Neurology Book

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Focal Seizure

Aka: Focal Seizure, Partial Seizure, Complex Partial Seizure, Focal Seizure With Impairment of Awareness, Simple Partial Seizure, Focal Seizure Without Impairment of Awareness, Jacksonian March, Jacksonian Seizure
  1. See Also
    1. Generalized Seizure
    2. Seizure Disorder
  2. Definitions
    1. Focal Seizure (Partial Seizure)
      1. Single hemisphere Seizure (contrast with generalized which involves both hemispheres)
    2. Simple Partial Seizure
      1. Focal Seizure Without Impairment of Awareness
      2. No loss of consciousness or mental status change
    3. Complex Partial Seizure
      1. Focal Seizure With Impairment of Awareness
      2. Example: Temporal Lobe Seizure (Psychomotor Seizure)
    4. Jacksonian March (Jacksonian Seizure)
      1. Focal Partial Seizure with maintained awareness that generalizes to greater distribution of involvement
      2. Generalized symptoms may include lip licking, eye movement, neck rotation, repetitive hand movement
      3. More common in Multiple Sclerosis, older age
  3. Types
    1. Awareness
      1. Focal Seizure Without Impairment of Awareness (Simple Partial Seizure)
      2. Focal Seizures with impaired awareness (Complex Partial Seizure)
    2. Subtypes
      1. Motor Seizures (focal motor activity)
      2. Sensory Seizures
      3. Autonomic Seizures (e.g. sweating)
      4. Temporal Lobe Seizure (Psychomotor Seizure)
  4. Symptoms
    1. Focal motor symptoms and somatosensory symptoms
      1. Spreads to other parts of the body
    2. Sensory Symptoms
      1. Visual, auditory, olfactory, or gustatory
    3. Autonomic symptoms (e.g. sweating)
    4. Psychological Symptoms (e.g. Temporal Lobe Seizure)
    5. Altered Level of Consciousness in some episodes
  5. Management: Prophylaxis in Children (age <16 years)
    1. Level A evidence
      1. Oxcarbazepine (Trileptal)
    2. Level C evidence
      1. Carbamazepine (Tegretol)
      2. Phenobarbital
      3. Phenytoin (Dilantin)
      4. Topiramate (Topamax)
      5. Valproic Acid (Depakene)
      6. Vigabatrin (Sabril)
    3. Level D evidence
      1. Clobazam (Onfi)
      2. Clonazepam (Klonopin)
      3. Lamotrigine (Lamictal)
      4. Zonisamide (Zonegran)
  6. Management: Prophylaxis for Younger Adults (age 16 to 60 years)
    1. Level A evidence
      1. Carbamazepine (Tegretol)
      2. Levetiracetam (Keppra)
      3. Phenytoin (Dilantin)
      4. Zonisamide (Zonegran)
    2. Level B evidence
      1. Valproic Acid (Depakene)
    3. Level C evidence
      1. Gabapentin (Neurontin)
      2. Lamotrigine (Lamictal)
      3. Oxcarbazepine (Trileptal)
      4. Phenobarbital
      5. Topiramate (Topamax)
      6. Vigabatrin (Sabril)
    4. Level D evidence
      1. Clonazepam (Klonopin)
      2. Primidone (Mysoline)
  7. Management: Prophylaxis for Older Adults (age >60 years)
    1. Level A evidence
      1. Gabapentin (Neurontin)
      2. Lamotrigine (Lamictal)
    2. Level C evidence
      1. Carbamazepine (Tegretol)
    3. Level D evidence
      1. Topiramate (Topamax)
      2. Valproic Acid (Depakene)
  8. Management: Prophylaxis - New adjunctive agents (2014)
    1. Perampanel (Fycompa)
    2. Eslicarbazepine (Apticom)
  9. References
    1. Liu (2017) Am Fam Physician 96(2): 87-96 [PubMed]

Jacksonian Seizure (C0022333)

