A complex partial seizure is a type of seizure that occurs in one brain lobe, rather than the entire brain. The seizure affects the consciousness of individuals, and can cause them to lose consciousness.
Specific partial seizures are also more generally referred to as focal onset impaired awareness seizures or focal impaired awareness seizures.
Anyone may have a complex partial seizure while people who have had head trauma, strokes, or brain tumors are at greater risk.
Important facts about complex partial seizures:
- This form of seizure is the most common type experienced by people with epilepsy.
- The symptoms are diverse and can vary from one seizure to another.
- Seizure first aid focuses on keeping the person safe and comfortable.
Common symptoms of complex partial seizures include:
Aura, known as a simple partial seizure, often precedes seizures. Auras typically only last a couple of seconds.
An aura is a warning sign according to Johns Hopkins Medicine. Such signs take on different types.
Some people may get a feeling of fear, for example, while others may get a peculiar sensation in their bodies, an unusual taste in their mouth, or hear a particular sound.
Individuals with a complex partial seizure are generally unconscious of their surroundings as it occurs.
They won’t respond to others or their surroundings, and usually don’t remember what happens during the episode. They can stare blankly into space, appear daydreaming, or unexpectedly wake up from sleep.
In certain situations, the person may “freeze,” which is called a focal impaired awareness behavior arrest seizure.
In addition to an aura and impaired consciousness, many people often perform repetitive movements, called automatisms. Examples of automatisms are:
- repetitive speech
- lip smacking
- head rolling
- picking at things
- removing clothing
- coordinated movements, such as cycling of the legs or a swimming motion
Symptoms usually last from 30 seconds to 3 minutes.
Complex partial seizures start in the front lobe tend to be shorter than temporal lobe seizures.
The person will become fatigued, disoriented, and confused after the seizure. Though these after-effects last just about 15 minutes, several people can not function normally for many hours.
Causes and triggers
Complex partial seizures are typically caused by epilepsy but anyone may experience them. Other factors which may result in seizures include:
- brain infection
- extreme stress
- head injury
- psychological distress or trauma
Frequently, the cause of seizures is unknown.
Complex partial seizures appear to occur without much warning, with the exception of having an aura in the individual. Some important factors likely to cause a seizure include:
- flashing lights
- intense activity
- loud noises
- low blood sugar or hypoglycemia
- reactions to medications
- strong emotions, such as anger or anxiety
A medical diagnosis is necessary before implementing a treatment plan. A doctor can diagnose complex partial seizures by performing one or more of the following:
The doctor should try information of what’s going on before, during, and after a seizure.
Typically people can’t remember their seizures. Memory is typically affected, due to changes in brain function.
As a result of this, a doctor may also ask someone who has experienced one or more individual seizures for guidance.
This diagnostic procedure measures electric brain activity. Even if the EEG obtains a good outcome, it does not rule out epilepsy or partial complex seizures. Sometimes, the check would need to be carried out again during a seizure for greater accuracy.
To detect possible triggers of seizures, a CT (computed tomography), an MRI (magnetic resonance imaging), or both, can be performed.
Blood or urine may be tested to check electrolyte levels, drug use and antiepileptic drug concentrations if prescribed. Those tests can often reveal the seizures’ underlying cause.
Treatment plans are focused on patient symptoms , diagnosis, and in some cases the involvement of other medical problems for people with complex partial seizures. Treatment options include:
Medication, such as antiepileptic medications or AEDs, is usually considered as the first line of treatment for people with epilepsy and seizures.
Many people are responding well to medication that may prevent future seizures or rising their frequency and intensity at least.
Some people may benefit from a single medication while others can need a combination of AEDs.
Many individuals can discontinue their medications after a few years of being seizure-free.
However, at least 30 percent of people are not responding to AEDs.
Dietary therapy can help in seizure control and is usually used in conjunction with AEDs.
A low-carbohydrate high-fat diet, such as ketogenic diet, is considered most effective. It’s essential that a doctor or dietitian, or both, prescribe and monitor dietary changes for seizures.
