Simple partial seizures and being engaged in activity

[greylostoffice]

My seizures are supposedly simple partial that generalize into atonic. I just had one today after a change in meds. Basically, I was in the car (as a passenger, not driving) and I started having what I believe to be an aura. I was just diagnosed like 2 months ago so I'm not really sure yet. But I started not being able to focus on anything, feeling really dizzy, lightheaded and weak. Then, I start having kind of an out of body dream-like experience, obviously a feeling that is really hard to describe, kind of like I am floating? I also feel jolts of "buzzing" in my left hand, and it opens and closes. This whole time I am kind of in and out of consciousness, like sometimes I am able to open my eyes and somewhat see what is going on around me, but I am not really aware of it, and then I am out again. Once I come to, I can remember what happened when I was "awake" with my eyes open, but I can't remember losing consciousness. Sometimes, if I am not leaning back like I was today in the car, my head will drop. I think this is where the atonic part comes in? I'm not sure. This happens several times within a time span of 5-10 minutes. Does anyone else have seizures like these? I can't tell where the "simple" and "complex" parts come in and when it actually generalizes. Can anyone explain this to me or do I just have some weird, unexplainable type of seizure? I have never heard of anyone else having seizures that kind of go in and out of consciousness.

And one more question - I have had about 5 seizures, and all of them have happened when I have been "idle" - in other words, none of them have happened when I am really engaged in activities. They have all been when I am just sitting/standing around, riding in the car (not driving), or walking around a store or whatever. Never have I felt even close to having a seizure when I am driving, engaged in an activity, or paying close attention to something. Is there any explanation to this or is it just coincidence? I would like to know because then I wouldn't be so afraid of driving...

Thanks for any insight you can give me! I know these questions are difficult to answer but, again, I am in the midst of trying to find a new neuro so I don't really have anyone to ask.

 

[kirsten]

If you can come up with an estimate of how much time in each day you spend idle/sitting or lying down, you might be able to answer your question. As someone who works seated for eight hours a day and sleeps for eight hours a day, I have had a lot of complex partials while seated or lying down. The reason is that the probability is high given that two thirds of my day are not spent standing. I tend not to have tonic clonics in those positions because I typically stand up right as I start having them.

Maybe you are going in and out of consciousness because you are having seizures back to back with post ictal stages in between. After tonic clonics, I come in and out of consciousness, and when that has happened, I have always had epileptic activity going on after the tcs. That has been very easy to confirm with EEGs.

 

[arnie]

A partial answer to your complex question is that it is not simple to generalize about seizures. (Sorry for the bad puns. I'm not sure where that all came from, but it seemed like the right way to start this post!)

Seriously, though, I think that seizures can be unpredictable and can probably change in quality over time. I also think that there can be a continuum with partial seizures; the simple and complex can sort of melt into and overlap with each other.
As for the activity part, in my experience I have had seizures at every possible activity level: asleep, riding a bicycle, running, driving, riding a motorcycle, getting a massage, eating, working, talking to customers, fixing a bicycle, reading, playing the piano, having sex. You name the activity, I have had a partial seizure while I've been doing it. Fortunately I never lose consciousness or motor control, but there certainly is an alteration of consciousness. I think over time you get to know the parameters of your own seizures, but also be aware that they can change. I always suggest that people keep a record of their seizures, and especially when you are newly diagnosed try to write down enough info so you can see if there are any correlations with anything else in your life. I did that for maybe 8 or 9 years and found absolutely no connections with anything. There seem to be no real triggers at all for me. I still record when I have seizures but not much other info.

Good luck with your journey! Keep us posted.

 

[Cint]

That floating feeling is a simple partial seizure (which is actually an aura) that may/may not go on into a complex partial--where you are semi-conscious but cannot speak, cannot understand what is being said and may utter jibberish to others and look at them with a blank stare. And for some, like me, these type of seizure can generalize (spread to both sides of the brain) to secondary TC (grand mal) seizures.

Here is some good info about simple partial seizures:

http://www.epilepsy.com/epilepsy/seizure_simplepartial

How long do they last?

Only a short time, usually less than 2 minutes.

Tell me more

Doctors often divide simple partial seizures into categories depending on the type of symptoms the person experiences:

Motor seizures:

These cause a change in muscle activity. For example, a person may have abnormal movements such as jerking of a finger or stiffening of part of the body. These movements may spread, either staying on one side of the body (opposite the affected area of the brain) or extending to both sides. Other examples are weakness, which can even affect speech, and coordinated actions such as laughter or automatic hand movements. The person may or may not be aware of these movements.

