IM
Partial Seizures
| Simple | Complex | Secondary generalized |
|---|---|---|
| 1. motor | Simple partial ⇒ altered consciousness | Simple partial ⇒ complex partial ⇒ generalized |
| 2. sensory | ||
| 3. autonomic | ||
| 4. psychic |
Focal (partial) seizures
- Simple partial seizures Motor, sensory, vegetative or psychic symptoms Typically consciousness is preserved
EEG: Partial Seizure
Right temporal seizure with maximal phase reversal in the right temporal lobe
Simple partial seizures with motor signs
- Focal motor without march
- Focal motor with march
Simple partial seizures with sensory symptoms
- Visual
- Auditory
- Olfactory
- Gustatory
- Vertiginous
Simple partial seizures with autonomic symptoms
- Vomiting
- Pallor
- Flushing
- Sweating
- Pupil dilatation
- Piloerection
- Incontinence
Simple partial seizures with psychic symptoms
- Dysphasia
- Dysmnesic
- Cognitive
- Affective
- Illusions
- Structured hallucinations
- Dysmnesic symptoms “déjà-vu”
- Affective symptoms
- fear and panic
- Cognitive
- Structured hallucination
- living through a scene of her former life again
Complex Partial Seizures
- Simple partial onset followed by impaired consciousness
Partial seizures evolving to secondarily generalized seizures
- Simple Partial Seizures to Complex Partial Seizures to Generalized Seizures
Pediatrics
Partial Seizure
-
Complex: Involves motor* or autonomic# symptoms with altered level of consciousness
-
Simple: Can involve motor,* autonomic# or somatosensory+ symptoms
-
May start in one muscle group and spread
Types of Symptoms
- Motor* - head/eye deviation, jerking, stiffening
- Autonomic# - pupillary dilatation, drooling, pallor, change in heart rate or respiratory rate
- Somatosensory+ - smells, alteration of perception (déjà vu)
Complex Partial Seizures
- Commonly temporal lobe focus
- Begins in one area, then spreads enough to impair consciousness, but not to evoke a generalized tonic-clonic seizure
- Staring is often part of the initial spread
- Also can see automatisms…
Automatisms
- Coordinated involuntary movements
- Consciousness impaired
- Patient does not recall activity
Types
- Simple: Lip smacking, chewing, sounds, picking, tapping, walking straight or in circles
- Complex (behavior involved): Undressing, chewing inedible objects, wandering, aggression