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]
Entire Body System
- Pain
[…] ictal abdominal pain remains unknown. [ijponline.biomedcentral.com]
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]
- Unconsciousness
Or, in some severe cases, it may cause unconsciousness and convulsions, when your body shakes uncontrollably. Seizures usually come on suddenly. How long and severe they are can vary. A seizure can happen to you just once, or over and over. [webmd.com]
After a brief period of restlessness, there is unconsciousness, generalized muscular activity, excessive salivation, chewing activity, opisthotonos, running movements, and often urination and defecation. [medical-dictionary.thefreedictionary.com]
If a focal seizure spreads from one hemisphere to the other side of the brain, this will give rise to a focal to bilateral seizure. [5] [6] The person will become unconscious and may well have a tonic clonic seizure. [en.wikipedia.org]
- Developmental Disorder
disorder and fragile X syndrome, are associated with severe EEG abnormalities in the absence of clinical seizures. [aafp.org]
Gastrointestinal
- 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]
In addition, a variety of migraine-like disturbances such as nausea, headache, dizziness, and visual hallucinations may be associated with pain during the attacks [ 4 ]. [ijponline.biomedcentral.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]
- Blood in Stool
He underwent a negative abdominal investigation including complete blood count, stool examinations for ova and parasites, abdominal ultrasound and upper gastrointestinal endoscopy. Physical and neurological examinations were normal. [ijponline.biomedcentral.com]
Ears
- Tinnitus
Auditory-vestibular Auditory-vestibular cortex involvement appears as a hallucination of sound (tinnitus) and vertigo with or without generalization. [dartmouth.edu]
Eyes
- Visual Impairment
The seizure, headache, and visual impairment have continued to be asymptomatic up to one year after established diagnosis. The hormonal assessment at 2 years after presentation remained adrenal insufficiency and hypothyroid. [bmcendocrdisord.biomedcentral.com]
Psychiatrical
- Delusion
However, since the person is still acting in the dream-like state from which they woke, they will assimilate any hallucinations or delusions into their communication, often speaking to a hallucinatory person or speaking of events or thoughts normally [en.wikipedia.org]
Neurologic
- Focal Seizure
Focal epileptic seizures can be the first manifestation of a diabetic disorder. Metabolic disturbances, including hyperglycemia, mild hyperosmolality, hyponatremia, and lack of ketoacidosis contribute to the development of partial focal seizures. [ncbi.nlm.nih.gov]
Complex Focal Seizures Complex focal seizures are often preceded by a simple focal seizure (aura). [hopkinsmedicine.org]
Link/Cite Link to this page Cite this page MLA Style "focal seizure." YourDictionary, n.d. Web. 16 January 2019.. APA Style focal seizure. (n.d.). Retrieved January 16th, 2019, from https://www.yourdictionary.com/focal-seizure [yourdictionary.com]
- Febrile Seizures
febrile seizures from recurring). [merckmanuals.com]
Also, the lower the temperature that provoked the first febrile seizure is, the higher the risk for future febrile seizure events. Treatment. Treatment for febrile seizures is usually unnecessary. [childbrain.com]
Ictal autonomic manifestations are frequent and may occasionally appear in isolation as in pure autonomic seizures. Febrile seizures are common. [epilepsy.com]
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]
Factors prognostic of unprovoked seizures after febrile convulsions. N Engl J Med. 1987;316:493–8. 4. Berg AT, Shinnar S. Complex febrile seizures. Epilepsia. 1996;37:126–33. 5. [aafp.org]
- 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]
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]
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]
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]
- Clumsiness
The individual may manifest any of the following “inappropriate” automatic behaviours: chewing movements uncoordinated activity meaningless bits of behaviour that appear random and clumsy including picking at their clothes or trying to remove them walking [epilepsyontario.org]
The seizures are often mistaken for clumsiness before diagnosis. Note: Even people without epilepsy can experience myoclonus or sudden jerks just as you are falling asleep. These are normal and not seizures. [epilepsy.org.au]
Often the person's actions are clumsy and they will not respond normally to questions and commands. [rch.org.au]
These are often overlooked or thought to be “clumsiness”. Some months or years later the patient has a primary generalized convulsion (sometimes following a flurry of myoclonic events). [dartmouth.edu]
- Tremulousness
