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NIH – Epilepsy (Medical Encyclopedia) “Symptoms: The severity of symptoms can vary greatly, from simple staring spells to loss of consciousness and violent convulsions. For many patients, the event is the same thing over and over, while some people have many different types of seizures that cause different symptoms each time. The type of seizure a person has depends on a variety of many things, such as the part of the brain affected and the underlying cause of the seizure. An aura consisting of a strange sensation (such as tingling, smell, or emotional changes) occurs in some people prior to each seizure. Seizures may occur repeatedly without explanation. Note: Disorders that may cause symptoms resembling seizures include transient ischemic attacks (TIAs), rage or panic attacks, and other disorders that cause loss of consciousness. SYMPTOMS OF GENERALIZED SEIZURES Generalized seizures affect all or most of the brain. They include petit mal and grand mal seizures. Petit mal seizures: • Minimal or no movements (usually, except for "eye blinking") -- may appear like a blank stare • Brief sudden loss of awareness or conscious activity -- may only last seconds • Recurs many times • Occurs most often during childhood • Decreased learning (child often thought to be day-dreaming) Tonic-clonic (grand mal) seizures: • Whole body, violent muscle contractions • Rigid and stiff • Affects a major part of the body • Loss of consciousness • Breathing stops temporarily, followed by sighing • Incontinence of urine • Tongue or cheek biting • Confusion following the seizure • Weakness following the seizure (Todd's paralysis) … When to Contact a Medical Professional: Call your local emergency number (911) if this the first time a person has had a seizure or a seizure is occurring in someone without a medical ID bracelet (instructions explaining what to do). In the case of someone who has had seizures before, call the ambulance for any of these emergency situations: • This is a longer seizure than the person normally has, or an unusual number of seizures for the person • Repeated seizures over a few minutes • Repeated seizures where consciousness or normal behavior is not regained between them (status epilepticus) Call your health care provider if any new symptoms occur, including possible side effects of medications (drowsiness, restlessness, confusion, sedation, or others), nausea/vomiting, rash, loss of hair, tremors or abnormal movements, or problems with coordination.”
NHS – Epilepsy “Symptoms of epilepsy: Repeated brain seizures are the main symptom of epilepsy. There are several different types of seizure and it's possible for the same person to have more than one type of seizure at different times. Partial seizure Affect one part of your brain. The exact symptoms depend on which part of the brain is affected, but often you won’t lose consciousness. There are two broad types of partial seizures, simple and complex. • Simple partial seizure. Only a small part of the brain is affected and the symptoms will depend on which part of the brain it is. You may have muscle jerks or pins and needles in one arm or leg. Some people have a feeling of déjà vu. You won’t lose consciousness; you'll be completely aware. • Complex partial seizure. You do not lose consciousness completely but you may not be fully aware of what is happening around you. Afterwards you may only remember a little of what happened. You might act in a confused way, mumble or seem preoccupied. Partial seizures can sometimes come before a generalised seizure. The partial seizure may warn that a generalised seizure is about to happen. Generalised seizures These affect all of your brain and will make you lose consciousness. The symptoms tend to affect much of the body. The main types of generalised seizures are: • Tonic-clonic (also called convulsive seizure or ‘grand mal’). This is what many people might think of as a ‘typical’ epileptic seizure. You may have some warning symptoms (called ‘auras’) before a seizure, such as strange movements, emotions or sensations (which are often related to smell and taste). However, for many people, seizures happen without warning. Your muscles tighten up and you become stiff. You lose consciousness, and may injure yourself by falling over. The muscles in your jaw tighten and you may bite your tongue. Your skin (lips, ear lobes and tongue) may turn blue. Sometimes the muscles in your bladder or anus tighten, which can cause urine or faecal leakage (you wet or soil yourself). After this comes a shaking (clonic) phase. Your muscles tense and relax causing convulsions (shaking). This lasts between a few seconds and a few minutes. You then gradually regain consciousness. It may take some time to recover fully from the seizure, even when the main symptoms have disappeared. You might feel tired and confused and may need to rest or sleep. • Tonic. There is a brief loss of consciousness and your muscles contract. You usually fall to the ground. Recovery is quicker than with a tonic-clonic seizure. • Atonic (meaning not tonic). There is a brief loss of consciousness and you become limp and fall to the ground. Recovery is usually quicker than with a tonic-clonic seizure. • Myoclonic. The muscles in one part of your body (usually an arm or a leg) twitch or jerk suddenly. The person is not actually conscious, but they appear to be as the seizure is so brief. • Absence seizure (also known as ‘petit mal’). You lose awareness for a short time. This occurs mainly in children. The child may seem to be staring blankly into space. There are no other obvious symptoms. The periods of absence are usually short (seconds rather than minutes). Absence attacks (see symptoms section) can cause poor performance at school because the periods of inattention impair learning.”
Epilepsy Surveillance Among Adults --- 19 States, Behavioral Risk Factor Surveillance System, 2005 (MMWR 2008) “Persons with a history of epilepsy and active epilepsy are more likely than those without such histories to be obese, physically inactive, and current smokers (15,16). The stress of living with a chronic disorder such as epilepsy, including its social limitations, might encourage unhealthy coping behaviors (e.g., smoking and poor diet) and discourage healthy behaviors (e.g., physical activity). Persons with a history of epilepsy experience more depression and anxiety than those without the disorder; these common comorbid conditions are associated with unhealthy coping behaviors (38--40). In addition, certain anticonvulsant medications can cause sedation and lethargy, which might impede physical activity, whereas others can stimulate appetite, resulting in weight gain (41,42). Although persons with epilepsy historically have been discouraged from participating in physical activity because of concerns about inducing seizures or sustaining injuries associated with seizures, physical activity can improve seizure control, mood, and quality of life (43,44). Although persons with epilepsy should avoid physical injuries, many can benefit from daily physical activity such as walking (44--46). “
Refractory Epilepsy: Clinical Overview (Epilepsia 2007)"The incidence of refractory epilepsy remains high despite the influx of many new antiepileptic drugs (AEDs) over the past 10 years. Epidemiological data indicate that 20–40% of the patients with newly diagnosed epilepsy will become refractory to treatment. Factors that may be used to predict whether or not a patient will respond favorably to AED therapy include the type of epilepsy, underlying syndrome, etiology, and the patient's history of seizure frequency, density, and clustering. Environmental factors, such as trauma and prior drug exposure, and genetic factors that predetermine the rate of absorption, metabolism, and uptake of a drug by target tissue may also uniquely impact an individual and influence their response to AED therapy."
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