- General
- These types of seizures are usually short, occur more frequently during sleep, and tend to cluster.
- Most patients report an initial aura of vague general body sensation or unspecified cephalic aura.
- The patient initially may develop staring and behavioral arrest.
- Numbers
- Is the second most common localization-related epilepsy,
- Accounting for 20-30% of surgical series.
- Types
- Jacksonian March.
- Aka: sequential seizure
- Focal seizure that starts primarily in the motor area and spreads,
- Can lead to
- LOC
- Generalized tonic-clonic seizures.
- Commonly begins in the hand and may involve the face early on.
- Because the thumb and the mouth are situated near each other on the motor strip of the cerebral cortex.
- Epilepsia Partialis Continua:
- Persistent focal motor seizure activity affecting distal hand and foot muscles
- A type of focal motor status epilepticus.
- Seen in Rasmussen’s encephalitis
- Lateralizing signs
- Head version and unilateral clonic, tonic, or dystonic activity that correlate with contralateral onset.
- Unless there is secondary generalization, responsiveness persists throughout the seizure.
- Complex partial seizures of frontal lobe origin are characterized by partial or complete loss of consciousness.
- Motor manifestations consist of prominent semi-purposeful automatism.
- There are frequently bilateral and involve both legs and arms with features of running, pelvic thrusts, and bizarre behavior.
- Upper extremity automatisms tend to be irregular, involving proximal muscles.
- Later during the seizures laughing and crying may be observed.
- Finally, hypermotor activity characterized by complex movements of the proximal segments of limbs and trunks may occur.
- MRI Abnormalities
- Encephalomalacia
- Neoplasm
- Vascular malformations
- Cortical dysplasias
- Migrational disorders.
- In contrast,
- Temporal lobe seizures
- Have early and prominent oroalimentary automatism and repetitive upper extremity automatism involving mainly the distal segments.
- Consciousness is more frequently affected or lost in temporal lobe epilepsy.
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