Diagnosing Epilepsy: Types of Epileptic Seizures

Diagnosing Epilepsy: Types of Epileptic Seizures

Epilepsy, can be a challenging to diagnose as seizures mostly occur outside medical environments and are not witnessed by doctors and other healthcare professionals. For this reason the epilepsy diagnosis depends very much on a well narrated history of the epileptic seizures a patient typically has. If the patient has experienced two or more unprovoked seizures, they are diagnosed with epilepsy. Since most epilepsy patients cannot themselves recall their experience after a seizure, it is pertinent that another person who has witnessed the episode gives a detailed description of the  seizure; this helps professionals reach a correct diagnosis of epilepsy, the sub-type and decide what must be done. While diagnostic tests for epilepsy exist and these can be conducted to gain more detailed insights, making the diagnosis remains a clinical process and can be time consuming.

What are the types of epileptic seizures?

Epileptic seizures can be broadly classified into two categories - generalized and partial. This classification is based on the typical clinical semiology of the seizure(s) as well as a combination of clinical investigations and data including brain imaging, electroencephalography (EEG), other investigations including laboratory parameters, all of which may guide the diagnosis.

Generalized seizures

Generalized seizures are a type of epileptic seizure in which the patient loses consciousness and all parts of the brain are involved. When such a seizure occurs, it may take the form of a generalized tonic clonic seizure, a myoclonic seizure, or as absences.

Generalized tonic clonic seizures are the most prominent and typical form of epileptic seizures we know of. In these, the patient becomes rigid, loses consciousness and may fall or collapse to the ground or an item of furniture. Patients may exhibit laboured breathing and have repetitive movements in which muscles tighten and relax, causing convulsions. This type of seizure is also known as a ‘grand mal seizure’, and may also appear as a tonic seizure (mainly stiffening) or an atonic (mainly loss of muscle tone resulting in sudden falls) seizure.

Myoclonic seizures cause the limbs to jerk abruptly, and occur most frequently a short while after waking up from sleep, either independently, or accompanied by another form of generalized tonic clonic seizures. Absences are a type of epileptic seizure which occur most commonly in children and is also known as ‘petit mal epilepsy’. During an absence, the patient experiences a brief bout of loss of consciousness, and while there are no telling signs of this type of epileptic seizure occurring, the patient may occasionally exhibit a fluttering of the eyelids during it and appear spaced out. 

Partial seizures

Partial epilepsy is also known as ‘focal epilepsy’ and only involves a distinct part or area of the brain. The disturbance in brain activity and the nature of the seizure is usually determined by the location and function of the part of the brain involved. This can be classified into two types of seizures - simple partial seizures and complex partial seizures.

When a seizure occurs and the patient remains conscious and also exhibits a twitch in a part of a limb or a whole limb, it is classified as a simple partial seizure. This type of epileptic seizure may also present itself as different sensations that vary from person to person, which may be in the form of pins and needles or even unusual tastes. These seizures can also morph into other different types of epileptic seizures.

When it comes to complex partial seizures, the seizures are characterised by changes in the level of awareness, as well as semi-conscious movements like fidgeting and fiddling, wandering around, or a state of dazed confusion. Complex partial seizures can affect the frontal, parietal and temporal lobes of the brain, but the most common type are temporal lobe seizures.

In some cases, these two kinds of partial seizures can spread, resulting in what is known as a secondarily generalized seizure. These types of seizures affect the whole brain.

While there are many other types of epilepsy that experts describe, they may be beyond the scope of this article.

Taking care of epilepsy patients

The signs and symptoms of epilepsy can vary according to the type of epileptic seizure the patient presents with. However, in all cases, epileptic seizures are experienced as being sudden, unexpected and often occurring in difficult or even dangerous situation (like being on a railway platform). It’s important that patients have a support system to help them through their seizures, and that appropriate medical care is sought out quickly if spontaneous recovery does not happen. While there are several drug treatments, medical procedures, surgeries and even diets that can help treat epilepsy, the condition can be managed better through changes in lifestyle as well. We at Buddhi Clinic specialise in integrated brain and mind care, and offer a holistic and comprehensive approach towards treating epilepsy as also a range of medical problems. Connect with us to experience our unique blend of modern science and ancient wisdom.

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