Responsive neurostimulation (RNS)
In 2013, receptive neurostimulation for seizures was approved by the United States Food and Drug Administration ( FDA).
RNS includes inserting a device around the brain inside the bone to monitor brainwaves for unusual electrical activity. If these are detected, the system will release stimulus pulses that return to normal brainwaves, thereby preventing a seizure.
Early reports indicate that RNS therapy cuts the seizure frequency in half after 2 years of use, and is well accepted by users according to 2015 study.
Vagus nerve stimulation
This procedure includes the implantation of a device wired to the vagus nerve in the neck into the chest. The device sends bursts of energy to the brain to prevent seizures.
Research indicates that vagus nerve stimulation in half of study participants decreases seizures by 50 percent or more while 25 percent of patients do not experience treatment benefits. In conjunction with this treatment most people still need medication.
If other therapies do not help control seizures, it may be suggested that surgery removes the part of the brain that causes seizures. The surgery is done when:
- seizures begin in a small portion of the brain only
- the area does not affect speech, language, motor function, vision, or hearing
Before treatment, it is necessary for a person to discuss the risks and benefits of surgery with a doctor thoroughly, because all surgeries carry risks.
What to do if someone is having a seizure
The most important thing to do, is to make the person calm and comfortable. This is particularly important in public areas since some people who experience complex partial seizures can walk out in front of traffic or remove clothing items.
Other measures to take will be rolling the person to their side and shielding their head from injury by putting something soft underneath them. Time the seizure is helpful in case the episode is prolonged, and medical intervention is needed.
Since untreated seizures can lead to complications such as injury or memory loss, it is important to consult with a doctor about episodes of seizure, especially if:
- it is someone’s first ever seizure
- the seizure lasts for 5 minutes or longer
- the person has a fever, diabetes, or may be pregnant
- the person does not regain consciousness after the seizure
If the person is receiving a rescue treatment, they should be given it. A rescue treatment is a drug taken to respond to seizures where appropriate.
The outlook for a person with complex partial seizures depends on the cause, the region of the brain where they begin and the care that the patient receives.
Children can outgrow seizures, and with a variety of therapies, including medication and dietary changes, both children and adults can sometimes successfully control their seizures.
Hence, visiting a doctor is necessary if seizures are encountered in order to receive a diagnosis and access to treatments.
What to know about epilepsy and pregnancy:
During pregnancy, people with epilepsy may have various symptoms. While some symptoms, such as hormonal changes and increased stress, are uncommon, they can be managed with the right medical care.
According to the Centers for Disease Control and Prevention (CDC), epilepsy affects around 3.4 million people in the United States. According to researchers, the majority of cases of the disease are caused by hereditary factors. There are, however, a variety of therapies available to help patients manage their epilepsy.
Individuals who have epilepsy and become pregnant should seek medical advice. They can have a healthy pregnancy and birth if they are given the necessary care.
Continue reading to learn more about epilepsy and pregnancy.
Epilepsy and conception
There is no evidence that epilepsy makes it more difficult to conceive. Women with and without epilepsy who were trying to conceive were compared in a 2016 studyTrusted Source, and the researchers observed no difference in conception time between the two groups.
Another study published in 2016 in the journal Neurology looked at conception and pregnancy in women with and without epilepsy. There were no significant differences between the two groups, according to the study.
People with epilepsy who want to get pregnant should contact with their doctor for more information.
Epilepsy in a pregnant woman
Those who have epilepsy may have additional health issues during pregnancy. People with the syndrome may have more seizures during pregnancy in various circumstances because:
- Changes in weight can have an impact on how the body reacts to drugs.
- Seizures can be triggered by elevated stress levels.
- Seizures can be exacerbated by hormonal changes.
This is, however, a rare occurrence. Approximately two-thirds of epilepsy people do not have more seizures during pregnancy.
However, it is critical to have regular check-ups with a medical practitioner; regular doctor’s appointments can help lower the risk of seizures.
Drugs and medicines for epilepsy
To treat epilepsy symptoms, a variety of medications are available. The following are some of the most commonly prescribed antiepileptic medications (AEDs):
- valproic acid
Various AEDs have been connected by health professionals to certain hazards during pregnancy. Some AEDs, for example, can raise the risk of neurodevelopmental problems.
