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Focal Seizure


Presentation

  • The clinical presentations, imaging studies and initial pathology studies can mimic lymphocytic hypophysitis. Here we report additional clinical clues in differentiating these two conditions.[ncbi.nlm.nih.gov]
  • We report an extremely rare presentation of non-febrile seizure from acute parvovirus infection in a child without encephalopathy who had an excellent recovery.[ncbi.nlm.nih.gov]
  • When present, spike and sharp discharges characteristically attentuate at the onset of rhythmic ictal activity.[ncbi.nlm.nih.gov]
  • A case of focal seizure disorder secondary to multiple ventricular shunt revision is presented.[ncbi.nlm.nih.gov]
  • A review of the medical literature for partial focal seizures is presented, followed by a case study of a patient who developed clonic seizures of the right foot secondary to hyperglycemia, hyponatremia, and hyperosmolality.[ncbi.nlm.nih.gov]
Pain
  • Parietal (pah-RIE-eh-tal) lobe- Controls sense of touch, response to pain and temperature, and understanding of language. Occipital (ok-SIP-eh-tal) lobe- Controls vision. Temporal (TEM-por-al) lobe- Controls hearing and memory.[nationwidechildrens.org]
  • […] at clothes or lip smacking Eyes moving from side to side Abnormal sensations, such as numbness, tingling, crawling sensation (like ants crawling on the skin) Hallucinations, seeing, smelling, or sometimes hearing things that are not there Abdominal pain[nlm.nih.gov]
  • Autonomic Seizures Section These seizures are accompanied by autonomic symptoms or signs, such as abdominal discomfort or nausea which may rise into the throat (epigastric rising), stomach pain, the rumbling sounds of gas moving in the intestines (borborygmi[epilepsyontario.org]
  • […] at clothes or lip smacking Eyes moving from side to side Abnormal sensations, such as numbness , tingling, crawling sensation (like ants crawling on the skin) Hallucinations , seeing, smelling, or sometimes hearing things that are not there Abdominal pain[medlineplus.gov]
Asymptomatic
  • This inflammation only resulted in a partial depletion of vasopressin which was asymptomatic and normal range of urine osmolarity was preserved.[bmcendocrdisord.biomedcentral.com]
Pathologist
Plethora
  • 2017 Theses Doctoral Spontaneous human focal seizures can present with a plethora of behavioral manifestations that vary according to the affected cortical regions; however, several key features have been consistently observed.[academiccommons.columbia.edu]
Vietnamese
  • Caucasian Panhypopituitarism with mass, sphenoid mass Pred 40 mg/day taper to 10 mg/day over 4 weeks Recurrent headache Pred 15 mg/day, then taper/reescalation and suspend until 1.3 years, improved headache but hypopituitarism Caputo, 2014 [ 27 ] M 40 y, Vietnamese[bmcendocrdisord.biomedcentral.com]
Nausea
  • A complex seizure can last for a minute or two, and you may feel a warning sign such as a feeling of uneasiness or nausea before the seizure. You may feel sleepy and confused after the seizure.[healthline.com]
  • The child may also experience sweating, nausea, or become pale. Complex-partial seizures Complex-partieal seizures commonly occur in the temporal lobe of the brain, which is the area of the brain that controls emotion and memory function.[chp.edu]
  • Seizures arising from the midline region of the temporal lobe can cause sensations of fear, sensations in the tummy, pallor and nausea.[epilepsyqueensland.com.au]
  • […] smacking Eyes moving from side to side Abnormal sensations, such as numbness, tingling, crawling sensation (like ants crawling on the skin) Hallucinations, seeing, smelling, or sometimes hearing things that are not there Abdominal pain or discomfort Nausea[nlm.nih.gov]
Malar Rash
  • She had erythematous malar rash along with reticulating pattern of rash over her both upper extremities. Parvovirus infection was suspected due to the characteristic erythematous malar rash.[ncbi.nlm.nih.gov]
Focal Seizure
  • These three classes are: (i) globally induced focal seizures; (ii) globally supported focal seizures; (iii) locally induced focal seizures.[ncbi.nlm.nih.gov]
  • Metabolic disturbances, including hyperglycemia, mild hyperosmolality, hyponatremia, and lack of ketoacidosis contribute to the development of partial focal seizures.[ncbi.nlm.nih.gov]
  • No patients without these electroencephalographic findings developed more intense focal seizures after surgery.[ncbi.nlm.nih.gov]
  • Abstract We studied the electroencephalographic pattern at the time of focal seizure onset in 41 patients. Progressive rhythmic EEG activity was characteristic of spontaneous focal seizures in man.[ncbi.nlm.nih.gov]
  • Focal seizure type aggregated as well, including complex partial, simple partial, and secondarily generalized tonic-clonic seizures.[ncbi.nlm.nih.gov]
Paresthesia
  • Symptoms vary with different lesion locations and may include but not limited to the motor (e.g. rhythmic muscle contractions in one area of the body), somatosensory and sensory alterations manifested by abnormal numbness, paresthesias or other hallucinations[fpnotebook.com]
  • Other symptoms include funny feelings in the skin, known as paresthesias, or absence of sensation, called numbness. Dizziness or a sensation of movement can also occur, as can rapid to and fro movements of the eyes, known as nystagmus.[childneurologyfoundation.org]
  • For example, paresthesias, flashing lights or smells may be perceived if the postcentral gyrus, calcarine cortex or uncus regions are involved in the seizure activity.[dartmouth.edu]
  • Auras may consist of motor activity or sensory, autonomic, or psychic sensations (eg, paresthesias, a rising epigastric sensation, abnormal smells, a sensation of fear, a déjà vu or jamais vu sensation).[msdmanuals.com]
Nystagmus
  • Dizziness or a sensation of movement can also occur, as can rapid to and fro movements of the eyes, known as nystagmus.[childneurologyfoundation.org]
Recurrent Headache
  • headache Pred 15 mg/day, then taper/reescalation and suspend until 1.3 years, improved headache but hypopituitarism Caputo, 2014 [ 27 ] M 40 y, Vietnamese Lacrimal gland mass, diabetes insipidus, panhypopituitarism with mass (Lymphocytic hypophysitis[bmcendocrdisord.biomedcentral.com]

