Simple partial seizures in adults occur without a loss of consciousness and are confined to one area of the brain.
As each part of the brain has a certain function, the expression of the partial seizure can be quite different. The Jacksonian seizure, for instance, involves the motor cortex of the frontal lobe where motor control of muscles is localized. Localized twitching of muscles in one area(for instance in a thumb) would migrate into the hand, wrist, the forearm and the upper arm to the shoulder.
In another patient the same type of partial seizure may start in the face and migrate down into an arm or a leg. Other types of partial seizures may involve the front part of the temporal lobe and the seizures then consist of chewing movements or smacking of lips. With partial seizures in the back part of the brain (occipital lobe) visual hallucinations would occur with flashes of light.
Treatment
Treatment consists of carbamazepine (brand name: Tegretol, Novo-Carbamaz), phenytoin (brand name: Dilantin, Phenytex, Diphenylan)or valproic acid( brand names: Depakene, Deproic) initially. If this does not control the seizures despite adequate blood levels of the medication, then other anticonvulsants can be added. Such second line drugs are: Gabapentin (brand name: Neurontin), topiramate (brand name: Topamax) or lamotrigine (brand name: Lamictal).
Simple Partial Seizures In Adults
References:
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6. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 172.
7. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 271, p.2415.
8. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.
9. Rakel: Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier
