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Partial (focal) seizure - Symptom

Alternative Names

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

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.

Abnormalmuscle 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
Automatisms -- complex, repetitive movements (such as picking at clothes)
- 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:

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

Signs and tests:

It is extremely difficult to diagnose a single focal seizure. However, the diagnosis is easier to make in patients who have repeated, similar episodes --especially if there are risk factors such as a history of head injury. A doctor will diagnose this type of seizure based on the symptoms and after ruling out other medical conditions that can cause similar symptoms.

An EEG may show changes and possible the location of the cause of the seizure. This test can be normal in between seizures. A normal EEG does not rule out a seizure disorder.

Blood tests may be done to determine the cause of the seizures. This may include:

Blood chemistry
Blood sugar (glucose)
Complete blood count
Kidney function tests (BUN, creatinine, and others)
Liver function tests
Tests for infectious diseases

Tests for the cause may include procedures such as:

Head CT or MRI scan

Central nervous system

Reviewed last on: 6/19/2008
Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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.

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