Concepts Disease or Syndrome (T047)
MSH D012640
SnomedCT 246529004, 67139004
English JACKSONIAN SEIZURES, Seizure, Jacksonian, Seizure(s) Jacksonian, Seizure (Jacksonian), Jacksonian Seizure, Convulsion Jacksonian, Jacksonian seizures, jacksonian's seizure, jacksonian seizure, jacksonian seizures, Jacksonian seizure, convulsions; jacksonian, jacksonian; convulsions, jacksonian; epileptic, jacksonian; seizures, seizure; jacksonian, Jacksonian seizure, NOS
Dutch convulsie van Jacksonse type, Jackson convulsies, Jackson; aanval, Jackson; convulsie, Jackson; epilepsie, aanval; Jackson, convulsie; Jackson, Jackson-aanval
French Convulsion jacksonienne, Crises épileptiques jacksoniennes, Crise jacksonienne, CRISE D'EPILEPSIE JACKSONIENNE, Crise Bravais-Jacksonienne
German Jackson-Konvulsion, Jackson-Anfaelle, Jackson-Anfälle, JACKSON ANFAELLE
Italian Convulsione jacksoniana, Crisi convulsive Jacksoniane, Attacchi jacksoniani
Portuguese Crises jecksonianas, Convulsão jacksoniana, Crise Jacksoniana, CONVULSOES JACKSONIANAS
Spanish Convulsion jacksoniana, Crisis jacksonianas, Crisis Jacksoniana, CRISIS JACKSONIANAS, convulsión jacksoniana
Japanese ジャクソン発作, ジャクソン痙攣, ｼﾞｬｸｿﾝｹｲﾚﾝ, ｼﾞｬｸｿﾝﾎｯｻ
Czech Jacksonská křeč, Jacksonské záchvaty, jacksonské záchvaty
Hungarian Jackson-féle görcsroham, Jackson-féle görcsrohamok
Norwegian Jackson-anfall
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Simple Partial Seizures (C0234974)

Concepts Disease or Syndrome (T047)
MSH D004828
SnomedCT 79348005, 193006008, 117891000119100, 193013008
English SIMPLE PARTIAL SEIZURES, Partial epilep.-consc.OK NOS, Partial epilepsy without impairment of consciousness, Partial epilepsy without impairment of consciousness NOS, Partial epilepsy without mention of impairment of consciousness, Partial epilepsy without mention of impairment of consciousness NOS, Partial epilepsy-conscious OK, Simple part seiz consc not imp, Epilepsy, partial NOS, without impairment of consciousness, Epilepsy, partial, without impairment of consciousness, Simple partial seizures with consciousness preserved, seizure partial (focal) simple, simple partial seizure, simple partial seizure (physical finding), partial simple seizure (diagnosis), partial simple seizure without impairment of consciousness (diagnosis), partial simple seizure, partial simple seizure without impairment of consciousness, Simple Partial Seizures, Simple partial seizures, Partial Seizures, Simple, Consciousness Preserved, Partial Seizures, Simple, Seizures, Simple Partial, Seizures, simple partial, partial seizures simple, Seizure;focal;simple partial, simple partial seizures, Partial seizures, simple, Partial epilepsy without mention of impairment of consciousness (disorder), Simple partial seizure (disorder), Partial epilepsy without mention of impairment of consciousness NOS (disorder), Simple partial seizure, Simple partial seizure, consciousness not impaired, Simple partial seizure, consciousness not impaired (disorder), seizure; epileptic, simple, partial, simple partial seizures; epileptic, Simple partial seizure, consciousness not impaired (finding), simple partial focal seizure, Partial epilepsy, without mention of impairment of consciousness
Italian Crisi convulsive semplici parziali, Crisi epilettiche parziali semplici, Epilessia parziale, senza menzione di alterazione della coscienza
Dutch partiële epilepsie zonder vermelding van verminderd bewustzijn, partieel insult eenvoudig, aanval; epileptisch, eenvoudig, partieel, eenvoudige partiële aanvallen; epilepsie, eenvoudige partiële insulten, Eenvoudige partiële epilepsie
French Epilepsie partielle, sans mention de diminution de la conscience, Crises partielles, simples, Crises partielles simples sans trouble de la conscience, CRISE CONVULS. PARTIELLE SIMPLE, Crise convulsive partielle simple, Crises partielles simples
German partielle Anfaelle, einfach, partielle Epilepsie, ohne Erwaehnung unbehandelbarer Epilepsie, Einfache partielle epileptische Anfälle, EPILEPSIE FOKAL, einfache partielle Anfaelle
Portuguese Epilepsia parcial sem referência a alteração da consciência, Crises Convulsivas Parciais Simples, CRISES PARCIAIS SIMPLES, Crises parciais simples
Spanish Epilepsia parcial sin mención de alteración de la conciencia, epilepsia parcial sin mención de alteración de la conciencia, Crisis Convulsivas Parciales Simples, CRISIS PARCIALES SIMPLES, convulsión parcial simple, epilepsia parcial sin mención de la alteración de la consciencia, SAI (trastorno), epilepsia parcial sin mención de la alteración de la consciencia, SAI, convulsión parcial simple (trastorno), epilepsia parcial sin mención de alteración de la consciencia (trastorno), epilepsia parcial sin mención de alteración de la consciencia, convulsión parcial simple sin alteración de la conciencia, convulsión parcial simple sin alteración de la consciencia, Crisis parciales simples, convulsión parcial simple sin alteración de la consciencia (hallazgo), epilepsia parcial sin mención de alteración de la conciencia (trastorno), convulsión parcial simple sin alteración de la consciencia (trastorno)
Japanese 単純部分発作, ﾀﾝｼﾞｭﾝﾌﾞﾌﾞﾝﾎｯｻ
Czech Parciální jednoduché záchvaty, Parciální epilepsie, bez zmínky o poruše vědomí, Parciální záchvaty, jednoduché
Hungarian Partialis epilepsia, tudatkárosodás említése nélkül, Egyszerű partialis görcsrohamok, Partialis görcsrohamok, egyszerű
Norwegian Enkle partielle anfall med bevart bevissthet, Enkle partielle anfall
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Complex partial seizure with impairment of consciousness (C0270834)