Sensory seizures:

These cause changes in any one of the senses. People with sensory seizures may smell or taste things that aren't there; hear clicking, ringing, or a person's voice when there is no actual sound; or feel a sensation of "pins and needles" or numbness. Seizures may even be painful for some patients. They may feel as if they are floating or spinning in space. They may have visual hallucinations, seeing things that aren't there (a spot of light, a scene with people). They also may experience illusions—distortions of true sensations. For instance, they may believe that a parked car is moving farther away, or that a person's voice is muffled when it's actually clear.

Autonomic seizures:

These cause changes in the part of the nervous system that automatically controls bodily functions. These common seizures may include strange or unpleasant sensations in the stomach, chest, or head; changes in the heart rate or breathing; sweating; or goose bumps.

Psychic seizures:

These seizures change how people think, feel, or experience things. They may have problems with memory, garbled speech, an inability to find the right word, or trouble understanding spoken or written language. They may suddenly feel emotions like fear, depression, or happiness with no outside reason. Some may feel as though they are outside their body or may have feelings of déja vu ("I've been through this before") or jamais vu ("This is new to me"— even though the setting is really familiar).

And here is info on CP seizures:

http://www.epilepsy.com/epilepsy/seizure_complexpartial

How long do they last?

They usually last between 30 seconds and 2 minutes. Afterward, the person may be tired or confused for about 15 minutes and may not be fully normal for hours.

Tell me more

These seizures usually start in a small area of the temporal lobe or frontal lobe of the brain. They quickly involve other areas of the brain that affect alertness and awareness. So even though the person's eyes are open and they may make movements that seem to have a purpose, in reality "nobody's home." If the symptoms are subtle, other people may think the person is just daydreaming.

Some people can have seizures of this kind without realizing that anything has happened. Because the seizure can wipe out memories of events just before or after it, however, memory lapses can be a problem.

Some of these seizures (usually ones beginning in the temporal lobe) start with a simple partial seizure. Also called an aura, this warning seizure often includes an odd feeling in the stomach. Then the person loses awareness and stares blankly. Most people move their mouth, pick at the air or their clothing, or perform other purposeless actions. These movements are called "automatisms" (aw-TOM-ah-TIZ-ums). Less often, people may repeat words or phrases, laugh, scream, or cry. Some people do things during these seizures that can be dangerous or embarrassing, such as walking into traffic or taking their clothes off. These people need to take precautions in advance.

 

[qtowngirl]

My seizures are supposedly simple partial that generalize into atonic. I just had one today after a change in meds. Basically, I was in the car (as a passenger, not driving) and I started having what I believe to be an aura. I was just diagnosed like 2 months ago so I'm not really sure yet. But I started not being able to focus on anything, feeling really dizzy, lightheaded and weak. Then, I start having kind of an out of body dream-like experience, obviously a feeling that is really hard to describe, kind of like I am floating? I also feel jolts of "buzzing" in my left hand, and it opens and closes.

as cint said (in the breakdown of the main four you'll find what you're referring to) this would be a simple partial, from the beginning of the odd feelings. an aura and simple partial are the same thing, just with interchangeable names. however...

This whole time I am kind of in and out of consciousness, like sometimes I am able to open my eyes and somewhat see what is going on around me, but I am not really aware of it, and then I am out again. Once I come to, I can remember what happened when I was "awake" with my eyes open, but I can't remember losing consciousness. Sometimes, if I am not leaning back like I was today in the car, my head will drop. I think this is where the atonic part comes in?

this is different- consciousness stays intact during a simple partial, as does memory of the entire event. if both are 'coming and going' it sounds that your brain is right on the brink of a generalized seizure, going in and out of a simple and complex (with a complex there is no/next to no memory of the event).
having simple partials are a hidden blessing in the sense that they warn us. without having them your head (and body, depending on your position), would drop without time to lay down somewhere safe.
and yes your head dropping and losing consciousness for a short period of time (seconds to a minute) is atonic. if it keeps coming and going it's a good idea to up your doseage/see your doc.

Is there any explanation to this or is it just coincidence? I would like to know because then I wouldn't be so afraid of driving...

in the case of driving this is regardless, you've been given an epilepsy diagnosis and unfortunately this means new boundaries. especially when diagnosed with seizures that bring unconsciousness- both in consideration of others and legally there should be no driving for a minimum 6 months until it's under control. as of this seizure it sounds like, well, not so much.

:hugs:

 

[horsehead]

Its interesting you say you only have seizures when idle. Most of my seizures are either while sleeping or just sitting.