All You Need to Know about Focal Epilepsy
Focal epilepsy or focal seizure occurs in a specific part of the brain usually involving one side. It was earlier known as simple partial/complex partial epilepsy and partial seizure.
What is a focal seizure?
A focal seizure starts as an abnormal electrical activity at one spot or multiple spots in a distinct area of the brain. Then it can propagate involving other areas of brain and even whole brain can get involved causing whole body generalized seizure. Onset of the seizure is what determines whether it is focal or a generalized seizure.
Each part of the body is controlled by a certain area of the brain therefore according to the area of the brain involved symptoms will occur. You will notice abnormal movements of a limb or muscle twitching involving a part of your body or an aura.
What are the causes of focal epilepsy?
Causes usually involve one area of the brain. It could be an acquired cause such as a scarring, stroke, tumor, traumatic brain injury and following brain surgery or a genetic and developmental disorder causing an area of abnormal formation of neurones in the brain leading to seizures in the future.
How focal seizures are classified?
According to the presentation, focal seizures are classified because it is important for the treatment. If someone is aware during the seizure it is known as Focal aware seizure and if someone has impaired awareness during the seizure it is called a focal impaired awareness seizure which is earlier known as complex partial seizure. Focal to bilateral generalized tonic-clonic seizure occurs starting from one area and spread to other areas of the brain causing abnormal movements involving the whole body.
How focal epilepsy is diagnosed?
Basically, you can identify the focal epilepsy and can differentiate from generalized seizure by seeing a video of convulsions which starts involving one area of the body or at least by having someone who saw the incident to describe it. The nature of the aura also helps to localise where the seizure is.
Investigation also helps to identify the area of abnormal electrical activity and the underlying structural cause in the brain.
EEG is useful to categorize epilepsy and understand the cause. In a focal seizure usually one spot sparks electricity in the brain.
Epilepsy protocol MRI is done which is specified for epilepsy and read by an expert in neuroradiology.
How to treat Focal epilepsy?
All the anti-seizure medications are known to be effective for focal seizures. Therefore, treatment is chosen considering the background of the patient. It is important to identify whether there are any underlying conditions which can be treated together with this condition. For example, If someone has depression Levetiracetam (Keppra) should be avoided which can worsen depression and anxiety. They can be given Lamotrigine (Lamictal) which can also treat depression and anxiety together with focal seizure.