Epileptic seizures are complex phenomena, especially since there are different types of epilepsy.
Already in the Bible, even in the Babylonian documents of the greatest antiquity, there are references to epilepsy, called in the time morbus sacer or sacred disease, by which people lost consciousness, fell to the ground and they suffered severe seizures from foaming through the mouth and biting their tongue.
As you can imagine from the name that was originally imposed on it it was associated with elements of a religious or magical typeWhereas those who suffered from it were possessed or were in communication with spirits or gods.
Over the centuries, the understanding and knowledge of this problem has grown, finding that the causes of this problem lie in the functioning of the brain. But the term epilepsy does not only refer to the type of seizure mentioned above, but actually encompasses different syndromes. So, we can find different types of epilepsy.
- To find out more: “What is epilepsy and how to treat this neuropathology?”
A disorder of neurological origin
Epilepsy is a complex disorder, the main feature of which is the presence of repeated nervous attacks over time in which one or more groups of hyperexcitable neurons are activated suddenly, continuously, abnormally and unexpectedly, causing excessive activity in the hyperexcited areas. who lead to loss of body control.
It is a chronic disorder that can be caused by a variety of causes, with some of the most common traumatic brain injuries, strokes, bleeding, infections, or tumors. These problems cause certain structures to react abnormally to brain activity, Can lead to the presence of epileptic seizures of secondary form.
One of the most common and recognizable symptoms is convulsions, violent and uncontrollable contractions of the voluntary muscles, but nevertheless they only occur in certain types of epilepsy. And it is that the specific symptoms that the epileptic person will present depend on the hyperactivated zone where the seizure begins. However, in general, epileptic seizures are similar in that their action extends to almost the entire brain.
Types of epilepsy depending on whether its origin is known
When classifying the different types of epilepsy, we must keep in mind that in any case, it is not known to cause them. In addition to this, they can also be grouped according to whether their causes are known, there are three groups in this regard: symptomatic, cryptogenic and idiopathic.
A) Symptomatic crisis
We call a symptomatic seizures whose origin is known. This group is the best known and most common, and one or more epileptoid areas or brain structures may be localized and damage or something that causes this alteration. However, at a more detailed level, it is not known what causes this initial alteration.
B) Cryptogenic crises
Cryptogenic seizures, currently referred to as probably symptomatic, are epileptic seizures in which they are suspected of having a particular cause, but the origin cannot yet be demonstrated by evaluation techniques current. The damage is believed to be at the cellular level.
C) Idiopathic seizures
As much in the case of symptomatic seizures as in cryptogenic seizures, epilepsy arises from the hyperactivation and abnormal discharge of one or more groups of neurons, originating from a more or less known cause. However, it is sometimes possible to find cases in which the origin of the epileptic seizures does not appear to be a recognizable damage.
This type of seizure is called idiopathic, which is thought to be due to genetic factors.. Although the exact origin is not known, people with this type of seizure usually have a good prognosis and a good response to treatment.
Types of epilepsy according to the generalization of seizures
Traditionally, the presence of epilepsy has been associated with two basic types called grand mal and petit mal, but research over time has shown that there is a wide variety of epileptic syndromes. The different syndromes and types of epileptic seizures they are mainly classified according to whether the neural discharges and hyperexcitation occur only in a specific area or at a generalized level..
1. Generalized crises
In this type of epileptic seizure, the electrical discharges from the brain are produced bilaterally in a certain area and eventually spread to all or a large part of the brain. It is common for an anterior aura to appear in these types of epilepsy (especially severe seizures).That is, some previous prodromes or symptoms such as tingling and hallucinations at the onset of the attack can prevent those who will suffer from its onset. Some of the best known and iconic of this type of epileptic seizure are as follows.
1.1. Generalized tonic-clonic seizure or seizure of great damage
The prototype of epileptic seizure, in severe seizures, there is a sudden and sudden loss of consciousness which causes the patient to fall to the ground., And is accompanied by constant and frequent seizures, biting, urinary and / or fecal incontinence and even screaming.
