Consultant: Dr. Ekaterina Viteva, MD
Symptoms of epilepsy
Seizures are the only visible symptoms of epilepsy. There are different types of seizures, and the symptoms in each person can manifest differently.
The duration of seizures is usually from a few seconds to a few minutes. It is possible for patients to remain conscious or lose consciousness, not remember what happened during the seizure, or not even know that they have had a seizure.
Epileptic seizures, which are associated with falling or muscle tightening and subsequent convulsions of the limbs, are easy to recognize. But many types of seizures do not include these signs and are harder to spot. In some attacks, patients stare for a few seconds, while others are characterized by only a few muscle twitches, head turning, the sensation of a strange smell, or visual disturbances that are noticeable only by the patient.
Epileptic seizures often begin without warning, although some people have a preceding aura. The seizure ends when the abnormal brain electrical activity stops and is replaced by normal electrical activity.
Epileptic seizures can be partial and generalized:
Partial (focal) seizures
Partial seizures start from a specific area in the brain. The most common types of partial seizures are:
Simple partial seizures
– consciousness is preserved.
Complex partial seizures
– no complete loss of consciousness, but consciousness is narrowed and contact with patients is lacking.
Partial seizures with secondary generalization – begin as simple or complex partial seizures, but then generalize and appear as generalized tonic-clonic seizures. Partial seizures with secondary generalization and primary generalized tonic-clonic seizures are sometimes difficult to distinguish but are treated differently. Most tonic-clonic seizures in adults begin as partial seizures and are manifestations of partial epilepsy, whereas primary generalized tonic-clonic seizures are more common in children.
Seizures in which abnormal electrical activity starts simultaneously from both brain hemispheres are called generalized seizures. The main types of generalized seizures are:
Generalized tonic-clonic seizures (grand mal seizures), during which the patient suddenly falls to the ground, often with traumatism, followed by muscle tightening for 15-20 sec. and respiratory disturbance; with subsequent simultaneous convulsions of the limbs for 30-40 sec. with recovered respiration. In these attacks, it is possible to discharge at a small or large need, as well as biting the tongue or cheeks. Some patients experience some confusion or drowsiness after a seizure, which lasts for varying lengths of time.
(petit mal seizures) – with brief loss of consciousness (a few seconds) with staring, no recollection of what happened.
– with short, rapid muscle twitches.
– characterized by sudden loss of muscle tone and falling.
– with sudden muscle tightening and frequent falls.
People give different names to seizures: convulsions, convulsions. But the correct term is flare. Seizures are just one characteristic of some seizures.
Epileptic seizures are sometimes confused with psychogenic seizures that are not the result of abnormal electrical activity. A psychogenic seizure can be provoked by stress, psychotraumatic experience, injury, etc.
When should I call an ambulance?
It is usually not necessary to seek ambulance help in an epileptic seizure, but it is mandatory to call 112 in the following cases:
– first bout;
– serious injury;
– difficulty breathing after the seizure is over;
– second attack immediately after the first, with no recovery between the two;
– the attack lasts 2 minutes longer than usual;
– the seizure lasts more than 5 minutes and you don’t know the usual duration of seizures.
These recommendations are especially important in tonic-clonic (convulsive) seizures.