These dangers, however, are uncommon. As a result, doctors advise that people with epilepsy continue to take AEDs while pregnant.
People with epilepsy should also take folic acid during pregnancy, according to medical experts. For those with the condition, this supplement can lessen the risk of some congenital impairments by up to 86 percent.
Before making any modifications to their AEDs, people with epilepsy should visit their doctor.
During pregnancy, people with epilepsy require specialized care. These people should be looked after in the following areas.
Counseling and education
During prenatal checkups, individuals with epilepsy should consult a specialised care team. An OBGYN, midwife, neurologist, and mental health counselor could be part of this team.
People with epilepsy can benefit from quality education to help them have a safe and successful pregnancy. Counselors can also assist in keeping track of stress patterns in order to lessen seizure risk.
Checkups on a regular basis
Over 95% of epilepsy-affected pregnant people have a healthy delivery. There is, nevertheless, a tiny risk of certain problems.
Individuals with epilepsy should undergo regular check-ups during pregnancy to avoid this risk. Medical professionals can keep an eye on the fetus to ensure that it develops normally.
Consistent checkups with a solid medical team, like with any pregnancy, are essential.
How to get ready
Education is the most effective strategy for people with epilepsy to prepare for pregnancy. Learning about risk factors, according to the Epilepsy Foundation, is the first step toward managing them.
Individuals should speak with their doctors about how to use AEDs. Take the smallest dosage of AED required to control symptoms, according to healthcare professionals. AED levels in the blood can also be monitored by doctors throughout and after pregnancy.
People with epilepsy should consume a well-balanced diet and keep their stress levels low throughout pregnancy. These tips can assist you in having a healthy pregnancy.
Parental and baby considerations
Being a parent or caregiver with epilepsy can be daunting, and many people worry that their condition will negatively affect their children.
According to studies, parents of children with epilepsy have many of the same concerns. They may be concerned about:
- not been able to care for their child due to a seizure.
- as a parent, not being able to achieve their own standards
- being in need of greater assistance and support than other parents
It is not simple to become a parent or caregiver. Before and throughout pregnancy, all people, regardless of their health, have comparable worries.
Individuals suffering with epilepsy may find solace in devising strategies to address their issues. They may, for example, establish or start a support group for people who have similar concerns, or they could keep a list of phone contacts on hand for case they need a helping hand.
Anxiety and apprehension are common emotions you experience as a parent. While people with epilepsy may have additional concerns, both the parent or caregiver and the newborn can thrive with the correct information and support network.
Delivery and labor
The great majority of epileptic people have a normal labor and delivery experience. For many of these people, the most terrifying aspect of childbirth is experiencing a seizure.
According to studies, 98 percent of people with epilepsy do not have a seizure during delivery. The chance of major problems during labor, on the other hand, is normally low.
Individuals who have epilepsy should, of course, take extra measures when planning their labor and delivery. These can include the following:
- selecting a medical center that is suited to treat epileptic patients
- collaborating with a skilled team of medical experts
- reducing the number of stressors in the delivery room
Making a birth plan can also help to reduce the stress and worry that comes with giving birth. Furthermore, adequate knowledge and support are essential for a healthy labor and delivery experience.
Breastfeeding and postpartum care
Parents with epilepsy may be concerned that nursing will affect their children. AED people can be concerned that their medication would hurt their children.
However, studies have shown that most AEDs are safe to use while nursing. As a result, doctors advise that people who are on AEDs continue to nurse.
Breastfeeding can also aid in the parent-child bonding process. Breastfeeding enhances infant nutrition and the immune system, hence medical specialists advise people with epilepsy to do so if at all possible.
Individuals with epilepsy, in particular, require important postnatal care. It could include the following:
- analyzing stress levels
- finding nighttime support to ensure good sleep
- regular blood tests to check medication levels
- screening for postpartum depression
Many new parents and caregivers may be concerned about the risks associated with epilepsy. Working with a postnatal care team to alleviate these worries and improve parent and child health is critical.
