1. Focal: involving a limited brain region
2. Generalized: involving the entire brain. Therefore always associated with loss of consciousness.

1. Partial (focal) seizures
   • Simple partial seizures (without loss of consciousness)
     • With motor signs (uncontrolled muscle movements)
     • With somosensory or special sensory symptoms (smell, vision,...)
     • With autonomic symptoms (nausea, blood pressure changes,...)
     • With psychic symptoms
   • Complex partial seizures (with loss of consciousness)
     • Simple partial followed by a loss of consciousness
     • Impaired consciousness from the onset
   • Partial seizures evolving to generalized seizures
     • simple partial with secondary generalization
     • Complex partial with secondary generalization
     • Simple to complex to generalized
       
2. Generalized seizures

• Typical absence seizures (petit mal): consists of staring for a few seconds then returning to full function, where activity was left at the onset of the seizure, as if nothing occurred. The patient has no recollection of the event. This is unlike most other seizures that will be followed by as after seizure (or postidital) drowsiness and confusion that may be prolonged at times.
• Myoclonic seizures: Usually presents with rapid muscle jerks. These may be caused by:
  • Benign (non-epileptic myoclonus): similar to the jerks one has when falling asleep.
  • Benign myoclonic epilepsy: A rare disorder that starts between 4 months and 2 years
  • Severe myoclonic epilepsy: A disorder that results in chronic progressive brain damage
  • Lenox-Glastaut syndrome: A severe epileptic disorder, associated with atypical absence (atonic and myoclonic), slow spike–wave complexes on EEG, and mental retardation.
• Clonic seizures:
• Tonic seizures
• Clonic tonic seizures (grand mal)
• Atomic seizures: Loss of muscle tone (drop effects)
• Unclassified epileptic seizures: seizures that do not fit in the above classification, such as neonatal seizures and febrile seizures.

4. What are Febrile Seizures?

Definition. Febrile seizures are convulsive events that are considered benign (not associated with serious difficulties), occurring between 6 months and 6 years of age. The typical febrile seizure is a convulsive event that lasts about one to five minutes. This usually occurs with the rapid rise of the fever and consists of a rhythmic jerking of the extremities, eye rolling, unresponsiveness, sometimes cyanosis (bluish discoloration around the mouth and the tips of the extremities), followed by 30 minutes of drowsiness and confusion. As the temperature normalizes, the child may return to his normal self. An occasion, a febrile seizure may occur differently, non-convulsive (without shaking), presenting a loss of tone and consciousness or with stiffening of the body.

Complex features. Some children may have complex febrile seizures. Complex features include the following:

• Duration, more than 20 minutes
• Focality when the seizure occurs on one side of the body
• Multiplicity, when more than one seizure occurs during a 24-hour period
  

  The significance of the complex features is that of a higher risk for future epilepsy; the more complex the features, the higher the risk for epilepsy or seizures without fever. Generally if a child has a simple febrile seizure the risk for epilepsy is 2% compared to 1% in the general population. The risk for future febrile seizures is about 30%, or 50% if the first seizure occurred before one year of age. Also, the lower the temperature that provoked the first febrile seizure is, the higher the risk for future febrile seizure events.

  Treatment. Treatment for febrile seizures is usually unnecessary. Lowering of the temperature with Tylenol or Motrin is usually ineffective. Anticonvulsants may be used in unusual situations, usually continuous Phenobarbithal or Depakene (Depakene after 3 years of age). Oral valium as premedication, given intermittently during febrile illnesses is highly effective and does not require continuous medication administration and monitoring. This is my first choice for febrile seizures that require treatment.

  Long-term effects. Febrile seizures are not considered to cause any damage to the brain. Studies have shown no difference in intelligence between children who suffer from febrile seizures or their siblings (or identical twins) who do not have febrile seizures. Some recent studies even suggest improved memory function in children who have had febrile seizures.

  Complications. Complications from febrile seizures are rare and are mostly associated with focal and prolonged febrile seizures. Future epilepsy, especially with recurrent focal seizures, was reported. Respiratory compromise is rare and may be caused by prolonged convulsions affecting the respiratory muscles and breathing.

  Mesial temporal sclerosis, or scarring of the inner part of the temporal lobe, called the hippocampus, is a condition thought-to-be-caused by recurrent focal febrile seizures. The hippocampus, if damaged, is highly epileptogenic (causing seizures). If mesial temporal sclerosis develops, this is associated with a form of epilepsy (partial complex seizures), difficult to control. This, however, is a rare and questionable complication of febrile seizures.

5. What are Some of the Possible Causes for Seizures?

The causes for seizures include the immediate causes for acute seizures and the chronic causes for epilepsy or a seizure disorder. The acute causes include hypoglycemia (low blood sugar, hypocalcemia (low blood calcium), meningitis, bacterial toxins (such as shigella), alcohol withdrawal, environmental toxins, electrical shock, and side effects of medication. Penicillin overdose may also cause a seizure. Chronic causes for epilepsy include genetic epilepsy (benign rolandic, absence and juvenile myoclonic epilepsies are some examples), congenital brain malformation associated with some neurocutaneous disorders (tuberous sclerosis, neurofibromatosis), migrational defects (where gray matter migrates to the wrong brain region during early development. Other causes include chronic effects of trauma or infection that did cause brain damage or damaged an area called the hippocampus in the front central temporal lobe that if damaged, becomes highly epileptogenic.

Seizure Disorders

By :Daisy Salas for Adaptive Physical Education

• Seizures are a condition of the brain.
  
• Around 650 out of ever 100,000 people are reported as having a seizure disorder.
  
• There are several types of seizures to find out more about the different types look on page 238 of Adapted Physical Education and Sport, by Joseph P. Winnick.
  

If some one is having a seizure:

• Put something soft under their head
• Do not restrain them
• Clear the area of hard or harmful objects
• Do not put anything into the persons mouth
• Clear the room, so when the person is finished they wont be embarrassed
• After the seizure the person should be told what happened
• After a seizure give support and let them know it is ok
  

Students with seizure disorders are aloud to participate in all types of sports and activities.

• As long as the seizure is controlled and supervised.
  The activity depends on the medication
• Physical activity is thought to elevate the seizure threshold.
  

When a student is swimming

• they must have their seizures under control
• they should swim with a partner
  

Activities that people with seizures can not do or need them to be modified.

• weight training
• gymnastics
• rope climbing