeat, changes in blood pressure and pupil.
• Mental - a feeling of fear arises, speech changes, paintings that were previously heard or seen are reproduced, objects and parts of the body may appear to be of completely different shapes and sizes than they actually are.

2. Complex. This occurs when a violation of consciousness joins a simple partial seizure. A person realizes that he has had an attack, but cannot make contact with people around him. All events that occur with the patient, he forgets. He has a feeling of unreality of the events.

3. With secondary generalization. Seizures begin with simple or complex partial seizures and turn into generalized seizures that last no more than three minutes. After their completion, the patient, as a rule, falls asleep.

Features of Simple Focal Seizures

As noted earlier, with simple partial or focal epileptic seizures, the patient is conscious. Epilepsy attacks last no more than five minutes. The following symptoms are characteristic of them:

• Rhythmic convulsive muscle contractions with varying strengths of manifestation. Extend to the upper and lower extremities, as well as the face.
• Violation of the functions of the respiratory system.
• Cyanosis of the lips.
• Profuse salivation.

In addition, vegetative signs are inherent in attacks:

• heart palpitations;
• heavy sweating;
• lump in throat;
• depression, the appearance of fear or drowsiness.

Simple attacks are accompanied by sensory reflexes: auditory, gustatory and visual hallucinations occur, sudden numbness of body parts occurs.

Features of complex symptomatic seizures

Complex flows are much harder than simple attacks. The main syndrome of partial type epileptic seizures is a violation of the patient’s consciousness and the following characteristic signs:

• the patient becomes inhibited, inactive, mentally depressed;
• the gaze goes to one point;
• no external stimuli are perceived;
• the same actions are repeated: stroking or stomping on the spot;
• there are no memories of what was happening. After an attack, the patient can continue to do what he did before him and not notice a seizure.

A complex partial seizure is able to turn into a generalized one, in which an excitation center is formed in both hemispheres of the brain.

Seizure classification

More than thirty types of epileptic seizures are known, which vary in character. Two main types of seizures are distinguished:

1. Partial (focal or focal) occur in a limited part of the brain.
2. Generalized, or general, cover both hemispheres.

Partial seizures include:

• Simple - consciousness never turns off, accompanied by unpleasant sensations in one part of the body.
• Complex - expressed by motor manifestations, they are accompanied by a change in consciousness.

The following subspecies belong to generalized:

• Tonic-clonic - are manifested by a loss of consciousness, tonic convulsions, twitching of the trunk and limbs, the tongue often bites, urine incontinence occurs, sometimes breathing is delayed, but suffocation does not occur.
• Abscesses - consciousness instantly turns off for up to 30 seconds, movement stops abruptly, there is no reaction to external stimuli, eyes can roll up, eyelids and muscles of the face twitch, then there are no cramps. The attack occurs up to a hundred times a day. More common in adolescents and children.
• Myoclonic - seizures last a few seconds, manifested by jerky muscle twitches.
• Atonic or akinetic - a sharp loss of tone of the whole body or its individual part. In the first case, the person falls, in the second - the head or lower jaw hangs.

All types of partial and generalized seizures can occur unexpectedly and at any time, so patients always remember this.

Prevention

To prevent the development of epilepsy, there are no specific methods. The disease often occurs spontaneously and is difficult to diagnose during the latent stage of the course. The following recommendations will help reduce the risk of developing the disease:

• strict observance of the daily regimen, good sleep and rest;
• timely treatment of brain diseases and infectious diseases;
• thorough treatment of traumatic brain injuries;
• refusal to use alcohol and drugs;
• consultation with a geneticist when planning a pregnancy;
• calm lifestyle: to eliminate stressful situations and depression, if possible.

The prognosis of the disease is favorable, up to 80% of all patients live a full life and forget about partial convulsive seizures if they receive appropriate therapy in a timely manner and follow all the doctor's recommendations. Particular attention should be paid to their health for expectant mothers, recently epilepsy is often found in childhood due to intrauterine abnormalities.

Conclusion

Patients suffering from bouts of epilepsy seek to receive good medical care and get rid of seizures in the future. Medicine is able to provide all patients with the necessary medication, with which it is possible to achieve positive dynamics. During the rehabilitation period, it is necessary to follow all the doctor's recommendations, maintain a proper diet and a healthy lifestyle.