Certain dangers may exist for epileptic people before, during, and after pregnancy. They can, however, have a healthy labor and delivery with the correct planning and support.
People who have epilepsy should talk to their doctors during their pregnancy. Counseling and education are crucial in their quest to become parents.
People with the condition can have a positive and healthy pregnancy with the right medical treatment and support.
A new study finds hypertension increases epilepsy risk by 2.5 times
- Researchers looked into hypertension and epilepsy.
- Antihypertensive drugs reduce the risk of epilepsy by roughly 2.5 times.
- Researchers need to do more research to understand how elevated blood pressure affects epilepsy.
After stroke and dementia, epilepsy is the third most frequent neurological condition that affects the elderly.
Late-onset epilepsy has become increasingly common in the previous two decades, according to research. As the population ages, the number of people suffering from epilepsy is projected to climb, and epilepsy will likely become a major public health condition.
Despite this, the fundamental causes of epilepsy are unknown in 32–48% of patients. According to some evidence, vascular risk factors may raise the likelihood of late-onset epilepsy. Other research suggests that vascular risk factors play a role in epilepsy in people in their 30s.
Understanding the significance of vascular risk factors in late-onset epilepsy could aid policymakers in developing public health initiatives and prevention efforts to reduce and manage the condition’s prevalence.
Researchers from Boston University School of Medicine in the United States recently undertook a study to look at the link between vascular risk factors and epilepsy onset.
The research was published in the journal Epilepsia.
The Framingham Heart Study (FHS), a community-based study that began in 1948, was utilised by the researchers. Its Offspring Cohort follows the health results of 5,124 of the initial participants’ offspring over the course of four years, based on health examinations.
The researchers collected data from 2,986 people who had their fifth assessment between 1991 and 1995, were at least 45 years old at the time, and had vascular risk factor data in their health records.
Systolic and diastolic blood pressure were among the vascular risk indicators gathered. High blood pressure was defined by the researchers as a systolic blood pressure of 140 mm Hg or higher, and a diastolic blood pressure of 90 mm Hg or higher, as well as the usage of antihypertensive drugs.
In addition, the researchers looked for:
- cholesterol levels
- smoking status
- cardiovascular disease
- body mass index (BMI)
The researchers employed routine record checks for neurological diseases, self-reported seizures, International Classification of Diseases Ninth Revision (ICD-9) codes linked to epilepsy or seizures, and antiepileptic drug use to screen subjects for epilepsy or seizures.
To determine cases of epilepsy, the researchers used brain imaging and electroencephalography (EEG), as well as cardiac and other pertinent data.
The study found 55 cases of epilepsy in the group, with 26 cases being confirmed, 15 being probable, and 14 being suspected. At the time of potential diagnosis, the participants were on average 73.8 years old.
Hypertension was linked to a nearly 2-fold increased incidence of epilepsy, according to the study. The other risk factors, on the other hand, had no link to epilepsy.
After removing antihypertensive drugs out of the equation, the researchers discovered that high blood pressure was linked to a 2.44-fold increased risk of having epilepsy.
They also discovered that every 10 mm Hg increase in systolic blood pressure was linked to a 17 percent increased incidence of epilepsy.
Mechanisms at work
The association between epilepsy and hypertension could be explained by a number of explanations. The renin-angiotensin system (RAS), which regulates blood pressure, could be one way.
According to studies, rats with repeated seizures had 2.6–8.2 times the components of RAS as mice without seizures. Antihypertensive medications that reduced RAS component levels slowed the onset of seizures and reduced seizure frequency.
More research is needed, however, to determine how much this mechanism explains the link between epilepsy and hypertension, as other research suggests the system may only have a minor impact.
Small vessel disease (SVD), a condition in which the walls of small arteries and capillaries are damaged and consequently do not supply enough oxygen-rich blood to numerous organs, is another likely underlying mechanism, according to the researchers. Scientists discovered that the duration of high blood pressure is a powerful predictor of SVD later in life in a recent study.