This type of comic crisis is the most studied, having found three main phases throughout the crisis: first the tonic phase in which there is loss of consciousness and fall to the ground, to then begin the clonic phase during which the seizures appear (Starting with the extremities of the body and gradually generalizing) and finally culminates in the epileptic seizure with the recovery phase in which consciousness is gradually regained.
1.2. Absence crisis or minor illness
In this type of seizure, the most typical symptom is loss or altered consciousness., Such as small stops of mental activity or mental absences which are accompanied by akinesia or a lack of movement, without other more visible alterations.
While the person temporarily loses consciousness, it does not fall to the ground and usually has no physical changes (Although they can sometimes cause facial muscles to contract).
1.3. Lennox-Gastaut syndrome
It is a subtype of generalized epilepsy typical of childhood, in which there are frequent mental absences and seizures in the first years of life (between two and six years) that usually occur with intellectual disability and personality, emotional and behavioral issues. It is one of the most serious neurological disorders in childhood and can lead to death. in some cases, either directly or due to complications associated with the disorder.
1.4. myoclonic epilepsy
Myoclonus is a sudden, spasmodic movement that involves moving part of the body from one position to another.
In this type of epilepsy, which actually includes several sub-syndromes such as juvenile myoclonic epilepsy, it is common for seizures and fever to occur more and more frequently, With some focal seizures in the form of tremors upon awakening. Many people with this disorder end up having severe seizures. It often appears as a reaction to light stimulation.
1.5. West Syndrome
A subtype of generalized childhood epilepsy beginning in the first half of life, West syndrome is a serious and rare condition in which children have disorganized brain activity (something visible on an EEG).
Children with this disorder suffer from flare-ups which mainly cause flexion in the limbs, their full extension, or both. Its other main feature is the degeneration and psychomotor disintegration of the child, losing his capacities for physical, motivational and emotional expression.
1.6. atonic crises
It is an epilepsy subtype in which there is loss of consciousness and in which the individual falls to the ground alone due to an initial muscle contraction, but without the onset of seizures and rapid recovery. Although it produces brief episodes, it can be dangerous as falls can cause severe trauma.
2. Partial / focal seizures
Partial epileptic seizures, as opposed to generalized seizures, occur in specific and specific areas of the brain. In these cases, symptoms vary widely depending on the location of the hyperactivated woman, limiting damage to that area, although in some cases the attack can spread. Depending on the area, symptoms may be motor or tender, causing hallucinations to seizures in specific areas.
These seizures can be of two types, simple (it is about a type of epileptic seizure located in a given area, and not affecting the level of consciousness) or complex (which alter the psychic capacities or the conscience ).
Some examples of partial seizures can be as follows
2.1. Jacksonian crises
This type of seizure is thought to be due to an overexcitation of the motor cortex, causing seizures located at specific points which in turn follow the somatotopic organization of this cortex.
2.2. Benign partial epilepsy of childhood
It is a type of partial seizure that occurs during childhood. They generally occur during sleep, without serious alteration in the subject’s development. They usually go away on their own throughout development, although in some cases they can lead to other types of epilepsy which are serious and affect the quality of life in many of their areas.
One last consideration
In addition to the types mentioned above, there are also other convulsive processes similar to epileptic seizures, such as dissociative and / or somatomorphic disorders, or seizures during fever. However, although in some classifications they are collected as special epileptic syndromes, there is some controversy and some authors do not agree that they are considered as such.
- Abu Khalil, BW; Gallagher, MJ and Macdonald, RL (2016). Epilepsy. A: Daroff RB, Jankovic, J .; Mazziotta, JC and Pomeroy, SK (eds). Bradley’s Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier :: chap 101.
- Classification and Terminology Commission of the International League Against Epilepsy. Proposal for a revision of the clinical and electroencephalographic classification of epileptic seizures. Epilepsy. nineteen eighty one; 22: 489-501.
- Engel, J. Jr. (2006). Report of the ILAE core classification group. Epilepsy; 47: 1558-68.