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 may sometimes turn into generalized seizures, which affect the whole brain. This is called secondary generalization.

Partial seizures can be further characterized as:

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

For more information, see:

• Epilepsy
• Seizures
• Generalized tonic clonic seizure (grand mal seizure)
• Petit mal seizure

Alternative Names

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

Causes, incidence, and risk factors

Symptoms

Patients with focal seizures can have any of the symptoms below, depending on where in the brain the seizure starts.

Patients with simple focal seizures do not lose consciousness. They will be aware of and remember the events that occur at the time.

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

• Abnormal muscle contraction
  • Muscle contraction/relaxation (clonic activity) -- common
  • Affects one side of the body (leg, part of the face, or other area)
  • Abnormal head movements
  • Forced turning of the head
• Staring spells, with or without complex, repetitive movements (such as picking at clothes) -- these are called automatisms and include:
  • Abnormal mouth movements
  • Lip smacking
  • Behaviors that seem to be a habit
  • Chewing/swallowing without cause
• Forced turning of the eyes
• Abnormal sensations
  • Numbness, tingling, crawling sensation (like ants crawling on the skin)
  • May occur in only one part of the body, or may spread
  • May occur with or without motor symptoms
• Hallucinations
• Abdominal pain or discomfort
• Nausea
• Sweating
• Flushed face
• Dilated pupils
• Rapid heart rate/pulse

Other symptoms include:

• Blackout spells -- periods of time lost from memory
• Changes in vision
• Sensation of deja vu
• Changes in mood or emotion

See also:

• Epilepsy
• Seizures

Signs and tests

Treatment

Support Groups

Epilepsy Foundation of America -- www.epilepsyfoundation.org

Expectations (prognosis)

Complications

Calling your health care provider

Prevention

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References

Duvivier EH, Pollack Jr CV. Seizures. In: Marx, JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009: chap 100.

Krumholz A, Wiebe S, Gronseth G, et al. Practice parameter: evaluating an apparent unprovoked first seizure in adults (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology. 2007;69:1991-2007.

Rubin DH, Kornblau DH, Conway Jr EE, et al. Neurologic Disorders. In: Marx, JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009: chap 173.

Schachter SC. Seizure disorders. Med Clin North Am. March 2009;93(2).

Trescher WH, Lesser RP. The Epilepsies. In: Bradley WG, Daroff RB, Fenichel GM, Jakovic J, eds. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa; Butterworth-Heinemann; 2008: chap 71.

Walker SP, Permezel M, Berkovic SF. The management of epilepsy in pregnancy. BJOG. 2009; 116(6):758-67.