TYPES OF SEIZURES

There are many different types of seizures and therefore, many different types of epilepsy. It is important to distinguish amongst the different types of seizures because they require different medications, and have different causes and outcomes.

Some of the most common types of seizures are noted in this section. Each has a new name and an old name (in parenthesis).

SIMPLE PARTIAL SEIZURES (Focal Cortical Seizures)

Simple partial seizures result from epileptic activity which is localized to one part of the brain, usually the cortex or limbic system.  Consciousness is not impaired and children can talk and answer questions.  They will remember what went on during the seizure.  These seizures take different forms in different children:

Sensory: Some simple partial seizures consist of a sensory experience. The child may see lights, hear a buzzing sound or feel tingling or numbness in a part of the body. These seizures are sometimes called Jacksonian sensory seizures.

Motor: Other simple partial seizures consist of convulsive movements, which are generally clonic (jerking). Jerking typically begins in one area of the body: the face, arm, leg or trunk. Jerking may then spread from that part to other parts of the body. These seizures are sometimes called Jacksonian motor seizures and the spread is called a Jacksonian march.  It cannot be stopped.

Emotional and Other: Simple partial seizures which arise in or near the temporal lobes often take the form of an "odd experience".  Children may see or hear things that are not there. They may feel an emotion: often fear, but sometimes sadness, anger or joy. They may smell a bad smell or taste a bad taste. They may have a funny feeling in the pit of their stomach or a choking sensation.  These seizures are sometimes called simple partial seizures of temporal lobe origin or temporal lobe auras.

Simple partial seizures usually last just a few seconds, although they may be longer. If they do not involve convulsive movements, they may not be obvious to the onlooker. In some children, simple partial seizures lead to complex partial seizures or to tonic-clonic convulsions.

Simple Partial Seizures are NOT:

hysteria
acting out
mental illness

SOME MEDICATIONS USED FOR SIMPLE PARTIAL SEIZURES:

DILANTIN  (PHENYTOIN)

Rarely used in children

Can cause:

nausea, vomiting, constipation
sedation (high dose)
increase in body hair
gum overgrowth

LAMICTAL (LAMOTRIGINE)

Broad-spectrum anti-convulsant

Can cause:

dizziness
visual disturbances
ataxia
sedation
skin rash

Less Common Side Effects:

allergic response (skin rash)

***Labeling suggests this medication not to be used in children under the age of 18***

MYSOLINE (PRIMIDONE)

Can cause:
drowsiness/dizziness/clumsiness
nausea/vomiting

Less Common Side-Effects

skin rash
fever

Since Mysoline is partially changed to Phenobarbital in the body, it is not usually prescribed in conjunction with Phenobarbital.

NEURONTIN (GABAPENTIN)

Safety and efficacy in children are still under investigation

Can cause:

stomach upsets
sedation

PHENOBARBITAL

Oldest established anti-epileptic medication

Can cause:

sedation (very common)
irritability, paradoxical excitement

Less Common Side Effects

skin rash
fever

Children who show the sedative side effects of Phenobarbital may experience memory and cognitive problems. The abrupt discontinuation of Phenobarbital may lead to a sudden increase in seizures.

SABRIL (VIGABATRIN)

Often used as an add-on with other anticonvulsants.

Can cause:

drowsiness
gastrointestinal upset
weight gain

Less Common Side Effects

behavioral disturbances (aggression, psychosis)

TEGRETOL (CARBAMAZEPINE)

Can cause

nausea/vomiting

blurred/double vision
transient leukopenia
drowsiness

Less Common Side Effects

skin rash
fever
anemias (low white blood cell count)

With regular Tegretol , a wide daily fluctuation in blood levels of the drug is seen in some children. For this reason, it may be difficult to get the right dosage. The Tegretol-CR (controlled release) formulation, however, provides steady blood levels and many people find that the side effects are not as prevalent.  Tegretol is also available in a liquid (Tegretol Suspension) and in a chewable formulation (Chewtabs - must be chewed completely to be effective).

July 4, 2002