Partial Epilepsy

Overview

Focal epilepsy, also called partial epilepsy, is caused by an abnormal electrical activity which begins in one region of the brain but may spread to other areas during an episode. Some focal seizures that involve only small areas of the brain may not affect memory, awareness or consciousness. However, most focal seizures do involve enough brain tissue to cause noticeable symptoms.  People may experience “auras” – that is warnings – at the onset of a seizure, experience staring or odd behaviors during a seizure, with confusion and disorientation immediately following.

In over 30% of cases, secondary generalization occurs, which is when the focal seizures expand into seizures that affect the whole brain and cause loss of consciousness and convulsive activity.

When witnessing a seizure, the best thing to do is to remove any objects nearby that pose a risk for injury and monitor the individual’s breathing and pulse. Never forcibly restrain an individual who is having a convulsion as that can increase the risk of injury. Similarly never place any object or fingers into the mouth of a person having a seizure, as there is a risk of injury, breaking a tooth or breathing a foreign object into the lung.  Instead, place a soft cushion or rolled garment under the head to protect against injury during the convulsion.

Risks

Focal epilepsy seizures are due to disrupted electrical activity that takes place in the large part of your brain. Some causes of seizures include:

  • Rapid metabolic changes, including low level of glucose
  • Sudden high rise in body temperature
  • Birth defects
  • Family history of seizures
  • Brain injury
  • Alcoholism
  • Illicit drug use
  • Brain tumor
  • Stroke
  • Encephalitis or other brain infection
  • Drug withdrawal
  • Sleep deprivation

Symptoms

Warning signs of seizures have been reported to involve feelings of anxiety or déjà vu, a metallic taste in the mouth, nausea, dizziness, flushing, changes in sensation, focal limb jerking or changes in vision, such as seeing flashing or bright lights, spots or lines.

Seizures occur suddenly and can include:

  • Brief loss of consciousness
  • Behavioral changes
  • Sudden changes in mood
  • Drooling
  • Frothing at the mouth
  • Unusual eye movements
  • Shaking
  • Convulsions
  • Sudden falling
  • Clenched teeth
  • Loss of bladder or bowel control
  • Impaired breathing

Diagnosis and testing

If your doctor suspects that you’ve had a seizure, the focus will be on determining an underlying medical condition that may have triggered it. This may include reviewing your medical history and eyewitness reports.

 

Diagnosis may also include a thorough medical and neurological examination with a variety of tests, such as:

  • Blood tests
  • Computerized tomography (CT) scan
  • Magnetic resonance imaging (MRI)
  • Drug screening
  • Spinal tap (lumbar puncture)
  • Brain CT or MRI
  • Electroencephalogram (EEG) 

Treatment

If you’ve been diagnosed with focal epilepsy, you’ll be prescribed an anti-seizure medication. Your doctor will start with a low dosage and adjust this based upon what is needed to control your seizures. Additional treatment may include surgery, vagus nerve stimulation implant or lifestyle changes, which include:

  • Avoiding alcohol and caffeine
  • Getting plenty of rest
  • Ketogenic diet