Can Types of Auras Determine Location of a Seizure Focus?

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PFunk

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I'm sure there is already a thread on this (Nak, oh keeper of knowledge, if you know of any, please post a link :))

Has any ones doctor been able to determine your seizure focus (if you have one) by the type of auras you have?... or at least what lobe your E stems from? (this can be in addition to an MRI or EEG) I know my simple partials metastasise to other parts of the brain and can send me into a TC (I have TLE). The reason I ask is, while I have all types of auras my brain likes to settle on three main ones. Deja Vue, Depersonalization, and Olfactory Hallucination. The latter is today's pick of the week.
 
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I've had neurologists speculate on where they think the seizures are coming from based on my symptoms, but they have all told me they would have to do a lot of testing to be really sure. Most neurologists agree that mine very likely are coming from the Temporal Lobe, but I had one neurologist tell me he thinks they could be spreading into other lobes.
 
This is an interesting question. I would like to see the answer you get.
 
I will add, though, that I do not have auras like the ones you describe. My seizures are all pain and motor, including the auras. I don't get deja vu at all. I get lots of pain, everything sounds like it's coming from far away and originating from a tin can, and then I get a black out that closes in over my eyes, and then I'm out. The only generalized seizures I've ever had have been drop attacks. Everything else has been partial.
 
My seizures are all pain and motor.

When you say pain, do you mean during the seizure or when your postictal. That sounds horrible!

If I'm going to have a tonic clonic, my simple partial will intensify until I start to feel a black void sucking me in. Sometimes I can fight it, other times, no such luck. During its onset does your "black out" feel similar to what I described.

Random fact I'm sure a bunch of people wit E know. (In Alice In Wonderland) Lewis Caroll had Alice fall into the rabbit hole as it was a simile of his epilepsy. That was one of his many metaphors to epilepsy in the book.
 
I have always found it fascinating how many creative people in history had epilepsy or are presumed to have had it. There really does seem to be a link there. I have been interested in illustrating my whole life, and pursued self educated (that is, non-institutional education) art techniques for many years. I also enjoy writing and other creative outlets. This seems to be very common in people with Epilepsy. I wonder why that is.

The pain is not post-ictal, it is during the simple partial stage. Sometimes the SPs develop into CPs, but sometimes they are just simples. But they start with a crawly feeling inside my brain, like my brain is full of bugs. Then it moves down into my teeth. I've always described it as feeling like someone is going at my teeth with sand paper, hence the severe tooth pain. Then at that point, the fire-like heat pain starts in my feet and moves up my legs and basically sorta takes over. When it develops into a CP, I get the blackout. I don't so much feel like I am being sucked in, but it feels almost like I am disappearing, if that makes sense. I obviously don't remember anything during the CP, but when I come to, I can remember everything that happened other than the unconscious state. My post-ictal phase is really just a couple minutes of mild confusion and slow mental function, as well as tiredness and listlessness.
 
I also am sometimes able to fight it if I sit down/lay down and concentrate. Sometimes it also helps to talk to myself and try to keep myself connected to reality. But sometimes, there is no stopping it, no matter the effort. I used to recite the alphabet when I was in a SP, to try to prevent the CP. It worked about 65% of the time. But when seizure control is poor, I have no control, no matter what kind of effort I put in.
 
I also have temporal lobe E and mine stem from the left side. They would usually start as CP with a feeling of just fading away. My family says I just stare into outer space and I don't understand nor hear a word that is said to me. It usually last a minute or two. The post-ictal period is usually 10-15 minutes for me. But, if I go into a tonic/clonic, my aura is much more intense. I get this terrible gloom & doom sensation, my world starts going into slow motion, like in the movies, and then I start hearing voices softly that get SO loud I cannot stand it...... then I'm gone. I don't remember what happens until hours later.

Here is a good link on the subject: www.epilepsy.com/epilepsy/auras
 
This seems to be very common in people with Epilepsy. I wonder why that is.

There are a bunch of theories regarding creativity and epilepsy. That the way continued seizures can effect your brain or the fact that one lobe has to over compensate for the other, thus strengthen it. There is actually a lot of interesting literature behind this... it's been a while since I have read it though. On the plus side, this seems to be about the only good thing to come from having E. :) Also look up hypagraphia and geschwind syndrome.

Your simple partials sound terrible, I'm so sorry you have to endure that!

I used to recite the alphabet.

Reciting the alphabet, I'll have to try that. I just try to concentrate on not giving in to the darkness, while simultaneously trying to get down on the floor.
 
