Jacksonian epileptic attack: what it is, its symptoms and how it progresses

Seizures can be of several types, the most common being on the ground, shaking, and fainting. However, there is a specific form of seizure in which this does not happen: Jacksonian epileptic seizure.

These types of epileptic seizures can be so subtle that the person doesn’t even realize they are having a seizure because sometimes they just feel a kind of tingling and there is rarely any confusion.

Below we will take a closer look at this type of epileptic phenomenon, which first described it, the causes of its occurrence, the most common diagnosis and treatment.

    What is the Jacksonian epileptic seizure?

    Jacksonian epileptic seizures are a type of partial seizure with motor symptoms. Other names for this type of seizure are focal epileptic seizure, partial (focal) seizure, and temporal lobe seizure. They are characterized by occurring, first, in a very localized way, and then by transmitting the seizure to other parts of the body..

    The seizure generally spreads in the order of somatotopic representation of the area of ​​the cerebral cortex that is affected, which includes areas responsible for voluntary movements.

    Usually the seizure begins to affect only a small part of the body, usually a finger of the hand or foot or the corners of the lips. As the seizure progresses, the symptoms become more worrying and move to other areas of the body.

    What makes this type of epileptic seizure so characteristic is that there is usually no seizure. They are called “Jacksonians” because they were first discovered by the English neurologist John Jackson in 1870, a scientist who intensely studied the structure and function of the brain.

    In all epileptic seizures, abnormal electrical changes occur at the cortical level. Focal epileptic seizures occur when this activity occurs in a specific area of ​​the brain. However, on many occasions this activity shifts to areas bordering the affected region. This is called secondary generalization.

    Partial seizures can be divided into two types. On the one hand, we have the simple seizures, which would affect neither consciousness nor memory, and on the other hand, we have the complex seizures, which affect these two cognitive domains. Jacksonian epileptic seizures turn into simple seizures.

    the causes

    Partial epileptic attacks this is the most common type of seizure in people 12 months and older. In people over 65, who are more likely to have certain cerebrovascular diseases or brain tumors, these attacks are also very common.

    Multiple sclerosis is one of the main causes of a Jacksonian epileptic seizure. Another cause behind this type of seizure is the lack of oxygen to the brain (hypoxia), having suffered a traumatic brain injury and injuries to the frontal lobe. They can also be due to auriculo-venous malformations.

      symptoms

      There are two main symptoms that allow us to detect a Jacksonian epileptic seizure.. The first is that it is a simple partial seizure, and occurs only in one part of the body. The second is that this seizure, as we have already mentioned, progresses through the body, starting with a small region and moving to the rest of the body.

      Among the first symptoms we can find that we have weakness of a finger which is then moved to the rest of the hand within seconds.

      People who suffer from this type of seizure usually do not suffer serious damage. Indeed, this type of seizure is usually short-lived and moderate, so mild that sometimes the person is not even aware that they have just suffered one. Another thing that catches the attention of this crisis is that, unlike most of them, there is no brief period of confusion after suffering.

      Some of the symptoms that we can find when experiencing a Jacksonian epileptic seizure include:

      • Automatisms, rhythmic behavior or compulsive movements.
      • ramps
      • Abnormal muscle contraction, head and limb movements.
      • Episodes of absence, sometimes with repetitive movements.
      • Move your eyes from side to side.
      • Numbness and tingling sensation.
      • Abdominal pain or discomfort.
      • Visual, olfactory and auditory hallucinations.
      • Nausea.
      • Redness of the face.
      • Pupils dilated.
      • Tachycardia.
      • Fainting episodes or periods of memory loss.
      • Vision changes.
      • Dejavu (you feel as if you have already experienced the current place and time)
      • Mood changes.
      • Temporary inability to speak.

      diagnostic

      Electroencephalograms (EEGs) are usually done, To review the electrical activity of the patient’s brain. People with epileptic seizures show abnormal electrical activity in this test. This same test can show the specific area of ​​the brain where the seizure begins. However, it can be difficult to detect the damaged wound immediately after the seizure with this test.

      MRI and computed tomography can be used to investigate the particular case. These neuroimaging techniques show where the Jacksonian epileptic seizure occurs in the brain. They are also used to see what are the possible causes of abnormal brain activity.

        treatment

        The treatment options that apply to people who have had a Jacksonian epileptic seizure are different. Among the main ones, there are the prescription of antiepileptics, Valproate, topiramate, vitamin B6, zonisamide, clobazam and carbamazepine. However, if the exact area of ​​the brain with the seizure is known, surgery may be performed.

        Another option is to improve the patient’s lifestyle, motivating them to adopt better eating habits and exercise more, as protection against future attacks.

        Bibliographical references:

        • Abou-Khalil BW, Gallagher MJ, Macdonald RL (2016). Epilepsy. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley’s Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016: Chapter 101.
        • Kanner AM, Ashman E, Gloss D, et al (2018). Practice Guideline Update Summary: Efficacy and Tolerability of New Antiepileptic Drugs I: Treatment of Newly Emerging Epilepsy: Report of the Subcommittee on Guideline Development, Dissemination and Implementation American Academy of Neurology and Society American Epilepsy. Neurology. 91 (2): 74-81. PMID: 29898971 pubmed.ncbi.nlm.nih.gov/29898971/.
        • Wiebe S (2020). Epilepsies. A: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier: chap 375
        • Cerdà, JM, Argani, MT, Llerda, JM, González, FL, Puig, XS and Rieger, JS (2016). Official guide of the Spanish Society of Neurology of the clinical practice of epilepsy. Neurology, 31 (2), 121-129.

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