Focal seizures are seizures which affect initially only one hemisphere of the brain. The brain is divided into two hemispheres, each consisting of four lobes – the frontal, temporal, parietal and occipital lobes.
They can involve twitching or jerking muscle movements, uncontrolled tightening up of muscles, or repetitive/automatic movements (smacking your lips, blinking or tapping a hand or finger). Focal motor symptoms can also spread across an affected body part and to other parts of your body.
Complex Focal Seizures
Patients experiencing a complex focal seizure may stare blankly into space, or experience automatisms (non-purposeful, repetitive movements such as lip smacking, blinking, grunting, gulping or shouting). Specializing In: Seizure Disorder.
Who is at risk for focal aware seizures (simple partial seizures)? Anybody can get them. They may be more likely in people who have had a head injury, brain infection, stroke, or brain tumor. Yet many times the cause is unknown.
EEG during focal seizures without impairment of consciousness may demonstrate focal evolving rhythmic discharges, but of importance, they may be normal on scalp EEG. The seizure may be so limited in spatial distribution that the resulting electro potential may not be picked up by scalp EEG.
FAS are sometimes called 'warnings' or 'auras' because, for some people, a FAS develops into another type of seizure. The FAS is then a warning that another seizure will happen (see focal to bilateral tonic-clonic seizures).
Focal Seizure that Becomes Generalized
This type of seizure begins with nerve cells having extra discharges in one part of the brain. This then spreads and affects the whole brain.
Focal epilepsy may be treated with medication, and occasionally with diet, nerve stimulation or surgery, especially if the condition is due to a scar or other lesion in the brain.
Previously called secondarily generalized seizures, the new name for this is focal to bilateral tonic-clonic seizures. They usually last between 30 seconds and 3 minutes. Afterward, the person may be tired or confused for about 15 minutes and may not be return to normal function for hours.
Emotional stress also can lead to seizures. Emotional stress is usually related to a situation or event that has personal meaning to you. It may be a situation in which you feel a loss of control. In particular, the kind of emotional stress that leads to most seizures is worry or fear.
Supportive tests, although helpful, need not be abnormal for a diagnosis of focal seizures. Monotherapy with anticonvulsant medication is the initial and preferred treatment. Choice of medication should be tailored to the needs of the individual patient, taking into account factors such as age, sex, and comorbidities.
Epilepsy of infancy with migrating focal seizures is a very rare form of epilepsy. The typical age of onset is before 6 months with an average age of onset of 3 months of age. It equally affects boys and girls.
Call 911 or seek emergency medical help for seizures if: A seizure lasts more than five minutes. Someone experiences a seizure for the first time. Person remains unconsciousness after a seizure ends.
Narrow spectrum AEDs primarily are for the treatment of focal or partial seizures. These include but are not limited to lacosamide, pregabalin, gabapentin, carbamazepine, oxcarbazepine, ezogabine, phenytoin, and vigabatrin.
“Some symptoms can include what looks like daydreaming or a lack of focus, which may be presumed as rude. But in fact, [the person] is experiencing a seizure,” Fisher says. Focal seizures can get worse if they are not treated, allowing for more serious symptoms to develop.
Focal seizures (formally called partial seizures) can be scary and frustrating. But they can usually be controlled.
Patients with simple partial seizures remain aware and awake throughout the seizure, and some patients can even talk during the episode.
Some states may allow people with epilepsy to drive if they have certain kinds of seizure disorders, including nocturnal epilepsy (seizures only during sleep), focal aware seizures (during which they remain aware and can drive safely), or have a long aura (warning) before a seizure.
Doctors also classify focal seizures into two additional types depending on their cause. One type is an unprovoked seizure, which occurs without a known cause. The other is an acute symptomatic seizure, which results from a triggering event or injury.
Todd's paresis (or postictal paresis/paralysis, "after seizure") is focal weakness in a part or all of the body after a seizure. This weakness typically affects the limbs and is localized to either the left or right side of the body. It usually subsides completely within 48 hours.
An MRI scan will not say for certain whether the person has epilepsy or not. But alongside other information, it might help the specialist to decide what the likely cause of the seizures is.
Tonic, Clonic and Tonic-Clonic (Formerly called Grand Mal) Seizures. Tonic-clonic seizures can evolve from any of the focal or generalized seizure types. For example, a focal seizure can spread to both sides of the brain and cause tonic-clonic seizures.