Medical Forum / Diseases and Disorders / Epilepsy / November 2004
absense vs. temporal lobe seizures
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pamela in florida - 25 Oct 2004 21:09 GMT Could anyone tell me how the distinction is made between absence and T.L. (complex partial) seizures? How quickly do absence seizures pass over? Can one move about with them (walk) or are they typically too short-lived (1-2 seconds long)? Do they arise in a specific area of the brain? Can an EEG be abnormal? I seem to remember reading that with T.L. seizures typically the person will be amnesic (sp?) after the episode. Is that true?
Also, can anyone enlighten me to a site that might talk about the % of children that may outgrow seizures. We are so new to this and still have so many questions.
Mary Fisher - 25 Oct 2004 21:18 GMT > Could anyone tell me how the distinction is made between absence and > T.L. (complex partial) seizures? How quickly do absence seizures pass [quoted text clipped - 7 lines] > children that may outgrow seizures. We are so new to this and still > have so many questions. I don't think that figures can be given to answer any of your questions, there are too many variants.
That's good news, it means that you won't despair by reading a worst case scenario :-)
Mary
gaross - 26 Oct 2004 00:47 GMT Your earlier post (still on my groups messages) said the Dr. had recommended one of two medications for your 14? year old, then left.... Did he leave a Prescription and a procedure to start them since you won't see him again until April? Or did they just tell you the sleep deprived EEG shows seizure waves but the MRI didn't? then leave ?
I can't see anything in the history I still have 'visible' that says where you were at, except for below and an earlier post. I think one of the sites within the U.S. Ep. Foundation http://efa.org site, you can enter your Zip Code and get the nearest Ep. Association Office to you. I'd prefer if you had a Family Doctor where all the Medical stuff could be gathered for you, then We can give you opinions and experiences (most from Adult point of view), although there are people with Children around from time to time too, or who've grown up with seizures. If you go to above or Julie's Website (Idaho -- she posted a reply to you earlier and put her website at end of her post), an Absence Seizure is grouped within in Simple Partial Seizure, and can just include an Aura -- a taste or aroma or 'feeling' that's not there, then Pass ... Often unless he knew those were Simple Partial seizures he might not think those were strange to him or not *tell you if he's having them.. :-< (Some older sites might still group Temporal Lobe Seizures under its old heading -- most newer ones now, cluster T.L. under C.P. now.) A Complex Partial Seizure **Usually ends with the patient losing Consciousness or Falling down when it Generalizes (spreads across the brain), for those of us who have that type. So far as I know we all (I think) pass out before the seizures are controlled with medications. And most (80%?) of us might have a Simple Partial Aura as a Warning that a Big one is coming, OR just the S.P. and then it passes without getting worse. The Temporal Lobe seizures happen in one of the 2 temporal lobes of the brain. Those are behind the cheeks roughly above the mouth on left and right side. They are also the 'short term memory buffers of the brain'... New learning or information goes there first, then is moved later to longer term memory. *If there were damage there, he'd risk not being able to do schoolwork well or learn new things, since stuff we hear or read has to go there First before it moves to other parts of the brain for Long Term Memory and storage.
When mine were stronger (uncontrolled) I'd pass into 'the twilight zone' (where I'd not know what I was doing or if I was in danger) after the S.P. seizure moved to the C.P. type seizure. At that point I wouldn't remember what happened until I came back or regained consciousness (on a floor or in a hospital). An Absence can last from 1-2 seconds to longer, so he could have one for e.g. 5 seconds-- and unless you knew what to watch for, you wouldn't see him 'drift away' and return, since he'd stay upright and continue writing his homework or reading where he left off without any apparent outward sign to you. Likely the only thing you might notice is if he dropped something, if his type were triggered by e.g. an Aroma or Sound that he was sensitive to. (Mine was Lemon or Bleach -- taste (1st) or odour (2nd) -- and strong aromas of those used to start me into a dizzy disoriented space where I'd lose awareness of where I was or what I was doing.)
