What are epileptic auras?

At the brain level, epileptic auras They are the result of altered activation of an area of the cerebral cortex, due to abnormalities in the firing of neurons.. These alterations occur in one hemisphere, for a short period of time (from seconds to several minutes) and in a localized manner. That is, the abnormal activation occurs in a specific functional area, which will determine the characteristics of the aura.

Because during the epileptic aura the person is conscious, presenting “abnormal” behavior in only some areas of the brain – if we compare it with a moment of complete seizure -, they are considered simple partial seizures. Thus, Although they generally occur punctually, they can lead to a complex partial crisis.then affecting consciousness and causing a generalized crisis.

Types of auras

Although there is generally confusion in the descriptions of the different types, they are usually classified based on the symptoms presented, since they refer to the area where the crisis occurs.

Autonomic auras

In the event that the abnormal activation is related to the autonomic system, the symptoms that will occur will be of this type. That is, they can occur vomiting, tachycardia, hair erection, paleness, etc..

In this group, the most reported by patients are epigastric sensations which are often associated with epilepsy in the temporal lobe. In this case, the sensations consist of abdominal pressure, an empty stomach, or nausea.

Experiential auras

Experiential symptoms are related to alterations in the activation of limbic areas and temporal cortex. Therefore, This set of symptoms affects memory, emotions and cognition, and perceptual illusions or sensory hallucinations can occur.. They are also known as psychic auras and it can sometimes be difficult to differentiate whether they are psychological or sensory in nature.

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Regarding amnestic alterations, it may occur that memories or the feeling of familiarity are distorted (déjà vu), depersonalization or derealization. In the case of emotional auras, associated with the amygdala in middle frontal epilepsy, sensations of sadness, joy, pleasure or irritability are described.in addition to anxiety or fear of suffering a heart attack.

Sensory auras

The Exclusively sensory auras affect some of the senses. For example, auras associated with crises in occipital or temporal areas report vision of spots, alterations in vision of movements and even blindness.

In the case of more complex visual areas, visual hallucinations or tunnel vision occur. Likewise, auditory alterations may occur, such as ringing, buzzing or noise, or olfactory or gustatory auras.

Somatosensory auras may also occur due to parietal or frontal epilepsy.experiencing numbness, paresthesia, sensation of cold or heat, pain, etc.

Other auras

These classifications of epileptic auras still generate debate and controversy, since auras are usually defined as the sensations that patients experience without clear visible signs. Despite this, descriptively, motor, cephalic and erotic or sexual auras could be added to the typology.

The Motor auras would consist of muscle contractions, phonatory disorders, chewing movements, etc.. However, these symptoms can arise from other alterations such as psychic, autonomic or somatosensory auras.

In the case of cephalic auras have also been considered somatic sensory aurassince the sensations referred to are dizziness, heaviness or pressure in the head.

Lastly, lSexual auras are accompanied by sensations in the genitals, erotic feelings and even the so-called “orgasmic epilepsy.”, which culminates in an orgasm, sometimes painful. In this case, some authors consider it a special type, or others include them in the autonomic auras.

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Differential diagnosis

It is essential to keep in mind that given the variety of symptoms that can manifest, Epileptic auras can be confused with other clinical conditions. Among the most frequent are cardiovascular disorders or panic attacks. However, these symptoms can hide otorhinological disorders, serious mental disorders or substance intoxication.

It is because of that It is essential to receive a thorough diagnosis with the appropriate toolsclearly differentiating the symptoms and alterations involved, as well as the type of latent focal epilepsy.