[…] funduscopy) Increased intracranial pressure (specificity is 80–90%*) Focal neurologic defects (eg, asymmetry of reflexes or muscle strength) Structural abnormality (eg, tumor, stroke ) Postictal paralysis Generalized neuromuscular irritability (eg, tremulousness [msdmanuals.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]
Ten years after onset of symptoms, he underwent extensive cardiac workup including 24-hour Holter monitor, which resulted in pacemaker placement, which had no effect on his symptoms, and was subsequently deactivated 1 year after placement. [touchneurology.com]
EEG
- Spike-and-Slow-Waves
Few reports described ictal EEGs: during the seizure the EEG often shows a runs of high voltage slow waves and generalized spike and wave discharges [ 2 – 4, 8 ]. [ijponline.biomedcentral.com]
EEG may detect epileptiform abnormalities (spikes, sharp waves, spike and slow-wave complexes, polyspike and slow-wave complexes). [msdmanuals.com]
Figure 2: EEG showing a typical pattern of benign epilepsy with centrotemporal spikes (BECTS) with clear spike-and-slow wave discharges phase reversing (pointing towards each other, suggesting the source of the seizures) at C4 & T4 (right centrotemporal [childneurologyfoundation.org]
A routine electroencephalogram (EEG) showed right centroparietal spike and slow waves with no tangential dipole and no activation with drowsiness or sleep. Brain magnetic resonance imaging (MRI) was normal. [touchneurology.com]
Serum
- Hypoglycemia
If you’re diabetic, hypoglycemia could be a side effect of your diabetes medication, which your doctor might need to adjust or change. If you're not diabetic, hypoglycemia can arise as a result of certain medicines or other conditions. [livestrong.com]
“Unprovoked” seizures are those that are not brought on by a clear cause, such as alcohol withdrawal, heart problems, or hypoglycemia, which is when a person has extremely low blood sugar levels. [nyulangone.org]
They may be genetic and are commonly provoked by severe metabolic upset (electrolyte disturbance, organ failure, hypoglycemia, hypoxia, sedative/alcohol withdrawal, etc). 22-4. Does epilepsy last a lifetime? 22-4. [dartmouth.edu]
The acute causes include hypoglycemia (low blood sugar, hypocalcemia (low blood calcium), meningitis, bacterial toxins (such as shigella), alcohol withdrawal, environmental toxins, electrical shock, and side effects of medication. [childbrain.com]
[…] seizure frequency Expanding intracranial lesions Hemorrhage, hydrocephalus, tumors Hyperpyrexia Drug toxicity (eg, with amphetamines or cocaine), fever, heatstroke Metabolic disturbances Commonly, hypocalcemia (eg, secondary to hypoparathyroidism), hypoglycemia [msdmanuals.com]
- Hyperglycemia
Metabolic disturbances, including hyperglycemia, mild hyperosmolality, hyponatremia, and lack of ketoacidosis contribute to the development of partial focal seizures. [ncbi.nlm.nih.gov]
Tonic Focal Seizures in Nonketotic Hyperglycemia of Diabetes Mellitus. Arch Neurol. 1981;38(8):512–514. doi:10.1001/archneur.1981.00510080074011 Download citation file: © 2019 New! JAMA Network Open is now accepting submissions. Learn more. [jamanetwork.com]
This is most common in adults, and neoplasm or ischemia-infarction of the brain is the most frequent cause followed by less common causes such as stimulant toxicity and hyperglycemia. [dartmouth.edu]
[…] toxicity (eg, with amphetamines or cocaine), fever, heatstroke Metabolic disturbances Commonly, hypocalcemia (eg, secondary to hypoparathyroidism), hypoglycemia, hyponatremia Less commonly, aminoacidurias, hepatic encephalopathy, uremic encephalopathy, hyperglycemia [msdmanuals.com]
Treatment
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]
The doctor will watch for side effects to find the best treatment. Surgery may be an option if medication can't control the seizures. [cedars-sinai.edu]
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]
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]
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]
Abstract OBJECTIVE: To document the effect of unprovoked status epilepticus (SE) on the prognosis for otherwise normal children with focal epilepsy. [pediatrics.aappublications.org]
The prognosis of patients with SPS is similar to that of patients with complex partial seizures. [emedicine.medscape.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]
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]
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]
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]
Pathophysiology Any structural lesion of the brain that causes an electrical variation in the surrounding tissue can provide an adequate substrate for epileptogenesis. [emedicine.medscape.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]
For many people with simple partial seizures, correct treatment can lower or prevent seizures. In some cases, patients may not have any more seizures for the rest of their life. Partial and generalized seizures are often treated differently. [cedars-sinai.edu]