*Many of us (not I) could have a Normal EEG, since it has to measure the waves when they happened, so if we didn't have any events as they measured them, the EEG might be Clean even if we're 'not' . You said his Sleep Deprived one had EEG waves? (another post) --> they Do that (keep them awake on purpose) since that lowers our guard and makes a Seizure more likely (if we were at risk) than if we were fully rested. IF those are the only times he's having seizure events that you can see (i.e. when he's well rested), he certainly could reduce his Risk of having any Events if he made sure he stayed well rested. The *doctor could possibly tell you if his are Mild enough for that to be the Only thing that he'd have to do.
*Any seizure meds. they give, the Dr. will start on the Lower target dose for his Age and Weight and move up to control. He won't become a 'Zombie'... or 'Possessed by pills' -- like I sensed you might be worried about... *If they get control Soon and at a low dose (ask the Dr. what's a low dose for his age and what they might try), then it's conceivable that your Son can move OFF pills later, **with the Doctor, when they have these controlled for a while.
I think? you said before he'd had an MRI? (unless I mixed that up with someone else). If he has and the Dr. found nothing-- an MRI measures 'glitches' inside down to Parts of a millimetre -- Tiny Tiny glitches. If there was nothing found there, his episodes could have other causes -- allergies, puberty, ?? (There's an Issue of Scientific American in 199? or later, entirely on 'The Brain', that has a picture of a 'green brain' on the cover -- so you can find it at a Library, if you want. The Green picture is part of the MRI described in more detail inside the issue. There's not a lot inside the issue about Epilepsy, but they have diagrams of EEGs, MRIs and other tests that have been developed over last 70 years.)
*If there's any statistics gathered on percent of kids who outgrow seizures, they might be either at the http://efa.org website or Julie's Idaho website.
I don't remember seeing your 'diagnosis', but think (for now) you're Scaring yourself before we have a full diagnosis. We know that's Natural, but it could be e.g. a reaction to something else that's happening (an infection, allergy, vaccination or other things that could trigger a reaction)? Others here might show up during the week with other ideas (who have kids being treated). I *think there was a site under a Microsoft? health link for Parents of Kids, but don't have the url. You could try a Google search on something like parents&epilepsy, children&seizures, or something that would pull up messages that you can use. If you try a search on absence seizures (note spelling vs. subject line), or temporal lobe seizures, you're libel to get about 200 posts -- a bunch of them mine !! :-< Skip those ones now (mine), but I think the efa site and Julie's site will pull you up enough information to start with, and you can post here to get clarification of " what does This mean? " And we have had a few people here (over the years) whose kids outgrew the types of seizures they were having. Some things have just changed a little. The world will not end-- we're all here to help. G./
> Could anyone tell me how the distinction is made between absence and > T.L. (complex partial) seizures? How quickly do absence seizures pass [quoted text clipped - 7 lines] > children that may outgrow seizures. We are so new to this and still > have so many questions. pamela in florida - 26 Oct 2004 23:34 GMT Gaross,
I thank you and every one else who has responded to my questions here and in the "is medication always necessary" post. If you all have other lives besides helping people on this board it would be hard to imagine where you find the time to enjoy them.
The doc who prescribed the meds did so based solely on my son's and my report (none of the studies had been carried out yet.) The tests came during the next month and we have not talked to the doctor since, having only nurses to field the questions for him. Besides, he has said in his recommendation that it did not matter to him whether the tests came back normal or not, he would still recommend the meds. He wrote up the diagnosis as simple partial seizures of the temporal lobe as well as complex partial seizures as he has a change in level of consciousness (he has never lost consciousness but talks of feeling deja vu.)
I think that some of my problem with all this is that being in the health care field (I am an O.T. in the school system) I am probably more hyper alert to some of the problems and where other parents might just see a child who is zoned out for a while and leave them alone, I pushed wondering what was happening. I suppose I am wondering if what I could possibly be seeing are absence seizures (because they have been so mild over the two year period) and not something stronger. I quite agree with who ever talked about denial and that it would be wrong to deny the meds if he absolutely needs them, but I am also not convinced that the episodes he is having which still are so mild and infrequent warrant twice daily anti-convulsant therapy. I guess that is where my dilemma lies. I hope I don't sound closed down to medication but rather, questioning and trying to do the right thing for my 14 year old.
By the way there is not epilepsy foundation of america place close by. Thanks for the suggestion to try. I live in Northern Florida.
