Partial (focal) seizure

Definition

All seizures are caused by abnormal electrical disturbances in the brain. Partial (focal) seizures occur when this electrical activity remains in a limited area of the brain. The seizures can sometimes turn into generalized seizures, which affect the whole brain. This is called secondary generalization.

Partial seizures can be divided into:

• Simple, not affecting awareness or memory
• Complex, affecting awareness or memory of events before, during, and immediately after the seizure, and affecting behavior

Alternative Names

Focal seizure; Jacksonian seizure; Seizure - partial (focal); Temporal lobe seizure; Epilepsy - partial seizures

Causes

Partial seizures are the most common type of seizure in people 1 year and older. In people older than 65 who have blood vessel disease of the brain or brain tumors, partial seizures are very common.

Symptoms

People with complex partial seizures may or may not remember any or all of the symptoms or events during the seizure.

Depending on where in the brain the seizure starts, symptoms can include:

• Abnormal muscle contraction, such as abnormal head movements
• Staring spells, sometimes with repetitive movements such as picking at clothes or lip smacking
• Eyes moving from side to side
• Abnormal sensations, such as numbness, tingling, crawling sensation (like ants crawling on the skin)
• Hallucinations, seeing, smelling, or sometimes hearing things that are not there
• Abdominal pain or discomfort
• Nausea
• Sweating
• Flushed face
• Dilated pupils
• Rapid heart rate/pulse

Other symptoms may include:

• Blackout spells, periods of time lost from memory
• Changes in vision
• Sensation of déjà vu (feeling like current place and time have been experienced before)
• Changes in mood or emotion
• Temporary inability to speak

Exams and Tests

The doctor will perform a physical exam. This will include a detailed look at the brain and nervous system.

An EEG (electroencephalogram) will be done to check the electrical activity in the brain. People with seizures often have abnormal electrical activity seen on this test. In some cases, the test shows the area in the brain where the seizures start. The brain may appear normal after a seizure or between seizures.

Blood tests may also be ordered to check for other health problems that may be causing the seizures.

Head CT or MRI scan may be done to find the cause and location of the problem in the brain.

Treatment

Treatment for partial focal seizures includes medicines, changes in lifestyle for adults and children, such as activity and diet, and sometimes surgery. Your doctor can tell you more about these options.

Images

References

Abou-Khalil BW, Gallagher MJ, Macdonald RL. Epilepsies. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SK, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 101.

Wiebe S. The epilepsies. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 403.