A distinction is made in epilepsy generalized from partial seizures. The latter can be further subdivided into simply focal, complex focal and secondary generalized seizures. There are also special forms that have characteristics of both types of seizures.
Important terms related to epilepsies concern the description of the seizures. These include the expressions "tonic" and "(Myo-) clonic" .
"Tonic" refers to the muscles and describes a cramping tension. "Clonic" also affects the muscles and describes the involuntary rhythmic twitching of certain muscle groups.
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A very common symptom of epilepsy is muscle twitching. A distinction can be made between different forms of muscle twitching.
On the one hand there are so-called myoclonia, which are very violent, sudden and uncoordinated muscle twitches. On the other hand, there are clonic phases in some forms of epilepsy, which include rhythmic and even muscle twitching. These two forms of muscle twitching can occur alone or in combination.
In the classic form of epilepsy of the grand mal seizure, for example, there is a clonic phase after initial strong convulsions in which first rhythmic small muscle twitches occur, which then become more and more coarse and irregular. In other, rarer forms of epilepsy, there are initially strong uncoordinated muscle twitches, i.e. myoclonus, which can then also turn into rhythmic muscle twitches over time.
Muscle twitches are based on a shift in electrolytes, which leads to a lowering of the arousal threshold necessary for a muscle to be activated and moved.
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Read more on the subject at: Twitches
Cramps are the defining symptom that can occur in epilepsy. This type of epileptic seizure is most often referred to as a tonic seizure. This is a sudden muscle spasm. Most of the time, the affected people are passed out. If such an attack occurs during the day, it is usually accompanied by a fall, which injures the person affected. In addition, if the person is lying on the floor, the cramp usually persists and there is excessive stretching and bending in various areas of the body. These tonic seizures can also occur while sleeping and coexist with other types of seizure.
For example, in a grand mal seizure, the first thing that occurs is a muscle spasm that affects the entire body and usually lasts only a few seconds. These are then followed by various forms of muscle twitching.
Depending on the spread of the epileptic seizure, cramps in different parts of the body can occur. If it is a so-called focal seizure, cramping of the hands or legs often occurs. In a complex epileptic seizure, however, there are convulsions throughout the body.
Due to the enormous cramping of the muscles all over the body, the muscles become very slack after an epileptic seizure. Due to the heavy strain on the muscles, those affected feel very exhausted after such an attack.
$config[ads_text3] not foundIn epilepsy, different types of contractions (i.e. tensions) of the muscles can occur. This also includes tremors, i.e. the very brief and very rapid contraction of muscles. This is often found in all muscles in the body and usually only takes a few seconds to minutes.
If it occurs independently of an epileptic seizure or if it is present at rest, for example, a doctor should be consulted for clarification. Many patients with epilepsy also suffer from one, for example tremor (i.e. trembling in rest).
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Some of the types of seizures in epilepsy are associated with fainting or loss of consciousness. People become unconscious as the attack progresses, which can be very dangerous. The complete loss of one's own bodily functions often leads to unintentional self-harm.
In addition, those affected cannot remember it after a seizure. Some types of epilepsy occur more often at night, so fainting usually goes unnoticed.
A wide variety of symptoms can occur during an epileptic seizure. This includes many vegetative symptoms, i.e. symptoms that occur due to a dysregulation of the systems that are otherwise automatically controlled by the body.
Therefore, excessive production of saliva can also occur. This is called Hypersalivation designated. In combination with violent muscle twitching, the saliva produced becomes frothy and vesicles form. This can result in the image of a person foaming at the mouth during an epileptic seizure.
$config[ads_text4] not foundHeadache can be a symptom associated with epilepsy. This usually results in headaches that are very similar to a migraine or a tension headache.
The headache can occur before the epileptic seizure and, as a kind of "warning symptom", occur a day before the actual seizure. However, some sufferers also experience headaches after the epileptic attack, which in turn can last for up to a day after the attack.
Occasionally, symptoms of epilepsy may include nausea. This is then a so-called vegetative or autonomous seizure. This describes a type of epilepsy that leads to symptoms that disrupt the body's own organ control, such as the heart or the gastrointestinal tract. Accordingly, this includes, for example, cardiac arrhythmias and rising nausea, which can occasionally lead to vomiting after an epileptic attack.
Occasionally, wetting can occur as part of epilepsy or during an epileptic seizure. This often happens during a phase of the seizure when muscle twitching occurs at the same time.
Since various areas of the brain can no longer work properly as a result of epilepsy, the body temporarily loses the function of controlling the bladder. Often wetting occurs along with other symptoms, such as increased salivation and loss of consciousness.
A symptom of an epileptic seizure that is not that common but is still possible is shortness of breath. This usually occurs at the end of the attack.
