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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 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

Figures

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. 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.

Symptoms can include:

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

References

Abou-Khalil BW, Gallagher MJ, Macdonald RL. Epilepsies. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC. Bradley’s Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 67.

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