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:
Alternative Names
Focal seizure; Jacksonian seizure; Seizure - partial (focal); Temporal lobe seizure
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 and will be aware and remember the events that occur at the time.
Patients with complex partial seizures will have abnormal consciousness and may or may not remember any or all of the symptoms or events surrounding 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
- 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
- Hallucinations
- Abdominal pain or discomfort
- Nausea
- Sweating
- Flushed face
- Dilated pupils
- Rapid heart rate/pulse
- Black out spells -- periods of time lost from memory
- Changes in vision
- Sensation of deja vu
- Changes in mood or emotion
Support Groups
Epilepsy Foundation of America -- www.epilepsyfoundation.org
References
Foldvary-Schaefer N, Wyllie E. Epilepsy. In: Goetz, CG. Textbook of Clinical Neurology. 3rd ed. Philadelphia, PA: Saunders Elsevier; 2007: chap 52.
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(21):1991-2007.
Pollack CV Jr. Seizures. In: Marx, JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. Philadelphia, PA: Mosby Elsevier; 2006: chap 100.
Spenser SS. Seizures and Epilepsy. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, PA: Saunders Elsevier; 2007: chap 426.
Tomson T, Hiilesmaa V. Epilepsy in pregnancy. BMJ. 2007 Oct 13;335(7623):769-73.
Reviewed By: Reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Previously reviewed by Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. (6/19/08)
