Manifestations of seizures

  Seizures can manifest in a variety of ways, and are often described simply as “seizures”. But the so-called “convulsion” is only one of the most common forms of seizures! There are still many other types of seizures that are not commonly recognized by the general public, and people often treat some specific types of epilepsy as other diseases.  Modern medicine divides seizures into three major categories, namely generalized seizures, partial seizures, and seizures that cannot be classified. There are different classifications within each of these broad categories. The performance of the major seizure types is briefly described as follows: (1) Generalized seizures: there are six types. The most common one is what people usually call “jerk”, the medical terminology is called “tonic-clonic seizure”, that is, loss of consciousness, generalized tonicity followed by clonic sequence of activities, that is, tonic contraction of the muscles in the body Some patients have a tonic-clonic seizure with foaming at the mouth, loud shouting, and sometimes tongue bite or other injuries. In fact, “tonic-clonic seizure” is only one type of generalized seizure, there are also “tonic seizure” (only tonic contraction of whole body muscles), “clonic seizure “(seizures in which only reciprocal movements of the limbs occur), and “myoclonic seizures” (rapid, brief, electroshock-like muscle contractions throughout the body, similar to cramps) are three types of seizures similar to “tonic-clonic seizures The types of myoclonic seizures are similar to “tonic-clonic seizures”. There are two other types of generalized seizures that are not easily detected, one is “disorientation seizure”, which is mostly seen in children, typically manifested as “daze”, i.e., sudden stopping of activities, mechanical repetition of pre-seizure actions, lasting for a few seconds and then returning to normal. It can occur dozens or hundreds of times a day, and some parents and teachers often think that the child has “inattention” or “hyperactivity” without proper diagnosis and treatment; the other is “atonic seizure Another type of seizure is “atonic seizure”, which is characterized by sudden fall, sudden and brief dropping of the head and limbs, and is often mistaken for “calcium deficiency” or “dozing” and not taken seriously.  (2), partial seizures: including simple partial, complex partial, partial secondary to generalized seizures three types.  (1) Simple partial seizures: A common feature of this type is that consciousness is always present, i.e. the patient is awake during the seizure. The patient is able to recall the seizure, but people often think that it is impossible for the epileptic to know the status of his or her seizure. This type can be divided into four subcategories: A. Motor seizures: brief involuntary jerking in one part of the body, mostly in one eyelid, corner of the mouth, hand or toe, occasionally lasting several hours (focal motor seizures); other patients have seizures that start in one limb or face and progress to one upper and lower limb and face (Jackson seizures or Jacksonian seizures); also manifesting as double eye deviation to one side, head turning to the same side, and a shift of the head to the same side. Other patients have a specific posture: arms raised, eyes gazing at the ipsilateral raised arm, and head twisting to the ipsilateral side, as in “fencing” (postural seizure); and a less recognized form, in which the patient involuntarily repeats There is also another form that is not easily recognized, that is, the patient involuntarily repeats the language before the seizure or suddenly cannot speak, which is often mistaken for “stuttering” or some laryngeal diseases (linguistic seizure).  B. Sensory seizures: sudden numbness, pain, pins and needles on one side of the face, limbs and torso, which can spread to one side of the torso (somatosensory seizures); sudden sensation of falling, floating, horizontal or vertical movement (vertigo seizures); illusory sensation of body movement (proprioceptive seizures); sensory flashes or hallucinations in front of the eyes (hallucinations); tinnitus or hearing non-existent sounds such as music in the ears (hallucinations); smelling non-existent sounds (hallucinations) (phantom hearing), smelling a non-existent odor (phantom smell), feeling a special taste on the tongue such as metallic taste, etc.  C. Autonomic seizures: recurrent episodes of stomach discomfort, nausea, vomiting, pallor, a feeling of gas going up from the lower abdomen, localized sweating and redness in the body, vertical hair, dilated pupils, but no examination of any organ disease exists. Some patients have mainly paroxysmal abdominal pain (stomach pain), called abdominal pain epilepsy; some have mainly paroxysmal headache, called headache epilepsy; and some patients have paroxysmal hypersexuality, etc.  D. Psychotic seizures: often mistaken for “psychosis” or “hypersensitivity”. The manifestations are complex and varied, including sudden forgetfulness, déjà vu to strangers, déjà vu to familiar people, uncontrollable thinking about something, uncontrollable projection of past events in the mind like a movie, unexplained fear, depression, ecstasy, anger, delusion, hallucination, similar to “schizophrenia” and “depersonalization”. The main reason for these episodes is the presence of incomprehensible feelings or behaviors such as “schizophrenia” and “depersonalization”.  ② complex partial seizures: the main feature is accompanied by disorders of consciousness, can also be divided into four types: A. Automatism: disorders of consciousness, no response to external stimuli, there are some seemingly purposeful but actually purposeless repeated activities, such as smacking, pouting, chewing, tongue licking, swallowing; repeatedly rubbing hands, touching the face, putting on and taking off clothes, unbuttoning, fumbling with clothes; purposeless running, wandering, opening and closing doors and other similar “Sleepwalking”; talking and singing to oneself. The consciousness is hazy after the seizure and cannot recall the seizure situation.  B. Disorders of consciousness only: similar to “anhedonia”, but different from anhedonia in that both children and adults can have episodes, with long duration, slow start and termination, and few episodes.  C. Simple partial seizures as described above, followed by impaired consciousness.  D. Simple partial seizures as described above, followed by automaticity.  (3) Seizures that cannot be classified: Seizure forms that cannot be classified according to current classification criteria, including some neonatal seizures, such as rhythmic eye movements, chewing movements, swimming movements, tremors, and apnea.