Concepts Pathologic Function (T046)
SnomedCT 4103001
English Complex part seiz,impair consc, partial complex seizure with impairment of consciousness, partial complex seizure with impairment of consciousness (diagnosis), complex partial seizures, complex partial seizure, Complex partial seizures with consciousness impaired, Psychomotor fit, Complex partial seizure, Complex partial seizure with impairment of consciousness (disorder), Complex partial seizure with impairment of consciousness (finding), Complex partial seizure with impairment of consciousness
Spanish convulsiones parciales complejas con alteración de la conciencia, convulsiones parciales complejas con alteración de la conciencia (hallazgo), convulsiones parciales complejas con alteración de la conciencia (trastorno)
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Seizures, Focal (C0751495)

Definition (NCI_FDA) Partial seizure.
Definition (NCI) A transitory alteration in movement, sensation or autonomic nerve function due to abnormal electric activity in a localized area of the cerebral cortex, usually without change in awareness or alertness. Symptoms vary with different lesion locations and may include but not limited to the motor (e.g. rhythmic muscle contractions in one area of the body), somatosensory and sensory alterations manifested by abnormal numbness, paresthesias or other hallucinations, including several types of aura; autonomic and psychic symptoms, e.g. with changes in speech, thought, personality, mood, sensation of deja vu or hallucinations.
Definition (CSP) any seizure due to a lesion in a specific, known area of the cerebral cortex; symptoms vary with different lesion locations.
Concepts Sign or Symptom (T184)
MSH D012640
SnomedCT 29753000, 363692008, 3485007, 67139004
English CONVULSIONS LOCAL, Focal Seizure, Partial Seizure, partial seizure, focal seizure, partial seizure (physical finding), seizure partial (focal), Convulsions local, Partial seizures NOS, Partial seizures, NOS, Focal Seizures, Seizure, Focal, Seizures, partial, seizure focal partial, seizures partial, focal seizures, partial focal seizures, partial seizures, focal seizure partial, local seizures, partial focal seizure, focal fit, Partial seizure (finding), Local convulsion (disorder), Seizures, focal, FOCAL SEIZURES, SEIZURES, FOCAL, Local convulsion, Partial seizure, Focal seizure, Local seizure, Partial seizures, Partial seizure (disorder), Focal seizure, NOS, Seizures, Focal, Focal fits, Focal seizures
Italian Convulsioni localizzate, Crisi epilettiche parziali, Crisi convulsive focali, Crisi epilettiche parziali NAS, Crisi focali
Dutch focale convulsies, focale insulten, partieel insult NAO, convulsies lokaal, partieel insult, Insult, focaal
French Crise convulsive partielle SAI, Crises focales, CONVULSIONS LOCALISEES, Crises convulsives focales, Convulsions localisées, Crise convulsive partielle
German fokale Anfaelle, partielle Anfaelle NNB, Fokale Anfälle, Anfälle, fokale, KONVULSIONEN LOKAL, Konvulsionen lokal, partielle Anfaelle
Portuguese Crises focais, Crises parciais NE, Crises Convulsivas Focais, CONVULSOES LOCALIZADAS, Crises parciais, Local de convulsões
Spanish Crisis focales, Ataques focales, Crisis parciales NEOM, Crisis Convulsivas Focales, CONVULSIONES FOCALES, convulsión parcial (trastorno), convulsión parcial, convulsiones parciales, convulsiones parciales (trastorno), convulsión focal, convulsiones locales (concepto no activo), convulsiones locales, convulsión parcial (hallazgo), convulsión motora focal, Convulsiones focales, Crisis parciales
Japanese 焦点性発作, 局在性痙攣, 部分発作ＮＯＳ, 部分発作, ｷｮｸｻﾞｲｾｲｹｲﾚﾝ, ﾌﾞﾌﾞﾝﾎｯｻNOS, ﾌﾞﾌﾞﾝﾎｯｻ, ｼｮｳﾃﾝｾｲﾎｯｻ
Czech Křeče lokální, Parciální záchvaty NOS, Fokální záchvaty, Parciální záchvaty, Fokální křeče, fokální záchvaty, parciální záchvaty
Hungarian Partialis görcsrohamok, Partialis görcsrohamok k.m.n., Focalis görcsrohamok, Parciális rohamok, Focalis rohamok
Norwegian Fokale anfall
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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