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Seizure Disorder, Partial

Seizure Disorder, Partial is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

  • Seizures occur when abnormal synchronous neuronal discharges in the brain cause transient cortical dysfunction.
  • Generalized seizures involve bilateral cerebral cortex from the seizure’s onset.
  • Partial seizures originate from a discrete focus in the cerebral cortex.
  • Partial seizures are further divided into simple and complex subtypes:
    • If consciousness is impaired during a partial seizure, it is classified as complex.
    • If consciousness is preserved, it is a simple partial seizure.

Epidemiology

Prevalence
Partial seizures occur in 20/100,000 persons in the United States.

Etiology and Pathophysiology

  • Partial seizures begin when a localized seizure focus produces an abnormal, synchronized depolarization that spreads to a discrete portion of the surrounding cortex.
  • The area of cortex involved in the seizure determines the symptoms; for example, an epileptogenic focus in motor cortex produces contralateral motor symptoms.
  • In some cases, etiology is related to structural abnormalities that are susceptible to epileptogenesis. Most common etiologies vary by life stage:
    • Early childhood: developmental/congenital malformation, trauma
    • Young adults: developmental, infection, trauma
    • Adults 40 to 60 years of age: cerebrovascular insult, infection, trauma
    • Adults >60 years of age: cerebrovascular insult, trauma, neoplasm
  • Complex partial seizures: A common cause is mesial temporal sclerosis.

Genetics
Benign rolandic epilepsy, a form of partial seizure disorder, has an autosomal dominant inheritance pattern with penetrance depending on multiple factors.

Risk Factors

  • History of traumatic brain injury (TBI)
  • Children exposed to a thiamine-deficient formula

Commonly Associated Conditions

Epilepsy patients have a higher incidence of depression than the general population.

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Citation

Stephens, Mark B., et al., editors. "Seizure Disorder, Partial." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116855/all/Seizure_Disorder__Partial.
Seizure Disorder, Partial. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116855/all/Seizure_Disorder__Partial. Accessed March 26, 2019.
Seizure Disorder, Partial. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116855/all/Seizure_Disorder__Partial
Seizure Disorder, Partial [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 March 26]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116855/all/Seizure_Disorder__Partial.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Seizure Disorder, Partial ID - 116855 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116855/all/Seizure_Disorder__Partial PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -