Patient's question:
I'm having a small attack right now, but I'm not very clear about the reason yet. I also don't remember when it started.Doctor's answer:
1. Grand Mal Seizure: Accounts for about 50% of all epilepsy seizures, typically occurring around 1 year of age or between 14-17 years old. Grand mal seizures can be divided into four phases:(1) Aura Phase: Symptoms include dizziness and stomach discomfort.
(2) Tonic Phase: Sudden loss of consciousness, falling to the ground, head extension, and rigid limbs. Due to diaphragmatic spasms, the patient may emit a "sheep-like" bellow. The face may turn purple, pupils dilate, and breathing may pause for several seconds.
(3) Clonic Phase: Rhythmic twitching of the entire body, often biting the tongue, foaming at the mouth, and possible incontinence of urine and feces. Generally lasts 1-3 minutes.
(4) Recovery Phase: It usually takes several minutes to regain consciousness. The patient cannot recall the seizure process and may experience body pain and fatigue. In some cases, patients may exhibit agitation, running around, shouting, or destructive behavior during recovery.
2. Petit Mal Seizure: Also known as absence seizure, characterized by brief loss of consciousness. Most patients experience complete loss of consciousness, though occasionally they may retain some awareness of their surroundings, able to hear questions but unable to respond. The key feature is the brief and frequent nature of the episodes. Most seizures last 2-15 seconds, not exceeding 1 minute, occurring several times to dozens of times per day. They begin and end suddenly. The patient may suddenly interrupt speech or activity, stare blankly (occasionally rolling their eyes upward), and sometimes appear pale without any prior warning. Objects held in the hand may fall, and in some cases, dishes may be broken. After the seizure, the patient resumes their previous activity.
3. Psychomotor Seizure: Against a background of impaired consciousness,,, and may occur. As they are often caused by temporal lobe lesions, they are also referred to as temporal lobe epilepsy. The onset age is relatively late among all types of epilepsy, typically occurring around 20 years old for the first time. Approximately 40% of patients experience auras, such as stomach discomfort, auditory hallucinations, olfactory hallucinations, dizziness, nausea, or fear. Clinical manifestations can be divided into:
(1) Impaired Consciousness Only: Should be distinguished from absence seizures, as the impaired consciousness during these seizures usually lasts more than 1 minute, whereas in absence seizures, it typically lasts less than 1 minute.
(2) Recognition Symptoms: Memory impairment is most common. Some patients may feel familiarity toward strangers or objects, referred to as "déjà vu." Others may experience a sense of strangeness toward familiar people or environments without apparent reason.
(3) Emotional Disturbances: May cause episodic emotional abnormalities, such as sudden feelings of sadness, anger, fear, impending doom, or the end of the world.
(4) Psychosensory Symptoms: Such as illusions. During auditory hallucinations, others' speech may sound as if it is coming through a wall. Visual illusions may include seeing things as if they are covered in a veil, feeling the ground uneven, or perceiving objects as distorted. Objects may appear magnified or diminished.
(5) Psychomotor Symptoms: Automatisms are common. Involuntary oral-pharyngeal movements, such as sucking, chewing, or swallowing. Some patients may rub clothes, make circles in the air with their hands, or engage in more complex automatisms like sleepwalking or somnambulism.
(6) Complex Forms: Characterized by a combination of multiple complex symptoms. Some patients may suddenly erupt with impulses, even engaging in illegal acts such as harming others, destroying property, self-harm, suicide, or murder.
4. Focal Seizure: Also known as simple seizure, characterized by rhythmic twitching in a specific part of the body, lasting several seconds, with consciousness remaining intact. If the seizure discharge spreads, it may extend to the entire half-body or.