I have left temporal lobe that sometimes generalize but I was wondering if anyone gets a pressure in their head like they are yawning (is the best way I can describe it) before they have a partial seizure. After this feeling my environment seems strange and unfamiliar, then I feel a rush in my chest. I can hear my coworker or family in the background but I can't interact with them because I have to wait it out. I can't put the words together and just can't think, write etc. I am after hanging up on people in the middle of a conversation because I didn't know why I was talking to them or what they are talking about. I just can't respond. And again I kinda hear them in the distance as I am so wrapped up in this sensation; trying to reason what is happening to me...where I am and what am I doing here. Then I get sick to my stomach the don't want to eat and feel so drained and weak and kinda feel emotional because I hate what happens to me. But at least I am not having a Grand Mal. I had to laugh when Jemsister said her brain was full of bugs because I feel like I have live wires shocking my head every 2 seconds. Bing! Ouch. Bing! Ouch. It's such a horrible feeling...and when you get the bigger seizures it's a real workout with sore arms, tongue, and memory lost for a period of time. But I haven't had any big ones for a couple of months now which is awesome as I had those in my sleep or upon waking! Real spiritual feeling with the grand mals. Oh, and I am very artistic too!
 
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Electra, bleh, that sounds awful! =( I don't have the unfamiliar feeling, but I have heard of that as a seizure symptom. I can definitely relate to things sounding far away. I am lucky to have never had a GM seizure, but my neurologist tells me not to be surprised if I do. Hoping I don't though!
 
Many types of auras can correlate to certain areas of the brain, or a particular seizure focus. Below is a list of some of the known correlations. In general, auras of all kinds are associated with temporal and parietal-occipital lobe epilepsy. Keep in mind that it is a far from exact science, and regions of the brain that are close to one another can produce similar or overlapping symptoms.

1. Auras of all kinds are associated with temporal and parietal-occipital lobe epilepsy.

2. Somatosensory auras (tingling, numbness, electric sensations, etc) that occur on one side of the body tend to originate from the primary somatosensory area (located in the parietal lobe) in the opposite part of the brain. If they originate in the secondary sensory area (also in the parietal lobe but in a different part of it), these auras will show up on the same side of the body as the focus, or on both sides of the body. Somatosensory auras that evolve to include motor symptoms are associated with the perirolandic (mid-temporal) area of the brain. Somatosensory illusions (such as swelling, shrinking, and moving of body parts) tend to be associated with inferior parietal lobe on a person's non-dominant side.

3. Visual auras: Simple visual auras (flashing or moving lights, etc.) can arise from stimulation of the primary visual cortex. Complex visual auras (hallucinations/illusions) are associated with the junction between the temporal and occipital lobes, or the base of the temporal cortex. Blurry vision tends to be related to certain areas of the parietal lobe. One-sided visual auras tend to originate in the occipital lobe of the opposite side of the brain. Visual distortions like after-images, Alice-in-Wonderland syndrome, etc. can be connected to the pathway that connects the thalamus to the visual cortex.

4. Auditory auras: Simple ringing and buzzing = primary auditory cortex. Complex auditory hallucinations (voices, music) are produce by activation of auditory areas of the temporal-occipital cortex.

5. Vertigo/horizon shifts: Usually associated with visual and auditory areas of the temporal-parietal junction.

6. Olfactory auras: Associated with the amygdala, olfactory bulb, and the insular cortex (an area between the temporal and frontal lobes). Related taste auras can be connected to particular areas of the parietal and temporal lobes.

7. Autonomic auras (rapid heartbeat, shortness of breath, nausea and other stomach sensations, urinary urges, feelings of warmth or cold): Associated with regions connecting the frontal and temporal lobes, as well as the amygdala and the supplementary sensorimotor area of the brain. Abdominal auras are highly associated with temporal lobe epilepsy, especially when they evolve to include motor symptoms. When they occur with vomiting, they point to the non-dominant temporal lobe. Orgasmic auras are associated with the parasagittal region (near the center top of the brain).

8. Psychic auras (fear, anxiety, elation, sense of doom, deja and jamais vu, flashbacks): Associated with the temporal neocortex. Forced thoughts = frontal lobe. Fear = amygdala, hippocampus, middle frontal region, or temporal neocortex. Pleasant auras = middle lower temporal area. Out-of-body sensations arise from the temporo-parietal junction.

