Describing seizure types

When making a diagnosis of epilepsy, the doctor may use one of the following terms: idiopathic, cryptogenic or symptomatic. Idiopathic means that there is no apparent cause.

Cryptogenic means that doctors believe there is likely to be a cause but they are unable to find it.

Symptomatic means that a cause has been found.

Seizures can also be described by which part or parts of the brain the epileptic activity starts in. The three groups are: partial (also called focal), secondary generalised, and generalised.

  • Partial seizures involve epileptic activity in just a part of the brain. Partial seizures can be divided into simple partial and complex partial.
    • In a simple partial seizure the person is fully conscious. They remain fully aware of their surroundings, despite seizure activity
    • In a complex partial seizure a person partly loses consciousness and they are not aware of what they are doing. Because of this, they may not remember the seizure afterwards, or their memory of it will be unclear.
  • Generalised seizures involve epileptic activity in both halves of the brain. The person loses consciousness during the seizure.

  • Sometimes, the epileptic activity that starts as a partial seizure can spread to the rest of the brain. When this happens, the seizure is known as secondary generalised.

Comments

My daughter experienced what she described as de ja vu and episodes of feeling strange, but couldn't explain what was happening to her. She would have these episodes just before her menstral cycle and could have as many as seven over the space of a couple of days. On one particular occasion she had one of her episodes and actually wet herself. After these episodes she becomes very tired and just sleeps, she also has difficulty remembering things prior to these attacks, which is becoming a problem at school as she forgets work projects she had learned prior to her attack.

Our GP arranged for her to see a consultant to try and diagnose if her symptoms are epilepsy or migraines. The consultant asked us to keep a diary of when these attacks occurred and what happens, whilst MRI scans and eeg tests were carried out. The results came back normal occording to the consultant who telephoned me at home, although failed to provide a follow up appointment.

I have studied the internet for advice on epilepsy and I believe my daughter has Temporal Lobe Epilepsy, but the consultant who dealt with my daughter didn't seem to take my concerns seriously and treated me as if I was being over the top. My daughter continues to have these episodes which is extreemely distressing as I can not do anything to help her, I have been advised to go back to the consultant we originally went to by our GP, but when we last spoke he said that if the tests failed to find anything , then we would have to go down the psycological route! I know my daughter as I live with her every single day, I have a dad that has extreemely violent epileptic fits and I've seen enough of his to know there are certain similarities in the way my daughter behaves during these episodes.

As anything I have written about my daughter's symptoms given you any idea what the problem could be and is it worth going back to my GP and requesting a second opinion with another consultant.

hi Julie

my 17 year old daughter has been having these funny turns since xmas 07 too, she has been hospitalised 3 times and a neurololgist discharged her march saying that they were faints!
After another two episodes fitting ect unconcious, then comin round with headache i demanded we see a different neurologist, lluckily my g.p did this for me and my daughter was diagnosed last week with epilepsy. An c t scan came back normal we are waiting the results from e e g. luckily emma is now on medication.

Go with your heart and push for another referal

Sue

In response to Julie Bartlets last comment, my mother and I experienced a similar situation nearly 10 years ago in Wellington, New Zealand. I was 10 years old and started to experience what my mother thought were seizures-semi conscious convulsive movements, in which I could hear, but not respond, or stop movement. As we had no history or understanding of epilepsy this was very hard to deal with, as I was young and scared, and mum felt helpless. We went to our local GP, who was well respected in the community, but who insisted that mum was being dramatic and I was craving attention. She said that I was too healthy and intelligent to be having seizures. Like you, mum did as much research as possible and went back to her several times, requesting the referral to a specialist. She said, quote "you would be wasting their time, and we would have to wait 3 months anyway." Mum ended up taking matters into her own hands and took me straight to a paediatrician who diagnosed epilepsy and started trying to find an appropriate treatment. My MRI and eeg came back inconclusive like your daughters, but I still received medication, the diagnosis had been made prior. Within 2 months I was seizure free and getting back on track at school.
Our message to you is to trust your instincts. like you said, you know your daughter best of all and if need be, do all you can to see a specialist. If they don't listen, insist, or try somewhere else.

