Is there such thing as "partial generalization" of a seizure?

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masterjen

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Does a tonic-clonic seizure imply both sides of the body are being affected more or less equally? If the answer to this is no, would what is happening be called "partial generalization" of the seizure, and could this explain why some people do not lose consciousness during what otherwise appears to be a tonic-clonic seizure?
 
While it seems unclear, tonic clonic generally implies both sides/loss of consciousness. Most would describe a hemispherical seizure as a partial seizure that started or spread to a part of the brain with motor functions, such as the frontal lobe. Indeed, hemispherical twitching is a common kind of frontal lobe seizure. It could also be a psychogenic (psychological) seizure.
 
I've never heard of "partial generalization". ( i tried googling it too and couldn't find anything). I have however heard of partial seizures becoming secondarily generalized (meaning a partial seizure turns into a TC).
I believe a tonic clonic that only happens on one side of the body would be a hemiclonic seizure
 
Someone brought up a question a while ago, asking if it is possible to remain conscious during a tonic-clonic, and that interested me so I've been trying to determine how this could happen. That's what led to my made-up term partial generalization.
So, if a seizure affects a limited part of the body, and has mainly tonic but some clonic characteristics, it would still be considered a partial seizure in spite of similarities to a tonic-clonic for how the affected body areas are behaving . . . is that right?
 
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masterjen said:
Someone brought up a question a while ago, asking if it is possible to remain conscious during a tonic-clonic, and that interested me so I've been trying to determine how this could happen. That's what led to my made-up term partial generalization.
So, if a seizure affects a limited part of the body, and has mainly tonic but some clonic characteristics, it would still be considered a partial seizure in spite of similarities to a tonic-clonic for how the affected body areas are behaving . . . is that right?
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Can you give an example of what kind of seizure you mean? (Like symptom wise-only one sided body jerking, consciousness level etc). I would think that if the person has preserved consciousness it has to be some kind of simple partial seizure, because generalized seizures, and complex partials all impair consciousness

The sixth video down in this link shows a little girl having a one sided clonic seizure but definitely no preserved consciousness http://www.ice-epilepsy.org/identifying-seizures.html
 
Partial seizures often have tonic or clonic components or both. This is why there is no such thing as a partially generalized seizure. If conscious, it is a simple partial seizure. I have had hemiclonic seizures that begin with a tonic movement. In some cases, the clonus can affect both sides of the body but still be conscious.

But I must say the way seizures are labelled is not perfect, a bit abstract imo
 
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Thanks for the videos, chmmr. If it wasn't labeled, I'd have called the video of a clonic seizure "tonic", if nothing else because of the posturing of the legs and the seeming stiffening of the upper body on the one side. Was expecting more obvious jerking. And wouldn't you know it - the video of the tonic seizure says "no longer available"!
Based on the video of the clonic, this is exactly what I was meaning by partial generalization - so hemiclonic is the correct term. Thanks kevin.
Chmmr - thank you for the helpful video. I have yet to have a video EEG, and my seizures are at night. Based on descriptions given to the neurologist, she is suspecting nocturnal tonic, but after seeing the video on here I am wondering if clonic might be one I have as well. I say this because I have them in my sleep and when I have one I'll vaguely waken for a brief moment, aware it is happening and seem to fall asleep again and waken for a brief moment again . . . in those moments I gather a snapshot in time of what I'm experiencing and then I fall asleep again until the next moment. I don't know if I'm able to fall asleep because I'm so tired or what but I am often amazed that I can sleep through something happening like this.
 
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I would think maybe you aren't sleeping but actually drifting in and out of levels of consciousness? I hope they get you a video eeg soon And figure it out!!
 
Thanks, chmmr, I hope it is soon, too. Where I am it takes an average of 2 years to get in for a video EEG. It has now been 18 months, so I'm on the countdown.
 
I think you are right that the clonus is weaker when it's not a generalized seizure. It's usually not enough to cause muscle pain. And it sounds like the video had tonic components as well.

Good luck with the EEG! That is a long time to have to wait so I hope they get you some answers.
 
Thanks chmmr and kevin. I live in Canada, specifically B.C. The province has a population of 4.6 million (est. 40,000 with epilepsy), and only 2 beds for video EEG. Kind of makes you "laugh" doesn't it? Someone else posted in another thread about having her 6th vEEG, and I nearly choked!! Mind you, Canada's medical system has a lot of pluses in many ways, so I try not to complain.

I hope to get some answers, too. Thanks chmmr and kevin for your good wishes!
 
Oh funny Jen, I'm in BC too. Are you northern bc? I'm in the okanagan. I'm guessing by video EEG you mean long term? I have beds for overnight eegs right at our local hospital. I also had to take my daughter for one 5 day EEG at BCCH but the wait was much shorter ( 3 months ish). You're right there are so many perks but some if the frustrations are crazy. I need a repeat MRI for my daughter and we were going to do it here to avoid the long waits at BCCH but I just heard from a friend that local sedated MRI's have been on hold since May due to funding shortages I have to talk to our pediatrician this week and make a plan.
 
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That is funny, chmmr! I'm from the Lower Mainland!! Yes, you're right. The long wait is for a long-term video EEG. I have had an overnight at a local hospital but it was a "joke" (sorry to be sarcastic). The room was freezing and because it was also a sleep study I had all the clumsy gear on they use to check for sleep apnea, so I couldn't get to sleep for a long time. Then around 3 AM I pushed the buzzer so I could get the main cord unhooked to go to the bathroom, but after I don't know how many presses between 3 and 6 no one came so my sleep during that time was fitful. Then 6 was when I was told time to go home. No seizures that night, but the next night (back at home) I had a nasty cluster of them. Figures, doesn't it?! The only thing they learned was that during the test there was no evidence of sleep apnea.

I'm so glad your daughter didn't have to wait long at BCCH. How many beds do they have??
 
That sucks. Yes ours are sleep monitoring beds too. I think BCCH has two dedicated monitoring rooms on the neuro ward. Or maybe it's just 1. I can't remember. Everything else at BCCH seems to be a crazy long wait though. Sad more can't be done locally.
 
I agree about more needing to be done locally, especially for someone such as yourself having to travel several hours to get to Vancouver. What would be great is if a few centers opened that were fully qualified to do the testing, a couple in the Ok. region, one further north, one on Van Island and then a couple in the lower mainland. What can I say?! I like to dream . . .
 
masterjen said:
I agree about more needing to be done locally, especially for someone such as yourself having to travel several hours to get to Vancouver. What would be great is if a few centers opened that were fully qualified to do the testing, a couple in the Ok. region, one further north, one on Van Island and then a couple in the lower mainland. What can I say?! I like to dream . . .
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That's a great idea. If only we ran the world huh.........
 
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