Workup

  • Routine workup for all patients should include EEG and MRI of the brain; most of the time, the results will be normal.[emedicine.medscape.com]
  • EEGs obtained soon after a suspected seizure often record nonspecific patterns or may be normal (see Workup). In most patients with SPS, antiepileptic drug therapy is appropriate.[emedicine.medscape.com]
  • This requires extensive workup with detailed brain imaging and EEGs. A neurosurgeon will then surgically remove the area of the brain that is causing the seizures. This is called epilepsy surgery.[childneurologyfoundation.org]
Focal Delta Activity
  • Among the 35 patients, tumor was more common when intelligence and results of neurological examination were each normal, a plausible cause for uncontrolled seizures was lacking, and persistent focal delta activity occurred in a majority of electroencephalograms[ncbi.nlm.nih.gov]
Human Parvovirus B19
  • Serum human parvovirus B19 DNA polymerase chain reaction was positive which was consistent with acute parvovirus infection.[ncbi.nlm.nih.gov]

Treatment

  • An additional analysis was performed to determine whether a shift from more severe focal seizure subtypes to less severe occurred upon treatment with lacosamide.[ncbi.nlm.nih.gov]
  • Treatment For all types of epilepsy, the goal of treatment is to attain seizure freedom. 7 Many options are available to treat partial-onset seizures, either as monotherapy or as an adjunct to another treatment.[uspharmacist.com]
  • UCB Pharma SA assumes no responsibility of the views expressed and recommended treatments in these volumes.[epilepsy.com]
  • […] as needed Counselling about the risks of valproate treatment and the need for effective contraception throughout treatment A review of ongoing treatment by a specialist at least annually A risk acknowledgement form that patients and prescribers will[bestpractice.bmj.com]
  • The findings could aid in the interpretation of symptoms and EEG and may result useful for future treatment using brain stimulation or disconnective surgery. The limitations are clearly stated. 2010 Elsevier B.V. All rights reserved.[ncbi.nlm.nih.gov]

