Simple Partial Seizures In Adults

These seizures occur without a loss of consciousness and are confined to one area of the brain. As each part of the brain has a certain function, the expression of the partial seizure can be quite different. The Jacksonian seizure, for instance, involves the motor cortex of the frontal lobe where motor control of muscles is localized. Localized twitching of muscles in one area(for instance in a thumb) would migrate into the hand, wrist, the forearm and the upper arm to the shoulder.

In another patient the same type of partial seizure may start in the face and migrate down into an arm or a leg. Other types of partial seizures may involve the front part of the temporal lobe and the seizures then consist of chewing movements or smacking of lips. With partial seizures in the back part of the brain( occipital lobe) visual hallucinations would occur with flashes of light.

Treatment:

Treatment consists of carbamazepine (brand name: Tegretol, Novo-Carbamaz), phenytoin ( brand name: Dilantin, Phenytex, Diphenylan)or valproic acid( brand names: Depakene, Deproic) initially. If this does not control the seizures despite adequate blood levels of the medication, then other anticonvulsants can be added. Such second line drugs are: Gabapentin ( brand name: Neurontin), topiramate ( brand name: Topamax) or lamotrigine( brand name: Lamictal).

Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

1. F Zara et al. Am J Hum Gen 2000 May 66(5): 1552-1557.

2. S Yeung et al. Europ J Paediatr Neurol 2000; 4(1): 31-33.

3. LS Leung et al. Neurosci Biobehav Rev 2000 Sep 24(7): 763-775.

4. DJ Yen et al. Epilepsia 2000 Sep 41(9) 1162-1166.

5. E Starreveld et al. Can Fam Physician 2000 Sep 46: 1817-1823.

6. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 172.

7. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 271, p.2415.

8. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.

9. Rakel: Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier

Last Modified: Jan. 14, 2009