Hi

My husband suffered serious head injuries 3 years ago. Earlier this year, he suffered a seizure whilst walking back from the shops. Since then he has suffered 2 more. We are seeing the neurologist tomorrow to receive EEG results. It would be helpful if you could give us advise as to questions we should ask. He had a brain scan 1 year ago and it showed nothing of concern and I am worried that he may go undiagnosed. Sorry for the short notice for your help, but I have just stumbled upon it.

Thanks

Sarah

Hi Julie,
I just wanted to say my daughter, now 10 has been having "funny turns" since she was about 1 or 2 yrs old. At first the Drs said it was temperature related, even though her temp; taken by their nurses was 37.7max at the time. They wouldn't do any test. There isn't one to check for epilepsy! They then died down when she was 5yrs old. So after numerous turns over those years just as quickly as it started it stopped. I then calmed down and took on their idea of it all been temperature related.
Now after a futher 4 yr battle with countless nurses, G.P.'s, Peads, and neurologists she has now been diagnosed with "Probable Focal Epilepsy Syndrome".

Let me just clarify a few things though.

1. My mum like your dad has epilepsy.
2. My daughter is very sleepy and sleeps for upto 2hrs after each event.
3. Like most she has no memory of it afterwards.

My daughter's "funny turns" at first would consist of the Tonic Clonic which every Neurologist has agreed on for the past 2 yrs. Then at the age of 5 when we thought they had gone, they hadn't, just taken on a different type. Her turn results in her feeling funny, dizzy, faint, then been unable to move any part of her body except for the odd kick, eventually she would be sick, say within 15mins from the onset. Whilst all this happened, although she would look to be concious, to our dismay she can't remember anything.
She was treated as though she was attention seeking for sometime. It took for her to be admitted into our main hospital(Southampton) for video telemetry and then be discharged at the end of the week with migraine tablets and diagnosed as suffering with migraine, only to be found face down in a field of mud having had one of her turns, less than 6hrs after being discharged. The person who found her was my husband.
On the back of that and a witness statement from my neighbour they gave her the diagnoses of epilepsy in May this year. Luckily they had just got the results back of the video telemetry. All EEG's and MRI scans are normal apparently.They are slow. However on the video test, they found what they needed. To get that test I had to ask for it. I also argued with them and said that i would never accept the migraine diagnoses. It's over to quickly etc, and I googled the type of migraine that they thought it was. They couldn't diagnose that type unless they could rule out Epilepsy, which they couldn't. They then let us have this test.
If this helps and gives you the determination to go on and argue for your daughter then writing this has helped. One thing I have learnt through all this is NEVER give up and ALWAYS ask to see someone else if your not happy with the current Drs, neurologists etc. I have my first appointment with the peads dr who said my daughter was attention seeking, and tried to make me feel like I was neurotic, on the 4th November. I am so looking forward to that for personal reasons!!!! However I must stress, the knock on effect to this is my daughter is now performing at a level more fitting with that of a year2/3 pupil not that of a year 6 pupil.
Take care, keep going......

I have suffered from Epilepsy for the past 13 years and what you describe is exactly like what happens to me when I have a Complex Partial seizure. I also have absence and grand mal seizures but only started with my epilepsy when I was 18. All my test results have come back normal and the specialist was reluctant to diagnose me with epilepsy at first. It took 2 stays in hospital within 2 weeks for them to tell me I was epileptic. If you are not getting any luck then I would contact one of the Neurological centres that are around the country and just keep persevering until you get an appointment to see one of their specialists or write to your local health board to complain about the way your daughter is being treated.

hi julie
i have a 17 month old daughter whos been having funny turns for the last 2 months shes been admitted to hospital twice due to losing conciousness i really dont think were getting the service we deserve from the doctor me and my partner had an appointment today at the hospital and was told hes going to do a eeg again as it wasnt done properly the first time and an appointment has been booked for an mri late december i was told from the doc today that weve got to wait for all the results to come back before he do anything about it so i know exactly how you feel and i was in two minds wheather to ask for a second opinion and after today i definatly am

thanks caroline