Summary about Disease
Focal seizures, also known as partial seizures, start in one area of the brain. A focal seizure can cause a variety of symptoms depending on the area of the brain involved. People may or may not remain aware during a focal seizure. If awareness is maintained, it is classified as a focal aware seizure. If awareness is lost or altered, it is classified as a focal impaired awareness seizure. Focal seizures are a common type of seizure disorder and can sometimes be a symptom of an underlying brain condition.
Symptoms
Symptoms of focal aware seizures can include:
Jerking, twitching, or stiffening of a limb or part of the body
Sensory changes such as tingling, numbness, or visual disturbances (flashing lights, spots)
Auditory hallucinations (hearing sounds that aren't there)
Olfactory hallucinations (smelling odors that aren't there)
Emotional changes (feeling fear, joy, or sadness)
Déjà vu or jamais vu (a feeling of familiarity or unfamiliarity with a place or situation) Symptoms of focal impaired awareness seizures can include:
Staring blankly
Repetitive movements such as lip smacking, chewing, hand rubbing, or picking at clothing
Unresponsiveness or slowed responses
Confusion or disorientation
Automatisms (involuntary, automatic behaviors)
Causes
The cause of focal seizures can vary. Some potential causes include:
Brain injury or trauma
Stroke
Brain tumors or cysts
Infections (such as encephalitis or meningitis)
Scarring in the brain (gliosis)
Genetic conditions
Developmental abnormalities
In many cases, the cause is unknown (idiopathic)
Medicine Used
Several medications are used to treat focal seizures. The choice of medication depends on the individual's specific seizure type, medical history, and other factors. Common antiepileptic drugs (AEDs) used for focal seizures include:
Levetiracetam
Lamotrigine
Carbamazepine
Oxcarbazepine
Phenytoin
Valproic acid
Topiramate
Zonisamide
Eslicarbazepine acetate
Brivaracetam A doctor will determine the appropriate medication and dosage. Often, a combination of medications may be needed.
Is Communicable
Focal seizures are not communicable. They are not caused by an infectious agent and cannot be spread from person to person.
Precautions
While you can't necessarily prevent focal seizures, some steps can be taken to manage triggers and promote safety:
Medication adherence: Take prescribed antiepileptic medications exactly as directed.
Identify and avoid triggers: Keep a seizure diary to track possible triggers such as stress, lack of sleep, flashing lights, or missed meals.
Maintain a healthy lifestyle: Get enough sleep, eat a balanced diet, and manage stress.
Avoid alcohol and recreational drugs: These can interfere with seizure medications and increase the risk of seizures.
Inform family and friends: Educate them about your condition and what to do if you have a seizure.
Wear a medical alert bracelet or necklace: This can provide important information to first responders in case of an emergency.
Safety precautions: Take precautions to avoid injury during a seizure, such as avoiding activities that could be dangerous if you lose consciousness (e.g., swimming alone, driving) until seizures are well controlled.
How long does an outbreak last?
Focal seizures are not an "outbreak" in the traditional sense of an infectious disease. Each seizure event is typically brief, lasting from a few seconds to a few minutes. The underlying condition causing the seizures is chronic, meaning it can persist for a long time (years or even a lifetime) if not properly managed.
How is it diagnosed?
Diagnosis typically involves:
Medical history and physical exam: The doctor will ask about your symptoms, medical history, and family history.
Neurological exam: This evaluates your motor skills, sensory function, reflexes, and mental status.
Electroencephalogram (EEG): This test measures electrical activity in the brain and can help identify seizure activity or abnormal brain waves.
Brain imaging (MRI or CT scan): These scans can help identify structural abnormalities in the brain, such as tumors, cysts, or areas of scarring.
Blood tests: These may be done to rule out other medical conditions that can cause seizures.
Timeline of Symptoms
The timeline of symptoms varies greatly depending on the individual and the type of focal seizure:
Aura (sometimes): Some people experience an aura before a focal aware seizure, which can last seconds or minutes.
Seizure: The seizure itself typically lasts from a few seconds to a few minutes.
Postictal period: After the seizure, there may be a period of confusion, fatigue, or other neurological symptoms, which can last from minutes to hours.
Important Considerations
Driving: People with focal seizures may have restrictions on driving, depending on state laws and the frequency and severity of their seizures. Consult with your doctor about driving safety.
Pregnancy: Some antiepileptic medications can be harmful to a developing fetus. Women with epilepsy should discuss their medication options with their doctor before becoming pregnant.
Sudden Unexpected Death in Epilepsy (SUDEP): SUDEP is a rare but serious complication of epilepsy. It is important to take steps to reduce the risk of SUDEP, such as taking medications as prescribed and avoiding known triggers.
Comorbidities: Epilepsy can be associated with other medical conditions, such as anxiety, depression, and cognitive impairment. It is important to address these comorbidities as well.
Regular follow-up: It is important to have regular follow-up appointments with a neurologist to monitor your condition and adjust your treatment plan as needed.