SVD has been linked to temporal lobe epilepsy, according to the study. Cortical microinfarcts, minor lesions in cortical tissue, and the disruption of U fibers, which can contribute to excessive excitability and seizures, are all possible explanations. U fibers connect the cerebral cortex’s surrounding sections.
According to the researchers, hypertension is an independent predictor of late-onset epilepsy, with a 2-fold risk of seizures after 45 years.
They do acknowledge, however, that their research has limitations. It is possible that it does not reflect all ethnicities and races because it largely comprised white participants. The researchers also point out that because it is an observational study, it cannot show causation.
Dr. Jason Hauptman, a neurosurgeon at Seattle Children’s Hospital, told Medical News Today, “These results are particularly interesting because whether or not high blood pressure (hypertension) in and of itself is an independent risk factor for stroke has been a topic of controversy,”. “The thought is that independent of the presence of stroke, hypertension may lead to disease of small arteries throughout the brain that can cause injuries on the microscopic level.”
“These injuries could potentially lead to epilepsy with or without the presence of a visible or symptomatic stroke. This research is important because hypertension is not only common, but it is modifiable – that is, we may have ways of assessing and treating it. This would need to be pursued in larger, more diverse patient populations to fully assess exactly how much this is a risk factor and to test the potential interventions,” he stated.
“This work is observational, so does not confirm that there is a definite direct link. However, it builds on our knowledge base and highlights the importance of lifestyle, regular exercise, and a low salt intake to control blood pressure as an important way of reducing morbidity,” he noted.
“[These results highlight] the need for aggressive control of blood pressure — and encourage everyone —particularly those above the age of 50, to regularly monitor their blood pressure. We also need to assess the impact of blood pressure control in those with epilepsy and after a stroke.”
– Dr. Prasad
How can individuals tell if they’re having a seizure?
Seizures are caused by an abnormal surge of electrical activity in the brain. Seizures can be random, but some people have triggers that might cause them. Being aware of possible triggers can assist to reduce the likelihood of experiencing them.
Seizures are sudden, brief changes in movement, behavior, sensation, or states of consciousness caused by aberrant electrical discharges in the brain. Seizure symptoms range depending on which parts of the brain are affected and how severe they are.
Seizures are classified by the International League Against Epilepsy (ILAE) depending on the kind of onset or where they begin in the brain.
Seizures can be caused by a variety of factors, including genetics, brain damage, or underlying illnesses. Seizure triggers do not cause seizures, but they can cause them in people who are prone to them.
Stress, fatigue, and the lack of medications are all typical factors. Knowing what might cause seizures and how to avoid them will help you avoid them.
In this post, we will look at some of the most frequent seizure triggers, the distinction between causes and triggers, and how to detect probable triggers.
Some people with epilepsy, especially those who have experienced recurring seizures, may observe that they happen in predictable patterns or in certain people. These variables, often known as seizure triggers, may increase the likelihood of seizures. Some people with epilepsy, on the other hand, may not have any triggers. Seizures can be triggered by a variety of triggers, including:
Anti-epileptic medications must be taken on a regular basis to maintain a constant amount of medication in the body. A person’s risk of seizures increases if they miss a dosage, and seizures become more severe or occur more frequently as a result.
If you don’t take them as directed, you might develop status epilepticus, a long-term seizure that doctors consider a medical emergency.
Sleep deprivation and tiredness
According to a 2020 research, seizures and sleep have a bidirectional link, with seizures causing sleep deprivation and sleep deprivation triggering seizures. During typical sleep-wake cycles, changes in the brain’s electrical and hormonal activity occur, which may contribute to seizures and affect their intensity and length.
Seizures are frequently triggered by stress. However, the actual nature of their relationship remains unknown. Everyone reacts to stress differently, and stress can take many forms. A person may get stressed as a result of big life events or a pile of everyday annoyances.
Stress may have a physical impact on the body, resulting in a loss of sleep, a shift in dietary habits, and the use of alcohol or other substances, all of which can lead to seizures.
Small quantities of alcohol are unlikely to cause seizures. Even for people who do not have epilepsy, consuming an excessive amount of alcohol in a short period of time might trigger a seizure.