> Your earlier post (still on my groups messages) said the Dr. had > recommended one of two medications for your 14? year old, then left.... Did [quoted text clipped - 115 lines] > > children that may outgrow seizures. We are so new to this and still > > have so many questions. gaross - 27 Oct 2004 01:27 GMT > Gaross, > I thank you and every one else who has responded to my questions here > and in the "is medication always necessary" post. If you all have > other lives besides helping people on this board it would be hard to > imagine where you find the time to enjoy them. Blame it on the Rain ! :-< Otherwise I would have been out. G.
> The doc who prescribed the meds did so based solely on my son's and my > report (none of the studies had been carried out yet.) The tests came [quoted text clipped - 6 lines] > consciousness (he has never lost consciousness but talks of feeling > deja vu.) ***G* One or two of the websites I sent you addresses for describe seizures with just the Deja Vu (the aura of the *Right Temporal Lobe-based event) as Simple Partial Seizures unless they Generalize or become stronger to point of loss of consciousness. I thought (like you described) that if he's just having the Aura (the Deja Vu sensation), that it IS a seizure event but items of interest to you would be under **Simple Partial Seizures on the charts. While the Absence could be dangerous if he were Driving or operating machinery that required attention, they did not sound? (to a non-Doctor) like a Complex Partial or Grand Mal type seizure. My understanding was that a Full C.P. or Grand Mal seizure ended in Lost Consciousness and not just a return to 'normal' without passing out. Those reference sites should identify that, if I'm incorrect. In that case (if your son is just having Simple Partial events, I don't know anything about the Med. recommended, but if there was a risk of the seizures becoming Stronger if not treated, then they might consider some form of med. If his seizures are as *minor as you indicated here (this message thread), I don't know why they wouldn't try the Oldest, therefore most studied and *cheapest pill to start with for T.L. Seizures like *I first got -- that being Dilantin (Phenytoin? I think is the Pharmacy Med. name). That one, supposedly, had the Least potential side effects and disruption to the patient, *if it would work, and because it's from the 1930s? it's the cheapest to use if it worked. /
> I think that some of my problem with all this is that being in the > health care field (I am an O.T. in the school system) I am probably [quoted text clipped - 13 lines] > By the way there is not epilepsy foundation of america place close by. > Thanks for the suggestion to try. I live in Northern Florida. *G* Based on what you've been given so far and *lack of tests showing more serious side effects or actions related to stronger seizure types, without being a Dr. etc. I tend to agree with you. I'll only leave the 1st paragraph below - Usually (except the sleep deprived EEG) an MRI would show damage down to fractions of a *millimetre inside, which an EEG might miss. It's strange if I understood your earlier post correctly, that they seemed to see something on the EEG but *not on an MRI, and Then decided to move onto medications. Where are the Electrical waves showing up from if there's no Magnetic Image of internal damage of any kind? i.e. what is the cause of the seizures they are trying to treat? G./.
> "gaross" <> wrote in message news: > > Your earlier post (still on my groups messages) said the Dr. had > > recommended one of two medications for your 14? year old, then left.... Did > > he leave a Prescription and a procedure to start them since you won't see > > him again until April? Or did they just tell you the sleep deprived ***EEG
> > shows seizure waves but the ***MRI didn't? then leave ? > > [quoted text clipped - 4 lines] > > he knew those were Simple Partial seizures he might not think those were > > strange to him or not *tell you if he's having them.. :-<
> > So far as I know we all (I think) pass out before the seizures are > > controlled with medications. And most (80%?) of us might have a Simple > > Partial Aura as a Warning that a Big one is coming, OR just the S.P. and > > then it passes without getting worse.
> > An Absence can last from 1-2 seconds to longer, so he could have one for > > e.g. 5 seconds-- and unless you knew what to watch for, you wouldn't see him > > 'drift away' and return, since he'd stay upright and continue writing his > > homework or reading where he left off without any apparent outward sign to you.
> > ******** > > I think? you said before he'd had an MRI? (unless I mixed that up with > > someone else). If he has and the Dr. found nothing-- an MRI measures > > 'glitches' inside down to Parts of a millimetre -- Tiny Tiny glitches. If > > there was nothing found there, his episodes could have other causes -- > > allergies, puberty, ?? <--- I hadn't thought about *puberty when I typed that earlier.
