2025 – PAGE 404 – NEUROLOGY

SEIZURE TERMINOLOGY

Below are simplified definitions of common seizure terminology.

• PARTIAL SEIZURE: It’s focal in location.
  • MNEMONIC: PARTial = PART of the body.
    • SIMPLE PARTIAL SEIZURE: The patient is conscious.
    • COMPLEX PARTIAL SEIZURE: The patient is unconscious.
• GENERALIZED SEIZURE: It’s non-focal (generalized) in its location, involves both sides of the brain, and results in the loss of consciousness.

SIMPLE PARTIAL SEIZURES

In simple partial seizures, patients are awake and conscious. These often include motor activity of the arms or face and frequently occur as a child is going to, or coming out of, sleep. These can also be sensory in nature and might “march,” or go, from one location to another part of the body. Treatment is not always offered since these often resolve in adolescence.

COMPLEX PARTIAL SEIZURES

In complex partial seizures, patients are unconscious and have a focal seizure. These occur more often during the day.

MNEMONIC: It kind of sucks that the complex seizure which makes you unconscious happens to occur when you’re not near your bed!

BENIGN CHILDHOOD EPILEPSY WITH CENTROTEMPORAL SPIKES (AKA BECTS, BCECTS, BENIGN EPILEPSY OF CHILDHOOD, BENIGN ROLANDIC EPILEPSY)

Benign epilepsy of childhood with centrotemporal spikes (Benign Rolandic Epilepsy) is the most common form of epilepsy in children. The characteristic EEG feature, centrotemporal spikes, has an autosomal dominant inheritance pattern, though inheritance of the seizure disorder itself is less clear. There are facial motor symptoms with sensory involvement of the tongue. Seizures usually occur at night while the child is sleeping. The seizures are “simple,” so when they occasionally occur during wakefulness, patients are conscious but unable to talk. About half of affected children experience episodes of secondary generalized tonic-clonic seizures. Children with BECTS should be assessed for learning disabilities. If BECTS is treated, carbamazepine or other common anti-seizure drugs are typically used.

MNEMONIC: Imagine a child named BECT being UNABLE to talk because he is ROLling his FACE and TONGUE into a pillow. (ROLling = Rolandic. Pillow = Usually at night.)

IMAGE: (VIDEO) www.pbrlinks.com/BENIGNEPILEPSY1

JUVENILE MYOCLONIC EPILEPSY

Juvenile myoclonic epilepsy, which usually starts in adolescence, is one of the more common forms of generalized epilepsy. Nearly all affected kids have some level of myoclonus of the upper extremities, usually soon after awakening. The classic presentation is a teen that keeps knocking over or dropping her orange juice or dropping the soap in the shower. Most will also have GTCS, and a minority have absence seizures, sometimes starting years before the onset of myoclonus and/or GTCS. Valproic acid is the preferred treatment, and most of those affected will require lifelong treatment.