About Partial Onset Seizures
Partial onset seizures can occur as a result of various causes. One cause is the activation of a specific area of the brain due to abnormal disinhibition. This activation can be caused by a complex set of changes in the neurons, glia (support cells in the brain), extracellular matrix, and neuro-glia vascular interface. These changes can be triggered by factors such as trauma, inflammation, lack of oxygen, genetics, or a cerebrovascular accident (a stroke). These risk factors are similar to those for epilepsy, as partial onset seizures are a type of epilepsy.
Risk factors for partial onset seizures include:
- History of traumatic brain injury (TBI): These injuries increase the risk of developing partial onset seizures.
- History of brain infections, brain tumors , or stroke.
- Age: Individuals are more likely to have a seizure in early childhood or after the age of 60.
On the other hand, modifiable risk factors are factors that can be changed or controlled. Some common modifiable risk factors for partial onset seizures include:
- Lack of sleep
- Stress
- Alcohol consumption
It's important to note that triggers for seizures may vary from person to person and depend on the underlying cause of the seizures. By avoiding these triggers whenever possible and taking prescribed antiseizure medication, individuals may be able to better control or prevent partial onset seizures.
It's important for individuals with partial onset seizures to work closely with their healthcare provider to identify and manage these risk factors in order to minimize the occurrence and impact of seizures.
Common symptoms of partial onset seizures can vary depending on the type and stage of the seizure. Here are some of the most common early symptoms and other symptoms that may occur with later stages, progression, or higher severity of partial onset seizures:
Early symptoms:
- Aura: Many seizures are preceded by an aura, which is a simple partial seizure that acts as a warning sign. Auras typically last just a few seconds and can take different forms. Some people may experience feelings of fear, strange sensations in their bodies, unusual tastes in their mouth, or hear specific sounds.
- Impaired consciousness: During a complex partial seizure, individuals are usually not aware of their surroundings. They may stare blankly into space, appear to be daydreaming, or suddenly wake from sleep.
- Automatisms (repetitive movements)
Other common symptoms:
- External symptoms: These symptoms may be observed by someone else. It's important to note that these external symptoms may not always occur and can vary between seizures and individuals. Some examples include:
- Abrupt changes in emotions without cause such as laughing or crying for no reason
- Jerking or spasm of a single part of the body (usually a leg or arm)
- Difficulty speaking or speaking in nonsensible ways.
- Internal symptoms: Most symptoms associated with simple partial seizures are internal and noticed only by the person experiencing the seizure. These symptoms can include:
- Changes in taste, touch, vision, or sound perception
- Distorted vision
- Smelling odd odors
- Tingling sensations in the arms or legs
- Goosebumps
- Feeling like there are butterflies in the stomach
- Dizziness
- Seeing flashing lights
- Sudden feelings of fear or extreme happiness for no reason
- A sense of déjà vu
To diagnose partial onset seizures, doctors commonly perform the following examinations, tests, and procedures:
- Medical history: The doctor will ask about what happens before, during, and after a seizure. Since people often can't remember their seizures, it's important to gather information from someone who has observed the seizures.
- Electroencephalogram (EEG): This diagnostic test measures the electrical activity in the brain. Even if the EEG results are normal, it doesn't rule out epilepsy or partial onset seizures. Sometimes, to get a more accurate result, the test may need to be repeated during a seizure.
- Imaging tests: A CT scan or an MRI may be performed to identify potential causes of the seizures.
- Laboratory tests: Blood or urine tests may be done to check electrolyte levels, drug use, and concentrations of antiepileptic drugs if they have been prescribed. These tests can often reveal the underlying cause of the seizures.
To determine the stage or severity of partial onset seizures, additional examinations, tests, and procedures may include:
- Recording seizures with an EEG: To accurately assess the stage or severity of partial onset seizures, an EEG may need to record a seizure.
- Neurological exam: A doctor may perform a neurological exam to evaluate brain function and assess any abnormalities that could be contributing to the seizures.
It's important to note that these diagnostic procedures are typically performed by healthcare providers such as doctors or specialists in order to accurately diagnose and determine the stage or severity of partial onset seizures.
The goals of treatment for partial onset seizures are to eliminate or reduce the frequency of seizures, help patients maintain a normal lifestyle, and preserve their psychosocial and occupational activities while avoiding the negative side effects of long-term treatment. Here are some treatment options:
Medications
The main form of treatment for partial onset seizures is medication, specifically antiepileptic drugs (AEDs). The goal of AED therapy is to prevent seizures completely with limited toxicity and adverse drug reactions. Some commonly prescribed AEDs for partial seizures in adults include:
- Carbamazepine
- Phenytoin
- Oxcarbazepine
Carbamazepine and phenytoin are used to treat complex partial seizures in adults, while oxcarbazepine can treat both simple and complex partial seizures in adults. These medications work by stabilizing the electrical activity in the brain, reducing the likelihood of abnormal discharges that lead to seizures.
Therapeutic Procedures
In addition to medication, therapeutic procedures that can be used to manage partial onset seizures include:
- Vagus nerve stimulation (VNS): This involves implanting a device called a vagus nerve stimulator that sends bursts of electrical energy to the brain. This can help reduce the incidence of seizures. However, it's important to note that some people may still need to take their antiseizure medications even with the VNS device.
Lifestyle Behavior Changes
These can also play a role in managing partial onset seizures. These include:
- Avoiding common triggers for seizures which may help reduce their occurrence
- Getting enough sleep
- Following a ketogenic diet (low in carbohydrates and protein, high in fat) has been found to be beneficial for some individuals with partial seizures.
It's worth mentioning that treatment for partial onset seizures may involve a combination of these approaches, tailored to each individual's specific needs. It's important for patients to work closely with their healthcare provider to determine the most appropriate treatment plan for them.
Partial onset seizures can vary in their natural progression over time. The severity and frequency of seizures can differ from person to person. Some individuals may experience a gradual increase in the number or intensity of seizures, while others may have periods of remission where seizures become less frequent or stop altogether. It is important to note that not everyone with partial onset seizures will experience the same progression.
Complications can arise from partial onset seizures. One common complication is the risk of falls and injuries during a seizure. This is especially true if the person loses consciousness or experiences muscle stiffness during the seizure. Additionally, there is a potential for long-term nerve damage if a person does not receive proper treatment for their seizures.
It's important to consult with a healthcare professional to determine the most appropriate treatment plan for managing partial onset seizures. They can provide personalized recommendations based on an individual's specific needs and medical history.