G.- Might be a dead end, but you Could try looking at http://google.com ? I think gets to Google searches -- or Bob or Dave will know the correct address to find Google searches. Try search for seizures&puberty (like that without spaces -- note spelling of seizures). If that's the correct link to google searches, it should say something like "I found 200 articles containing those 2 words, would you like to see the 10 most likely now? " Then you can click downward to next group of 10 until you get more off-topic than you intended on your search. Usually the first 10 or 20 will be the most likely hits whenever I've used that. G./
> > > Could anyone tell me how the distinction is made between absence and > > > T.L. (complex partial) seizures? How quickly do absence seizures pass [quoted text clipped - 7 lines] > > > children that may outgrow seizures. We are so new to this and still > > > have so many questions. gaross - 26 Oct 2004 19:06 GMT > Could anyone tell me how the distinction is made between absence and > T.L. (complex partial) seizures? How quickly do absence seizures pass [quoted text clipped - 7 lines] > children that may outgrow seizures. We are so new to this and still > have so many questions. Here's a Briefer !! reply than earlier one. It's a cut and paste of a post I did about 5 weeks ago that lists about 5 main useful sites you might not have seen. Under the efa.org one it has a Medications Glossary (if you have anything prescribed already), and I think, a Search option where you can enter e.g Complex Partial and then click Search or Go and it will bring up what the Ep. Foundation of America has on that subject. (If you have trouble linking to any of those, use reply to sender and tell me where you had trouble getting to a link. So far as I know these are still all up to date. ) G. ****************************************
Here's an Earlier Post I did that lists about 5 Ep. sites that you might not have seen in the History file. ********** There are a number of sites around the group that get posted from time to time. Some of the symptoms (at bottom) that you might see, might be displayed on one of the First Aid for Seizures Websites below -- likely to first 'seizure' one. If you look down the first aid chart, I think it shows 3 or 4 main types of seizures down one column, then the types of things that can be done. Under the Symptoms or Sensations columns are the types of 'aura' or sensation that might be specific to a particular seizure type. That is usually used by a Doctor at first to identify possible location where the seizure is Launching From. Then further tests (EEG, MRI, CT) might look at more detailed internals.
NOTE - within Julie's Idaho Main website, and on Howdy Dave's there are links to the Ep. Foundation of America that has a Medications Glossary and more detail on specific seizure types that you can search out at your own pace. I also included the one entrance at bottom below. Also some of the minor seizures that don't result in loss of consciousness, might be grouped under either 'absences' (if a person appears to 'zone out' for short periods), or simple partials (that might just include an Aura then a return to normal. *If someone has been having these for a long time, these *might seem like the New Normal for them so they may not be Aware that those are an Aura. OR they might prefer to 'not see them' for what they are. //
Each of the sites can be put on a Bookmark or Favourite so that you can then refer back to see if there are updates without needing to remember the www address each time. hth. G.R. ********** For anyone who hasn't seen these already --> The General Site that Julie operates for Epilepsy Idaho group is at: http://www.epilepsyidaho.org .
The 'First Aid chart' I frequently refer to can be located by entering and wandering about site above, but can be reached direct at http://www.epilepsyidaho.org/seizure.htm . There's a Second topic added, that goes more into First Aid in Water, on Aircraft, etc. It's at http://www.epilepsyidaho.org/seizure2.htm .
Also accessible from top site, but more detail on Learning about Epilepsy can be found at http://www.epilepsyidaho/learn.htm . That one has quite a few more links, information on kids newly diagnosed? (I think) and general questions that others might ask, or those newly diagnosed.
If there's no link there to a Medications Glossary, the Ep. Foundation of America has one (of several) within http://efa.org . G./
Carl Weatherell - 26 Oct 2004 23:45 GMT A few quick and dirty answers;
- The term daydreaming or losing time are good general descriptions of absence seizures. - Absence seizures usually have a fairly specific EEG pattern (I think spikes and polyspike waves at 3-4 Hz) and can occur in the hundreds per day lasting 1-30 seconds. - They can lead to falling down, falling off bikes etc as you simply "lose time". - They can be outgrown by 18. - There are variants of absence seizures such as atypical absence and they can occur with other seizure types.
