Sunday, May 6, 2012

Sun 5/6/12 - Learned something new - Types of Seizures

Sun 5/6/12 - Learned something new

After a long day at work and shopping yesterday with my mom I came home to a quiet house and welcomed some study / research time. I found some great information:

Partial Seizures
Partial seizures are further divided into simple partial seizures with no alteration of consciousness or memory, or complex partial seizures with alteration of consciousness or memory.
Simple partial seizures can be motor seizures with twitching, abnormal sensations, abnormal visions, sounds or smells, and distortions of perception. Seizure activity can spread to the autonomic nervous system, resulting in flushing, tingling, or nausea. All such simple partial seizures will be in clear consciousness and with full recall on the part of the patient. (I don't recall Breck having any memory with her seizures... or we just have been completely unaware. I would think these would be very hard to pinpoint or even recognize as a seizure.)
If the patient becomes confused or cannot remember what is happening during the seizure, then the seizure is classified as a complex partial seizure. (Breck doesn't remember what is happening... so we can say that most of hers are Complex Partial Seizures)

Complex Partial Seizures
...Complex partial seizures may have an aura, which is a warning for the seizure, typically a familiar feeling (deja vu), nau-sea, heat or tingling, or distortion of sensory perceptions.
About half of the patients do not have any remembered aura. (Breck does have this warning or aura... to which I am very grateful) During the complex partial seizure patients may fumble or perform automatic fragments of activity such as lip smacking, picking at their clothes, walking around aimlessly, or saying nonsense phrases over and over again. These purposeless activities are called automatisms. About 75% of people with complex partial seizures have automatisms. Those who do not simply stop, stare and blank out for a few seconds to minutes.
(Learned something new!... What we were calling a "Grand Mal" are now call Generalized tonic-clonic seizures. But there are 2 classifications of these tonic-clonic seizures... These seizures start with sudden loss of consciousness and tonic activity (stiffening) followed by clonic activity (rhythmic jerking) of the limbs. The other is called Secondary tonic - clonic seizures... which starts after or during a Partial complex seizure. (This is what Breck has --- they start as the partial and then progress into a Secondary tonic-clonic seizure.)

Secondarily Generalized Seizures
Seizures that begin focally can spread to the entire brain, in which case a tonic-clonic seizure ensues. It is important, however, to distinguish those that are true grand mal, generalized from the start, from those that start focally and secondarily generalize. Secondarily generalized seizures arise from a part of the brain that is focally abnormal. Drugs used to treat primarily and secondarily generalized tonic-clonic seizures are different.

(Good news???)
Patients with secondarily generalized tonic-clonic seizures may be candidates for curative epilepsy surgery...; whereas, primarily generalized tonic-clonic seizures are not surgical candidates, because there is no seizure origin site (focus) to remove. Seizure surgery is discussed below.

Other types (not witnessed in Breck)
Atonic Seizures (drop attacks - such as suddenly falling down)
Myoclonic Seizures (brief un-sustained jerk - not repeating--)
Tonic Seizures (stiffing of arms and legs --- but no jerking)

Mixed Seizure Types (BRECKY!!)
Patients can have more than one seizure type. One seizure type may progress into another as the electrical activity spreads throughout the brain. A typical progression is from a simple partial seizure, to a complex partial seizure (when the patient becomes confused), to a secondarily generalized tonic-clonic seizure (when the electrical activity has spread throughout the entire brain). The brain has control mechanisms to keep seizures localized. Anti-epileptic medications enhance the ability of the brain to limit spread of a seizure.

(This may account for why while on Keppra Breck still felt the aura and tremors but it didn't seem to progress into a more severe seizure.. but she was still having the partial loss of consciousness. For example - she could take notes / copy things from a white board and have no memory of ever writing, seeing or hearing the teacher talk about what was being written.) School was really hard during her Junior Year. Breck thought she was just going crazy or making things up... or even that she was causing these feelings.

Well that is enough learning for one day... I am so glad I have found this resource which explains things in a way that I can understand. I feel like I am on a great learning curve.

Information is taken from a free download on my.epilepsy.com
OVERVIEW OF EPILEPSY
Robert Fisher, M.D., Ph.D.,
Maslah Saul MD Professor,
Stanford Neurology
Comprehensive Epilepsy Center, Room A343
300 Pasteur Drive, Stanford, CA 94305-5235
copyright 1997, 2006, 2010

I hope that these posts not only help Breck and our family, but maybe others who are having to also figure things out.

With all of this - again I want to say that our days are more happy than not. When it is bad - we feel the fear, pain and frustration... but when she is doing good -- she lives life just as full as anyone else. We as her parents are committed to this --- And she is very well balanced.

We spend a lot of time talking about how the lessons she is learning today will only help her later in life. It took me years to learn (and I am still learning) my limits on sleep, over extending myself, letting things go, not stressing over what I can't control, and healthy eating (still working on this!!!)... She will be an incredible wife and mother someday!

... ok... seeing that it is 1am, and I worked 10 hours, pushed myself to go shopping and ate at PF changs... maybe I am still learning all the lessons my daughter is having to figure out... lol!!)
smiles

Sean A'lee

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