The affected person loses control over various body functions. Excessive rapid breathing, called hyperventilation, occurs. As a result, the breathing muscles, such as the diaphragm, become exhausted over time. You get the feeling that you can't breathe so well and you get breathless.
It is therefore very important to calm the person affected in such a situation so that the shortness of breath subsides again. Often, shortness of breath and nausea occur at the end of an epileptic seizure.
The typical symptoms of nocturnal epilepsy include the image of an epileptic fit, which most people imagine when they think about epilepsy.
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The epileptic seizure begins with a very strong increase in muscle tone, i.e. a sudden, firm tension in all muscles, which manifests itself as a spasm. It can also happen that the person concerned bites their tongue. Usually the arms are stretched out, the legs drawn up a little and the eyes wide open. Usually the person does not breathe during this very short period.
Then there is increased muscle twitching. These first take place in a rhythmic pattern and become less coordinated after a while. The twitching may last a few minutes. This is followed by relaxation or slackening of all muscles. Since these cramps and twitches are very exhausting for the body, the person concerned then feels very exhausted and weak the next day.
Occasionally, during nocturnal epilepsy, the affected person can inadvertently wet himself or even pass stool. Furthermore, foam in front of the mouth can occur, especially during cramps and twitching.
There are many different forms of epilepsy in children and, accordingly, the associated symptoms.
The most common type of epilepsy in children is called absence epilepsy. There is an absence, i.e. a short absence, which usually lasts between approx. 5 and 30 seconds and can occur up to 100 times a day with a pronounced form. The affected children cannot be addressed for a few seconds and are “mentally absent”, so to speak. In doing so, they remain in the movement that they made shortly before the absence, and the gaze becomes fixed. Afterwards, those affected cannot remember this phase of the brief absence.
But there are also forms of epilepsy in children, those with so-called Myoclonia accompanied. These are very strong, jerky, pronounced movements. It often appears as if the affected children are lashing out. For some, these strong movements occur primarily at night or just before waking up in the morning.
For more information, also read: Epilepsy in the child.
Generalized epilepsies are characterized by the fact that both hemispheres are involved, which leads to disorders of muscle tone and consciousness.
The generalization can arise primarily, i.e. from the beginning, or secondarily. The latter means that the discharges begin in a hearth and only spread secondarily to the rest of the brain.
Examples of generalized seizures (epilepsy):
1. Grand mal seizure:
Typical sequence: sometimes beginning with aura, for example olfactory sensations or déjà-vutonic phase: falling, cramping of the muscles, increase in pulse and blood pressure, sweating phase: rhythmic twitching of the entire body, sometimes wetting / stooling / increased salivation / tongue bite postictal phase: short comatose state Waking up or "terminal sleep", amnesia related to the seizure
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This form occurs between 6 and 10 years of age. Disturbance of consciousness with a fixed gaze and automatisms such as blinking or tongue movements are typical. The whole thing can occur up to 100 times a day without the person concerned being able to remember.
3. West Syndrome / Blitz-Nick-Salaam convulsions
Between 3 and 8 months of age, muscle twitching occurs, with arms and legs lifted and the head and trunk bent. If the twitches intensify, the arms are crossed in front of the chest.
4. Lennox-Gastaut syndrome
This syndrome is found in 2 to 8 year olds and involves limited or generalized muscle twitching. Often tonic or tonic-clonic seizures also occur.
1.Simply focal (epilepsy):
no disturbance of consciousness
M.otoric = Occurrence of clonic or tonic symptoms in a specific area of the body (e.g. hand)
Sensitive = Tingling, pain in a certain part of the body
Sensory = Symptoms related to sight, hearing, smell or taste
Vegetative = Paresthesia stomach of the heart, Racing heart, Sweat
Mental = Inhibition of speech, hallucinations, illusions, cognitive disorders
2. Complex focal
1. Rolandic epilepsy:
Rolando epilepsy occurs in children between 3 and 12 years of age. Characteristic is the occurrence during sleep, which manifests itself as salivation, inhibition of speaking and muscle twitching on one side of the face (cloni), which can spread to the rest of the body (generalization). This form of epilepsy usually resolves on its own within 2 years.
2. Aphasia-Epilepsy Syndrome:
The aphasia-epilepsy syndrome is also one of the types of seizures that occur in children. Between 3 and 7 years of age, the patients have speech inhibition (aphasia) and rhythmic muscle twitching (tonic-clonic). The whole thing usually emerges from sleep and usually regresses by the onset of puberty.
The seizure forms of epilepsy can all lead to a status epilepticus, which is an emergency. This is understood to mean generalized tonic-clonic seizures lasting more than 5 minutes or absences lasting more than 20 minutes or seizures without twitching. This also includes consecutive seizures between which the patient does not wake up and which are permanently present in the EEG.
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