Epilepsia Partialis Continua (EPC)

A seizure happens when electrical activity in the brain surges suddenly. Epilepsia partialis continua (EPC) is a condition that occurs when seizures happen every few seconds or minutes. This can continue for days, weeks or even years.

EPC seizures are most common in the hands and face (focal).

EPC is also known as Kojevnikov's epilepsia.

Symptoms

EPC seizures are most common in the hands and face (focal). Symptoms may include:

  • Twitching of the muscles in the face or hands
  • Muscle weakness after the seizure
  • Jerky or rhythmic movements
  • Altered senses

In some cases other areas of the body, such as the legs, may be affected.


Causes and Risk Factors

The cause of EPC is often unknown.

EPC in adults is sometimes linked to damage in the brain tissue from a stroke.

EPC in children is linked to:

Diagnosis

Making a correct epilepsy diagnosis is important. The doctor will work to find out the type of seizure and whether it was caused by epilepsy. This information will help the doctor decide on the best treatment.

The most useful way to diagnose epilepsy is an electroencephalogram (EEG). This records electrical activity in the brain. The EEG can record unusual spikes or waves in electrical activity patterns. Different types of epilepsy can be identified with these patterns.

Magnetic resonance imaging (MRI) and computed tomography (CT) scans may be used to look at the cause and the location within the brain. The scans can show scar tissue, tumors or structural problems in the brain.

Other tests may include:

  • A complete blood count (CBC) will provide the doctor with information regarding infection, abnormal electrolyte levels (such as magnesium, potassium and calcium), kidney or liver malfunction or genetic conditions.
  • A lumbar puncture (spinal tap) can rule out infections, such as spinal meningitis and encephalitis.
  • A toxicology screening can show poisons, illegal drugs or other toxins.

Treatments

Treatment is based on:

  • The type of seizure
  • How often seizures happen
  • How severe the seizures are
  • The patient's age
  • The patient's overall health
  • The patient's medical history

Medication is the most common treatment. Anti-seizure (or anti-epileptic) medications can be very helpful. It may take a few tries to find the right drug and the right dose. The doctor will monitor for side effects to find the best option. These medications include:

  • Benzodiazepines
  • Barbituates
  • Levetiracetam
  • Lacosamide
  • Depakote

Surgery may be an option if medication can't control the seizures.

A vagus nerve stimulator (VNS) is sometimes implanted and used with anti-epileptic medication to lower seizures. The VNS is a tool placed under the skin of the chest. It sends electrical energy through the vagus nerve in the neck to the brain.