Prognosis

  • Defining the type of epilepsy should now be considered mandatory as it offers the best guide to both management and prognosis. Most epileptic syndromes and diseases are well defined and easy to diagnose.[epilepsy.com]
  • Prognosis If you have epilepsy and it is not caused by a treatable condition, such as infection, your tendency to have seizures may be life-long and may require long-term treatment with medicines.[drugs.com]
  • They are primarily characterised by the outward symptoms of the epileptic seizures, but also by the cause, the course of the disease, its prognosis (the probable outcome of the disease) and by the EEG findings (EEG: electroencephalography).[epilepsiemuseum.de]
  • Abstract OBJECTIVE: To document the effect of unprovoked status epilepticus (SE) on the prognosis for otherwise normal children with focal epilepsy.[pediatrics.aappublications.org]

Etiology

  • If an infectious or a metabolic etiology is suspected, laboratory tests can also be helpful.[amboss.com]
  • No differences were found between groups regarding sex, age, age at epilepsy onset, duration of epilepsy, frequency of seizures, and etiology. Temporal lobe epilepsies were significantly more activated than frontal lobe epilepsies.[ncbi.nlm.nih.gov]
  • After stabilization of the patient, finding the etiology of the seizure is of paramount importance. A careful history and physical examination may allow a diagnosis without need for further evaluation.[ncbi.nlm.nih.gov]
  • Etiology is variable, ranging from genetic, metabolic, or any type of focal structural lesions. Rolandic epilepsy is a common idiopathic syndrome with focal clonic seizures.[medlink.com]
  • In addition, SPS are frequently the result of symptomatic lesions, and the underlying etiology may impart additional risk for morbidity or mortality.[emedicine.medscape.com]

Epidemiology

  • Thurman DJ, Beghi E, Begley CE, et al; ILAE Commission on Epidemiology. Standards for epidemiologic studies and surveillance of epilepsy. Epilepsia. 2011;52(suppl 7):2-26. 3. Taylor RS, Sander JW, Taylor RJ, Baker GA.[uspharmacist.com]
  • […] brain can result in SPS, including the following: Developmental abnormalities Vascular lesions Meningitis/focal encephalitis Trauma Tumors Hypoxic insults Postsurgical changes Metabolic and electrolyte shifts Endocrine disorders Medications and toxins Epidemiology[emedicine.medscape.com]
  • Descriptive epidemiology of epilepsy: Contributions of population-based studies from Rochester, Minnesota. Mayo Clinic Proceedings , 71(6). 576-586.[epilepsyaustralia.net]
  • The natural history of epilepsy: An epidemiological view. J Neurol Neurosurg Psychiatry 2004;75:1376-81. 3. Cockerell OC, Johnson AL, Sander JW, Shorvon SD.[neurologyindia.com]
Sex distribution
Age distribution

Pathophysiology

  • As the pathophysiological characteristics of this phenomenon remain unclear, this case implies that the posterior parietal cortex is a possible anatomical localization of the central integrator of visual extra-personal orientation.[ncbi.nlm.nih.gov]
  • In: Lueders HO, Noachtar S (eds) Epilepsy seizures: pathophysiology and clinical semiology. Churchill Livingstone, Philadelphia, pp 237–242 Google Scholar Ebner A, Kerdar MS (2000) Olfactory and gustatory auras.[link.springer.com]
  • Elucidating this issue is of paramount importance both for understanding the pathophysiology of focal epilepsies and for the development of new pharmacological strategies for drug-resistant forms of these disorders.[sciencedaily.com]
  • In this updated article, the author details the historical aspects, classification, clinical manifestations, pathophysiology, EEG, differential diagnosis, and management of patients with focal clonic seizures.[medlink.com]
  • Pathophysiology A seizure occurs when there is excessive excitation or inhibition within a large group of neurons. It generally begins with an initial spike in activity that disturbs normal synapses.[uspharmacist.com]

Prevention

  • Prevention If you have epilepsy, the best way to prevent seizures is to take prescribed seizure medicines without missing doses. You should also get enough sleep each night, don't fast and avoid drinking too much alcohol.[drugs.com]
  • You can’t always prevent seizures, but you can control them with medications. If you’re on a medication for this purpose, take it as instructed by your doctor and don’t miss doses.[healthline.com]
  • How Can You Prevent Focal Seizures You can’t really prevent a focal seizure without addressing the root cause.[doctorshealthpress.com]

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