Staring-Spell Seizures They re Not All the Same
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Staring-Spell Seizures: Not All Are the Same
Summary:
While some epileptic seizures involve a fixed stare, they are not always "petit mal" attacks. This article highlights the crucial differences between two types of staring-type seizures that can easily be confused: absence seizures and partial-complex seizures.
Keywords:
epilepsy, epileptic, seizure, petit mal, absence, partial complex, psychomotor, temporal lobe, EEG, phenytoin, carbamazepine, ethosuximide
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Many people are aware that epilepsy includes various types of seizures. The most recognized?"and dramatic?"is often referred to as "grand mal" seizures, or more accurately, tonic-clonic seizures. During these episodes, individuals lose consciousness, fall, and experience convulsions for 1-2 minutes.
In contrast, less dramatic seizures involve a loss of consciousness without falling or convulsions. Known as "staring spells," these episodes cause individuals to stop their activities, lose eye contact, and appear to gaze into space without responding to others. However, it's critical to understand that more than one type of seizure can manifest this way, and distinguishing between them is essential for proper treatment.
Although often grouped under "petit mal" epilepsy?"a term meaning "minor illness"?"staring spells primarily fall into two categories today: absence seizures and partial-complex seizures. Absence seizures align with the original petit mal description, while partial-complex seizures were previously termed "psychomotor seizures" or "temporal lobe epilepsy," as they generally originate in the temporal lobes near the ears.
Both absence and partial-complex seizures share characteristics of staring and unresponsiveness, but they differ significantly in several ways:
1. Age of Onset:
Absence seizures typically begin in childhood, often before school age, and frequently cease by the twenties. Partial-complex seizures can start in childhood or adulthood, making them more common in middle-aged individuals.
2. Duration:
Absence seizures are brief, often ending within 10 seconds and rarely exceeding 30 seconds. Partial-complex seizures last longer, usually extending from 2-3 minutes.
3. Symptoms:
Children with absence seizures are often unaware of them, though they might notice lost time. Teachers may be the first to identify these episodes due to brief lapses in eye contact. Conversely, those experiencing partial-complex seizures often recognize them due to distinct, recurring symptoms. For example, they might notice unusual smells or experience déjà vu?"a sense of familiarity with their surroundings.
4. Behaviors During Seizures:
Absence seizures may involve minor eyelid flutters or shivers but are mostly characterized by inactivity. In contrast, partial-complex seizures can provoke intricate behaviors, such as facial movements, or repetitive actions like button-picking. These behaviors are consistent for each individual.
5. After-Effects:
After absence seizures, individuals often resume activities immediately without any after-effects. Partial-complex seizures, however, can leave patients disoriented for several minutes, often leading to fatigue and the need to rest.
6. EEG Patterns:
EEG readings during absence seizures show distinctive electrical discharges across both brain hemispheres, cycling at three beats per second, and can be triggered by hyperventilation. In partial-complex seizures, electrical activity is usually localized to one hemisphere, and hyperventilation is ineffective as a trigger.
7. Underlying Causes:
Absence seizures, typically hereditary, don't appear on MRI scans. However, MRI scans in partial-complex seizures can reveal brain defects like strokes or tumors that may require specific treatments.
8. Treatments:
Medications effective for one type may not work for the other. For instance, ethosuximide (Zarontin) is effective for absence seizures but not for partial-complex seizures, while phenytoin (Dilantin) and carbamazepine (Tegretol) are the opposite.
Understanding these differences is fundamental for accurate diagnosis and effective treatment, ensuring that each type of seizure is managed appropriately.
(C) 2005 by Gary Cordingley
You can find the original non-AI version of this article here: Staring-Spell Seizures They re Not All the Same.
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