When the effects of alcohol on the body start to wear off, alcohol-related seizures become more likely. They can happen anywhere between 6 and 72 hours after drinking. Alcohol can also impair sleep and interfere with medicines, raising the chance of a seizure.
Flashing lights or contrasting patterns might trigger a seizure in people with photosensitive epilepsy. Photosensitive seizures affect only around 3% of epilepsy people. This variety appears to be more frequent in females and younger people, according to evidence.
Nutrition and deficiencies
If a diabetic suffers from severe hypoglycemia, which can develop as a result of missing meals, their extremely low blood sugar levels might trigger a seizure.
Vitamin and mineral deficits can also cause seizures in certain people. Vitamin B6 deficiency can trigger seizures in newborns, however it is less prevalent in adults. Mineral imbalances, such as calcium, sodium, potassium, and magnesium, can cause seizures by altering brain cell electrical activity.
Infection and illness
Seizures might be triggered by illness in certain people. This might be caused by the illness’s physical impact on the body, a lack of sleep, bad dietary habits, certain drugs, or dehydration.
Seizures are frequently caused by a viral infection of the central nervous system. Seizures can be triggered by common ailments like sinus infections or a cold in rare cases.
Catamenial epilepsy is a kind of epilepsy in which seizures become worse or more common during specific people of the menstrual cycle. This is extremely uncommon, and research shows that it is caused by variations in progesterone and estrogen levels.
According to a 2017 research, low pressure and excessive humidity might trigger seizures. Although there isn’t conclusive evidence that weather has an influence on seizure risk.
Seizures are more common in the winter, according to a 2018 research. However, according to a survey conducted by the Epilepsy Society, extreme heat can provoke breakthrough episodes in well-controlled seizures and make uncontrolled seizures more severe and intense. This suggests that extremes in temperature might produce physiological changes that lead to seizures.
Seizures may be triggered by several over-the-counter drugs. Antidepressants, stimulants, tramadol, and isoniazid are among the drugs that have been linked to seizures in certain people, according to a 2016 research.
Triggers vs. causes
The cause of epilepsy is unknown in two out of every three people . It can, however, be caused by genetic problems or brain ailments including stroke, traumatic brain damage, infections, or other neurological diseases.
Although a seizure can be triggered by a trigger, seizure triggers are not the same as seizure causes. A stressful circumstance, for example, might provoke a seizure, but the underlying cause of the seizure could be brain structural damage.
Because seizures are unpredictable, it may be difficult to figure out why they happen, and some people mistakenly believe that triggers like exhaustion are to blame. However, it’s more likely that the person was already predisposed, and the trigger just triggered a seizure in someone who was already vulnerable.
Seizures are typically unpredictable and can happen at any time. While some people may identify triggers, many people’s triggers are more general, such as stress or exhaustion. Other people, on the other hand, may have reflex seizures, which are seizures that occur on a regular basis as a result of particular and recognizable stimuli or cognitive processes.
Potential stimuli, such as seeing flashing lights or touching hot water, or interior stimuli, such as feeling particular emotions or going through specific mental processes, can all cause reflex seizures. This is quite uncommon.
How to Recognize Triggers
Identification of a person’s particular seizure triggers can be challenging and time-consuming. A seizure diary can be kept to record actions or events that lead up to a seizure. Over time, a pattern may emerge, exposing likely seizure triggers.
A person should try to manage their condition and prevent or decrease exposure to potential triggers while seeking to identify likely triggers. People can attempt the following suggestions:
- taking medication as their doctor prescribes
- getting enough and regular sleep
- lowering stress
Stimuli that can induce a seizure in some people are known as seizure triggers. Individual triggers vary, but common ones include illness, tiredness, alcohol, and a lack of medication.
Triggers are not the same as causes. Seizures are frequently caused by underlying conditions, whereas triggers simply cause seizures in people who are already predisposed to them.
People may find it difficult to identify their own specific triggers, but maintaining a journal of possible triggers and avoiding certain stimuli may help prevent seizures.