Ever heard of Sub-Clinical seizures?

[Dignan]

I heard something about a possible cause of side effects I am having as being the result of "sub-clinical" seizure activity. Now, this was pure speculation mind you, but I thought I'd see if any of you guys had heard of this?

The person I was speaking to is a doc, though not mine, and we were discussing some side effects I had experienced after tapering off of dilantin some years ago.

He was wondering if I might have been having some type of seizure related activity that was so mild as for me not to otherwise notice (not my typical seizure symptoms, partial or general) other than what I thought at the time was simply side effects or feeling funny from tapering off the drug. I'd never heard of such a thing, and was thinking, how in the world do you protect against sub-clinical activity, if that even exists or was even the case.

I mean, if it doesn't impair you, or act like your typical aura, partial, or generalized seizure, or show any other typical outward signs, then how in the world do you know you would be having such activity unless you just walked around with a permanent EEG on your head?

I don't think that is what was going on, but I wanted to see if anyone had heard of such a thing.

 

[masterjen]

Generally, anything "sub-clinical" implies that the disease/virus/physical condition is not detectable by clinical means (eg. physical exam) and is not noticed by the person himself. A common incidence in which this is encountered is someone with sub-clinical cerebral palsy. The person does not notice it, and a general physical exam does not pick up on, but the brain shows damage in the area of the cerebellum that indicates the person does have cerebral palsy (a highly specific physical exam usually shows it but not just a general exam an infant or young child might receive in screening for cerebral palsy.

Extrapolating from this description to apply it to seizures, I would wonder if an example could be in the case of someone who does not experience auras and yet a continuous EEG might show the start of, or increase in, abnormal brainwaves some time before the actual seizure takes place.

 

[chmmr]

Our pediatrician feels strongly that my daughter has some sub clinical seizure activity. She has some things going on from time to time that could be attributable to other more normal things in kids, but there are a few different reasons that we think she has sub clinical seizure activity.
The way it was explained to me is that basically there are the electrical misfires, but that you don't necessarily notice the results-it could be language based, or some other minor symptom ( a brief space out etc). Basically it's not enough to through you into a full fledged obvious seizure (in our case complex partials) but enough that there is activity that is affecting her in some way.
Clear as mud? lol

 

[Cint]

Extrapolating from this description to apply it to seizures, I would wonder if an example could be in the case of someone who does not experience auras and yet a continuous EEG might show the start of, or increase in, abnormal brainwaves some time before the actual seizure takes place.

According to this definition of a subclinical seizure from Wikipedia, I would say that these would show up on the EEG even for a person who doesn't experience an aura.

A Subclinical seizure is a type of seizure often experienced by people with epilepsy, in which an EEG trace will show abnormal brain activity, usually for a short duration of time but which does not present any noticeable clinical signs or symptoms. This is often manifest as a single spike on the EEG trace or a slowing of brain activity not correlating to their level of consciousness or awareness. Subclinical seizures can be useful to a neurologist in the diagnosis of epilepsy.

 

[masterjen]

Made a correction to my post above. I used the abbreviation "c p" for cerebral palsy, and didn't realize it would automatically come out as complex partial. Sorry for any confusion.

 

[Dignan]

Could something like dizziness be a sign of sub-clinical activity? This is very confusing. If you are taking your pills like you normally do, and have thought that dizziness is likely drug related, how would you know if it just the "trace abnormal brain activity, usually for a short duration of time but which does not present any noticeable clinical signs or symptoms" (as defined by wikipedia) or if it truly is just a side effect of drugs?

Also, if someone is having sub-clinical activity, does that mean they need more medication? Or, can the sub-clinical activity, if unchecked lead to brain injury or cognitive problems?

 

[MAB]

Does anyone else seems to see possible seizure activity in any unusual symptom, or is it just me? For the last 2 weeks it's like, gee, my nose is runny but I don't have a cold and I hasn't been crying, wonder if that's related. It's like I question every little thing and I'm sure most of it isn't related to seizures but I have been having partial seizures for a long time and didn't have a clue. I hope this makes sense.

 

[arnie]

I have been giving subclinical szs a lot of thought in the past few months. I have several hundred simple partials per year, which are very obvious, but I also get the occasional "gasp" or a need to swallow, or some little twinge of something that I don't count as a simple partial but that seems to be something. My neuro said that those indicate seizure activity and are almost "subclinical" and that I probably have many more that I don't notice at all but that might show up on a continuous eeg. It's hard to find answers on exactly what kind of long-term damage can occur with such szs, but I don't think it can be good. I've had pretty bad luck getting good control of my simple partials with meds, and I'm on the verge of talking with my neuro about VNS.

 

[MAB]

What is VNS?

 

[arnie]

VNS is vagus nerve stimulation. You can get lots of info by googling it, but in a nutshell it involves implanting a device sort of like a pacemaker into your upper chest wall. That device sends an electrical current to the vagus nerve, which runs to your brain. The electricity apparently can help inhibit seizure activity. It's used mostly when meds are not able to give good seizure control.