A good general site in the US is www.epilepsy.com, data specific to absence is http://www.epilepsy.com/epilepsy/seizure_absence.html
Carl ;-)
> Could anyone tell me how the distinction is made between absence and > T.L. (complex partial) seizures? How quickly do absence seizures pass [quoted text clipped - 7 lines] > children that may outgrow seizures. We are so new to this and still > have so many questions. gaross - 27 Oct 2004 01:35 GMT > A few quick and dirty answers; > [quoted text clipped - 13 lines] > > Carl ;-) That site (mauve) has some comments about absence seizures possibly being related to puberty and stopping near age 16? or 18. If your son's as that mild that they don't show on the MRI, perhaps these will be his type. G./
Satch - 28 Oct 2004 07:18 GMT > That site (mauve) has some comments about absence seizures possibly being > related to puberty and stopping near age 16? or 18. If your son's as that > mild that they don't show on the MRI, perhaps these will be his type. Yep, according to statistics most people will outgrown absence type of epilepsy at age 16 / 18 or it will develop into another type of epilepsy. I am a strong believer that epilepsy and its seizures needs to be treated as quickly as possible.
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Marco The Netherlands
Satch - 28 Oct 2004 07:10 GMT > Could anyone tell me how the distinction is made between absence and > T.L. (complex partial) seizures? How quickly do absence seizures pass [quoted text clipped - 7 lines] > children that may outgrow seizures. We are so new to this and still > have so many questions. Hi!
I can certainly help with this as I had absence epilepsy in my childhood and outgrowing it can be very quick. At all times, I outgrown it immediately after taking medications.
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Marco The Netherlands
Satch - 28 Oct 2004 07:16 GMT Hi!
Welcome to our group. There are people from all over the world looking into this newsgroup (I was raised and born in The Netherlands, so sorry for my poor English) and some of them are really frequent posters -meaning they have an awfully lot of experience regarding this topic and yes, we regularly see new posters that just became parents and their baby / child was being diagnosed with epilepsy.
Personally, I am almost 30 years old and when I was a baby I was diagnosed with epilepsy as well. Though my parents can't recall correctly and 29 years
ago epilepsy was not that familiar as it is right now, I had grand-malls type of epilepsy (but it may well be another type of epilepsy -I really don't know). My parents thought it was their end of their world. Luckily, I was diagnosed quickly and a quick treatment was being done. Medications helped and at that time, I had to take: Phenobarbital / Luminal /Alepsal (brand names differ per country so I try to list all of them) and Diphantoine / Dilantin / Phenytoin. These worked quite well and they started discontinuing the medications very quickly. After a couple of years (we cannot recall how long it took to become seizure free /meds free) I was not taking any meds and I was seizure free.
During early childhood, absence type of epilepsy came back (which appears to be normal according to statistics) and they prescribed me Depakote / Depakine / Depakene and again after a couple of years (we cannot recall how long it took to become seizure free /meds free) I became seizure free / meds free. I certainly was seizure free without meds at the age of 15/16 years old. Now, at the age of 29, I am being diagnosed with primary generalized epilepsy because of a combination of having been "binge drinking" since late childhood during weekends only, having lack of sleep and having stress in the beginning of this year before the tonic-clonic seizure occurred in mid February. They presribed me 1000 mg of Depakote ER / Depakine Crono / Depakene ER (brand names vary per country). Right now: with medications I am seizure free and I am not terribly hit by the side effects which is great.
What I am trying to tell here with my small personal history is that it somehow proves that people who have been diagnosed with epilepsy since their earlies can have a good live and yes, epilepsy will have to be part of their live and the live of their relatives. Epilepsy will sometimes affect what they can and what they cannot do. My personal history shows that I "tended to forget" I was diagnosed with epilpsy and wanted to be "normal" -having similar weekend experiences as my friends during late childhood, etc. So I learned from that experience that I need to pay attention to how I feel and not push myself in any way. I also had to accept I am diagnosed with epilepsy and that this is not going away anymore.
