American Medical Association Family Medical Guide - American Medical Association [429]
Complex partial seizure
A person who has a complex partial seizure usually experiences an aura that lasts just a few seconds. He or she appears unaware and performs involuntary behaviors such as laughing for no apparent reason, speaking nonsensically, walking in circles, or smacking his or her lips. He or she may also lose consciousness. The person is not aware of the seizure as it occurs and does not recall it afterward. After a complex partial seizure, the person may sometimes feel detached from reality, be confused, or have memory problems.
Diagnosis
To diagnose epilepsy, a doctor performs a complete neurological examination that includes tests to evaluate the functioning of the nervous system, such as vision, reflexes, hearing, sensation, movement, and balance and coordination. The doctor will identify the type of seizure the person is having, usually by evaluating information provided by people who have witnessed the seizures. Sometimes video monitoring of epileptic seizures can help the doctor diagnose the type of seizure the person is having and determine the best course of treatment.
Electroencephalogram
In an electroencephalogram (EEG), electrodes are attached to the scalp to record electrical impulses from different areas of the brain using a device called an electroencephalograph, which records the impulses as a wave pattern on a moving strip of paper or on a computer screen. An EEG is used to diagnose brain disorders such as epilepsy.
The doctor will order an electroencephalogram (see below left), an examination of the electrical activity of the brain. He or she may also order a CT scan (see page 112) or an MRI (see page 113) of the brain to help rule out other possible causes of the seizures, such as a brain tumor. To check for an infection, the doctor may order blood tests or, in some cases, a lumbar puncture (see page 693), in which a hollow needle is inserted into the spine and a sample of cerebrospinal fluid is withdrawn and examined under a microscope.
Helping a Person Who Is Having a Seizure
The most important thing to do for someone who is having a seizure is to make sure that he or she is not injured. During a grand mal seizure, a person will begin to twitch or jerk and may fall to the ground. If a person is having a seizure:
• Do not panic.
• Do not attempt to move the person unless he or she is in immediate danger.
• Do not hold or attempt to restrain the person.
• Do not put your finger or another object in the person’s mouth because he or she may bite down on it. (It is not possible for a person to swallow his or her tongue.)
• Move large or sharp objects out of the person’s way.
• After the seizure, turn the person on his or her side and turn his or her head to one side to prevent choking on vomit. Loosen the person’s collar and try to pull the jaw forward and extend the neck so he or she can breathe easily. Make sure that the person’s airway is not blocked by food, chewing gum, dental devices, or vomit.
• Call 911 or your local emergency number if a seizure continues for more than about 5 minutes, if this is the person’s first seizure, or if another seizure starts a few minutes after the first seizure ends.
• After the person regains consciousness, call a doctor or take the person to the nearest hospital emergency department.
Treatment
Epilepsy usually cannot be cured. A doctor prescribes antiseizure drugs such as carbamazepine, phenytoin, or valproic acid to help prevent or control seizures. With the help of medication, most people who have epilepsy can live an active, productive life. Your doctor will tell you how to obtain an identification bracelet, pendant, or card that indicates you have epilepsy.