The following symptoms and complaints may indicate epilepsy:
Symptoms of focal seizures
- Motor symptoms such as.
- Tonic cramping or muscle twitching in individual regions of the body
- Turning movements of the head or eyes, respectively
- Simultaneous bending and stretching movements of the arms
- Sensory symptoms such as.
- Hallucinations
- Tingling
- Numbness
- Photopsia (flashes of light; flashes)
- Vegetative symptoms such as.
- Paleness
- Sweating
- Blushing
- Piloerection (goose bumps)
- Mydriasis (pupil dilation)
- Mental symptoms such as.
- Aphasia (speech disorder)
- Dysmnesia – memory disorder such as déjà vu.
- Cognitive disorders – disorders affecting the memory
- Affective disorders such as anxiety
- Illusions or hallucinations
Symptoms of generalized seizures
Non-convulsive seizures (petit mal seizures).
- Impaired consciousness lasting only a few seconds
- Amnesia – the affected person can not remember the seizure afterwards
- Motor and vegetative accompanying symptoms are possible
Convulsive (convulsive) seizures
- Tonic spasms – strong and prolonged contractions (continuous spasms) of single muscles or muscle groups.
- Clonic spasms – rapid successive, rhythmic muscle twitches of antagonistic (oppositely acting) muscles with intervening flaccid spasms
- Tonic-clonic convulsions (also called grand mal seizures) – muscle spasms of long duration are replaced by twitching muscle contractions during the course of the seizure
Atonic seizures
- Sudden brief loss of muscle tone, causing the affected person to sink to the ground
Myoclonic seizure
- Brief muscle contractions that can affect the entire body
Duration of epileptic seizures: Usually only a few seconds to about 3 minutes and rarely longer than 5 minutes.
Phases or symptoms of generalized tonic-clonic seizure (GTKA):
- Seizure onset
- Possibly aura (perceptions in the run-up to an epileptic seizure: e.g., acoustic, visual, vegetative) and/or involuntary vocalizations (initial cry)
- Falling down (tonic, “stiff as a board”) (frequent).
- Generalized tonic-clonic seizure (approx. 1-2 min).
- Postictal symptoms (“symptoms following an epileptic seizure”; 5-30 min; longer if preexisting brain disease):
- Twilight state (disorientation, psychomotor agitation and agitation, impaired consciousness) or terminal sleep (patient can be awakened only by strong stimuli).
- In focal seizures: Todd paresis or aphasia
Other symptoms
- Face color: bluish (sometimes)
- Eyes: open, fixed; hearth look.
- Tongue bite: often lateral tongue bite.
- Wetting (frequent)
Duration of GTKA: 0.5-3 minutes
Important notes on senile epilepsy!
- Almost always focal (rarely also generalized).
- Frequently atypical symptomatology: unclear mental changes, confusion, memory impairment, syncope (momentary loss of consciousness) or vertigo (dizziness)
- Episode of disturbed consciousness and fixed gaze followed by minutes of persistent confusion (may be the only clinical sign)!
- Seizure precursors (auras) are rare.
Status epilepticus
According to Lowenstein et al, status epilepticus is defined as follows:
- Epileptic seizure that exceeds >5 minutes in duration for generalized tonic-clonic seizures and >20 minutes for focal seizures or absences (earlier definition >30 min); or
- Sequence of single epileptic seizures (of above duration) between which complete restitution (recovery) does not occur clinically or electroencephalographically.