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THE KINDS OF SEIZURE: SIMPLE PARTIAL SEIZURES – WITH LOSS OF CONSCIOUSNESS AT ONSET LISA\S CASE HISTORY

The teacher has called and says Lisa is daydreaming in school. You have noticed some episodes of “daydreaming” at the dinner table. Does she have absence seizures? Does she have atypical absence seizures? Does she have complex partial seizures or is she daydreaming?The questions your physician will want to ask you about Lisa are:• “How frequently is she having these episodes?” Daydreaming would occur infrequently and be situational. Absence seizures may occur many times a day. Complex partial seizures rarely occur more than several times a day or a week.• “How do these episodes begin?” While most seizures have an abrupt onset, occasionally complex partial seizures begin slowly and a warning precedes them. Daydreaming usually does not start abruptly.• “Can you interrupt these episodes?” Daydreaming can easily be interrupted by calling Lisa’s name or by physically touching her. Seizures, on the other hand, cannot be interrupted.• “How long does the episode last?” Daydreaming can go on until something else catches a child’s attention. Absence seizures rarely last more than fifteen seconds. Complex partial seizures may last up to several minutes.• “What does the child do during the episode?” While daydreaming or during absence seizures, the child is likely to stare into space. During complex partial seizures, the child is likely to smack her lips, pick at her clothes, or display other automatisms.• “What is the child like when she ‘comes back?’” The child who is daydreaming or having an absence seizure immediately is alert. The child with a complex partial seizure is usually confused for seconds or minutes.• “Does the child remember what was said during the episode?” While daydreaming, the child may be aware of what is happening but not pay attention. During a seizure, the child is not fully aware of what is happening around her.• “Do the spells occur only at special times?” If they happen only, say, in math or geography class, the child is likely to be daydreaming. If they occur at random times or whenever the child is tired, they are more likely to be seizures.With these careful observations, you and your physician can usually differentiate the type of episode.*73\208\8*

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