That's a start -- you get the idea. There are additional connections to be found between simple and complex motor seizures and particular regions of the brain. Certain kinds of speech and language disturbances that show up during complex seizures are linked to the non-dominant temporal lobe. Post-seizure aphasia is linked to the dominant temporal lobe. Most of these connections can be helpful when the neurologist is trying narrow down a focus during a pre-surgical evaluation -- for example distinguishing temporal lobe epilepsy (narrow focus) from temporal-plus epilepsies (broader focus).

Hope this helps!
 
Ok... so it's Somatosensory, Autonomic auras, Psychic auras mushed into one lovely aura package. I have migraines too but those auras are totally different, I just lose my sight for 20 minutes and have a little headache. Since taking Lamotrigne for the seizures I don't get migraines which is wonderful and I can communicate with people. Nakamova, your my online resource person, you know so much, thanks for the info. But why do I have experience it...I don't like it. Makes me feel like I am loony tunes.
 
So this is my next question. What is the difference between those who consistently have the same aura verses those who have many different auras?

I would think the former would be the norm, (especially over time) as kindling carves a consistent path through the neural network.

I started having auras as a kid and 20+ years later I still get many different types. One would think I'd have already established my path of excitable neurons and would get only one or two consistent auras. That is not the case. In addition to some of the auras I described above, my brain might settle on language based auras. Where words in my internal monologue pop out, exploded, trip and stutter, become other words etc... or random memories keep surfacing, or maybe its a visual aura where pin pricks of color flashing for a moment. (I have described these in greater detail on some other reads so sorry to some of you for the reread).

What are the differences that cause a randomized path of misfiring neurons in one person and a consistent path of misfiring neurons in another. (I know this is a big question most likely doesn't have an answer at this time.. like most things in epilepsy.)
 
they don't know where or why. they can only tell me its possible because of scar tissue. I personaly think they are starting to spread.

I get the following: (excuse my terminology)

*disconnected (hate this one)
*slidding (like falling sensation)
*objects appear closer
*lights and holes with light
*reved up and charged
*unplugged , want to move but can't (hate this one)
*stomach ache and nausea (hate this one)
*amonia and lavender or other spells
*muscle twitches
*numbness of lips
*heavy heavy day dreams
*agitated and agressive
*constant stretching and yawning
*depth preception (hate this one)
*color shapes
*startle easily (hate this one)
*muscle cramps (legs/toes forearms/fingers)

thankfully not all at the same time. I can't tell postical? from aura?
I can only tell when its all over. The episodes last anywhere from a few seconds to an hour (so it seems).

Neuro suggested right temporal lobe, but like most of you, need more testing. I have 2 eeg's and only one came back with a hint of activity.

They're getting worse and I am praying for strength to take the keppra or lamictal, I have them both. But guys, Im so affraid and I can't bring myself to take either. I did take a keppra once, I felt great! I mean, I felt like my REAL self! Then I bottomed out 5 hours later, slept for 16 hours and havent taken it since. I was given 500 mg, I thought about just trying half since the tablet is scored for cutting?

Since I have a few days off this week, I think I am going to try it. My fear? well my fear is Im alone 99% of the time. I scared something will happen and no one will know. I Dont Want to Die, not now anyways
 
Hi maryltyme, I was on keppra and lamictal for many years, after my first 250mg of keppra I slept for 20hrs, after that initial hurdle it all went very well until other side effects stated showing up. So I wouldn't be frightened with the sleep thing your body needs to adjust. I would watch your mood as it made me very depressed and angry also it gave me very bad daytime fatigue, but as we all know if effects everyone differently an this is just my experience, I hope it works out for you! :) I also have more than one aura but have Epilespy in the frontal lobe yet I get temporal love symptoms it's all very weird!
 
Hi maryltyme --

I think it's worth it for you to try the meds. Often there is an adjustment period -- they are powerful medications -- but after that, many of the side effects can lessen or go away. And untreated seizures run the risk of spreading or escalating. If you're concerned about the dose, ask your doctor if there is a smaller dose available, or if you can cut the med in half. Once you start taking the med, it's important to be consistent in taking it in order for it to work. You don't want to stop and start abruptly -- that can make symptoms worse. The med process is often trial-and-error, but the payoff can be in better seizure control. That's a worthwhile goal.
 
I was on keppra and lamictal for many Epilespy in the frontal lobe yet I get temporal love symptoms it's all very weird!

thank you so very much for encouragement. I probably should have kept taking it inspite. Fear beats the crap out of me! I will post if i do in fact start taking it again. I put a call into neuro dr about cutting in half, waiting for a call back.

what is "temporal love symptoms? I never heard of that one.
 
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