Different functional areas of the brain have different epileptic seizures! Do you know which one you belong to?

Epilepsy, also known as epilepsy, is a brain disorder that causes recurrent seizures and is classified into a variety of clinical types. Some patients have a clear cause, while others have no clear cause.

Epilepsy is common, affecting about 1 in 26 people. Symptoms of epileptic seizures vary widely, and some people may lose consciousness during a seizure while others may not. Some people with epilepsy freeze in place for a few seconds during a seizure, while others may have repeated jerking of their arms or legs, movements called convulsions or spasms.

A single seizure does not mean you have epilepsy. If you have had at least two unprovoked seizures with at least 24 hours between them, you are diagnosed with epilepsy. Unprovoked seizures have no clear cause.

For most people with epilepsy, medication or even neurosurgery can control seizures. Some patients can be cured, while others need lifelong treatment. Some children with epilepsy may recover as they grow older.

According to the different anatomical parts of brain damage, it is divided into frontal lobe epilepsy (FLE), temporal lobe epilepsy (TLE), parietal lobe epilepsy (PLE), occipital lobe epilepsy (OLE), and insular lobe epilepsy (ICE).

1. Frontal lobe epilepsy (thinking function, mental function) often causes tension, anxiety, fear, etc. before an attack. Automatic symptoms will appear during an attack, such as blinking, chewing, and unconsciously grasping things with the hands.

Clinical features:

●Sudden movements (such as kicking and striking).

●Frequent attacks at night may affect sleep.

●Causes include congenital cortical dysplasia or brain damage.

2. The characteristics of temporal lobe epilepsy (sensory language center, auditory center, olfactory center) are mainly related to memory and emotions. Atypical absence seizures may occur during the seizure, which are often accompanied by loss of consciousness, purple lips, irregular breathing, etc.

Clinical features:

●Intense emotional experiences (such as anxiety and fear).

●Hallucinations (abnormalities in smell, hearing, etc.).

●The attack lasts for a long time and may be accompanied by confusion.

3. Parietal lobe epilepsy (somatic sensory awareness, processing of somatic sensations, proprioception) Sensation and movement may be affected during an attack, and the arms or legs may move involuntarily, such as twitching or shaking.

Clinical features:

●Abnormal tactile sensations (such as numbness, tingling).

●Disrupted sense of body spatial positioning.

● Seizures are shorter in duration but may spread to other brain areas.

4. In the early stages of occipital lobe epilepsy (visual function), it may only present with autonomic nervous system symptoms such as pallor and sweating, with or without behavioral disorders. Eye deviation is one of the most common manifestations of this disease.

Clinical features:

●Flashes of light, black spots, or blurred vision.

Abnormal eye movements (eg, deviations or tremors).

●The cause is often related to brain trauma or occipital lobe tumors.

5. Insular epilepsy has always been the most challenging area in epilepsy surgery. One of the reasons is that the insula is hidden deep in the brain, with numerous vascular networks on its surface and important nerve fiber conduction bundles such as the basal ganglia deep inside. There is also a lack of clear boundaries between the insula and the deep structures. The operation is very difficult and risky, and it is even called the nightmare of epilepsy surgeons.

6. Global epilepsy : whole body convulsions and loss of consciousness

When abnormal electrical discharges affect the entire brain, they usually manifest as a generalized epileptic seizure. The most common type is a grand mal seizure (tonic-clonic seizure), in which the patient suddenly loses consciousness and the muscles of the whole body become rigid, followed by clonic convulsions. Another common type is an absence seizure, which is characterized by a brief interruption of consciousness and is more common in children.

Clinical features:

●Systemic symptoms (such as convulsions, coma).

●Attacks are prolonged and may be accompanied by tongue biting or urinary incontinence.

●Often caused by genetic factors or widespread abnormalities in the brain.

Although there are many types of epileptic seizures, Changsha Yuxiang Hospital currently chooses appropriate treatment methods based on the patient's specific conditions, such as age, gender, liver and kidney function, etc. The most common ones are drug treatment (lamotrigine, oxcarbazepine, carbamazepine) and surgical treatment (deep brain stimulation (DBS), vagus nerve stimulation (VNS), and epileptic lesion resection).

Therefore, we need to have a comprehensive understanding of epilepsy, identify it in time, diagnose it accurately, and treat it in a standardized manner to minimize the pain of patients. Caring for epilepsy patients starts with correctly identifying epilepsy.

Source: Department of Neurosurgery, Changsha Yuxiang Hospital

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(Edited by YT)