Complications Of Seizure



How simple and generalized seizure progress to conditions far worse than what they originally were is poorly understood. It is clear, however, that not all epileptic seizures respond well to medications and therapies. There are cases when complications occur.

Partial Seizures
Simple partial and complex partial seizures, if not properly addressed or if these become refractory (unresponsive to currently available treatments) may develop into recurrent seizures with secondary generalization. This new condition, instead of being localized in just one area of the body, now spreads to other areas of the brain which are controlled by the affected areas of the brain. Typically, the seizure attack will begin in the area where the electrical discharges originated and spreads throughout neighboring parts of the body. As the abnormal discharge of electricity spreads to the other hemisphere of the brain, the other side of the body starts to exhibit symptoms of seizure.

Complex partial seizures, since these often originate in the limbic system or the structure composed by the hippocampus, anterior thalamic nuclei, limbic cortex and amygdala, all of which control emotion, long term memory, behavior and olfaction, specific behavioral and cognitive difficulties may develop as a result of permanent damage in this area. Symptoms such as interictal personality, memory loss, violent behaviors and poriomania may start appearing as complications.

Interictal personality is characterized by dependence on a caregiver, humorlessness, obsessions, emotionality, anger, and hyposexuality or hypersexuality. Memory loss, on the other hand, refers to loss of short-term memory as well as anomia or inability or difficulty recalling names or words of objects. Another symptom, the poriomania is prolonged purposeless wandering. Patients whose partial seizures advance to complex partial seizure may also show aggression and defensiveness when restrained.

Generalized Seizures
Epileptic seizures included in this category may progress into several forms of complications. Tonic-clonic or grand mal seizure, for example, may end up with aspiration or inhalation into the lungs of vomited stomach contents as well as stomach secretions, vertebral and skulls fractures, injuries associated with biting and shoulder dislocation. Rarely, generalized seizures develop into status epilepticus, a type of recurring seizure whose symptoms may last for as long as 30 minutes with possible loss of consciousness between attacks.

Status epilepticus is a medical emergency that is often fatal. It is estimated that some 42,000 deaths are attributed to this condition on top of several thousand more of cases of brain injury. Although most of these cases are not related to epilepsy, a huge number of such deaths and permanent brain damage cases come from epileptic patients whose symptoms were not adequately controlled by anti-epilepsy drugs and therapies.

Almost all types of seizures can progress to status epilepticus including minor childhood seizures like febrile seizure may later develop into status. Treatment is instrumental in controlling the symptoms of this seizure as well as in controlling the possibility of death.

Although rare, some seizures can cause sudden death in a condition called SUDEP or Sudden Unexplained Death in Epilepsy. As the name suggests, there is no known physical cause for SUDEP.


By Anders Eriksson
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