So, as I already indicated with my lengthy posting: I am not a parent having a child that is just being diagnosed with epilepsy but I may still be able to share some suggestions with you.In your situation and at this point, try to get as much as information as you can so that you know what the neurologist is talking about, ask as many questions as you can think of in this support group or contact your local Epilepsy Foundation.
For example, here are a couple of URLs: http://www.epilepsyfoundation.org http://www.epilepsy.com/
It all depends on in what country/city/state you are located on of course, but most countries do have a local Epilepsy Foundation.
You may also want to become a member of http://home.ease.lsoft.com/archives/epilepsy-l.html which is an E-mail based / Website based community. I posted a couple of questions and some Medical Doctors working for huge epilepsy centers in the US responded to me directly using my personal E-mail address regarding specifc questions I had in regards to my personal diagnoses. It is not a rule of thumb that they respond to every question but in my case, they responded which was great.
So, you already found this support group: that is a very good place to start with as well.
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Marco The Netherlands
Dave ???? - 28 Oct 2004 22:03 GMT Howdy!
The simplest answer that I can give is that
Absance seizures refers to what type of seizure you have.
Temporal lobe seizures refers to where the epileptic activity is located in the brain.
 Signature Dave ????
http://www.howdydave.com
> Could anyone tell me how the distinction is made between absence and > T.L. (complex partial) seizures? How quickly do absence seizures pass [quoted text clipped - 7 lines] > children that may outgrow seizures. We are so new to this and still > have so many questions. pamela in florida - 29 Oct 2004 10:53 GMT So if the EEG says the activity is in the Occipital Lobe is that different from a temporal lobe seizure with different symptoms? Can you have an absense seizure where the activity is occuring in any lobe? Would that require different meds? The neurologist didn't have the reports (2 EEGs 1-Normal and all night sleep deprived-abnormal and 1 MRI-normal)when he made suggested the meds. Has anyone gotten a neurologist to go back on the initial meds recommended and try something else. My son already has speech problems (stammering) and both Trileptal and Topomax seem to have language associated problems.
Thanks, Pamela
"Dave ©¿©¬" <dave@_nospam_howdydave.com> wrote in message news:<d4dgd.959$Qz4.134@news02.roc.ny>...
> Howdy! > [quoted text clipped - 16 lines] > > children that may outgrow seizures. We are so new to this and still > > have so many questions. Carl Weatherell - 01 Nov 2004 12:26 GMT Absence or other similar seizures can show EEG activiy in the occipital lobe. One of the best combinations for absence seizures is Valproic Acid (Depakote, Depakene) and Ethosuccimide).
cj ;-)
> So if the EEG says the activity is in the Occipital Lobe is that > different from a temporal lobe seizure with different symptoms? Can [quoted text clipped - 30 lines] >> > children that may outgrow seizures. We are so new to this and still >> > have so many questions. gaross - 01 Nov 2004 17:20 GMT Most newer medications are targeted for the particular seizure type or area of the brain. Your combination for your absence is Valporic and Ethosuccimide. I had absences (simple partial) seizures as control was reached for Complex Partial (Temporal Lobe) seizures, and medications used were Tegretol CR and Frisium. The particular medications that would (might) work would be selected by the Dr. based on the area where the seizure starts, and details of the particular patient (based on EEGs, MRIs and symptoms). We can offer samples or suggestions, but what works for one of us won't necessarily work for another. MANY of the symptoms though can be the same -- Memory loss, disorientation, tastes or aromas that aren't there, that might precede a stronger szr. or leave on their own. As I got closer to full control those latter bothered me more, since I wasn't 100% sure my pills would control the seizure from progressing. After a few **didn't I started to fully trust the dose level and control I had achieved. Adjusting and tinkering only took ~4 years plus or minus. Some here have achieved control in less than 1-2 years. We're each different (i.e. unique ) or we'd be Boring ... G./
> Absence or other similar seizures can show EEG activiy in the occipital > lobe. One of the best combinations for absence seizures is Valproic Acid [quoted text clipped - 20 lines] > >> > >> Temporal lobe seizures refers to where the epileptic activity is located in the brain.
> >> -- > >> Dave ???? [quoted text clipped - 11 lines] > >> > children that may outgrow seizures. We are so new to this and still > >> > have so many questions.
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