What is Focal Epilepsy?
Focal epilepsy is a type of epilepsy where seizures start in a specific part of the brain. These seizures are also known as partial seizures, and they may stay localized or spread to other parts of the brain. Focal epilepsy can affect awareness, movements, sensations, or emotions depending on where the seizure begins.
How is it different from generalized epilepsy?
In focal epilepsy, seizures originate from one part of the brain. In generalized epilepsy, the seizure activity affects both sides of the brain from the start. Focal seizures may evolve into generalized seizures (called secondary generalization).
What causes focal epilepsy?
Focal epilepsy can result from various underlying conditions, including:
- Head trauma
- Brain infections (like meningitis or encephalitis)
- Stroke
- Brain tumors
- Congenital brain abnormalities
- Genetic factors
- Scar tissue or brain malformations
Sometimes, the cause is unknown (idiopathic focal epilepsy).
What are the symptoms of focal seizures?
Symptoms vary depending on the brain area affected and may include:
- Jerking movements in one part of the body (e.g., hand or face)
- Strange sensations (tingling, numbness)
- Visual or auditory hallucinations
- Sudden emotions like fear or déjà vu
- Staring spells or confusion
- Automatic behaviors (lip-smacking, hand movements)
- Loss of awareness or responsiveness
Focal seizures are classified into:
- Focal aware seizures (formerly called simple partial seizures) – person remains aware.
- Focal impaired awareness seizures (formerly complex partial seizures) – person is confused or unaware during the event.
How is focal epilepsy diagnosed?
Diagnosis involves:
- Detailed medical history and seizure description
- EEG (electroencephalogram) to detect abnormal brain activity
- Brain imaging (MRI or CT scan) to find structural issues
- Video EEG monitoring for difficult cases
A neurologist or epileptologist may conduct additional tests to pinpoint the seizure focus.
What are the treatment options?
- Anti-seizure medications (ASMs):
- Most people respond well to medications like carbamazepine, lamotrigine, levetiracetam, etc.
- Surgery:
- In cases where medications fail and the seizure focus can be safely removed.
- Vagus nerve stimulation (VNS):
- A device implanted in the chest sends electrical impulses to reduce seizures.
- Responsive neurostimulation (RNS):
- Detects and disrupts seizures in real-time with a brain implant.
- Ketogenic or modified Atkins diet:
- May help in medication-resistant cases.
- Lifestyle management:
- Get enough sleep
- Avoid alcohol and triggers
- Stress reduction and regular routines
Can focal epilepsy be cured?
Some people achieve seizure freedom with treatment, especially if the seizures are well-controlled with medication or surgery. In others, focal epilepsy may be a lifelong condition, but symptoms can often be managed effectively.
What are the risks if left untreated?
Untreated focal epilepsy can lead to:
- Injury during a seizure
- Progression to generalized seizures
- Cognitive or memory issues
- Emotional and mental health challenges
- Sudden unexpected death in epilepsy (SUDEP) – rare but serious
When should I see a doctor?
Consult a neurologist if:
- You’ve had a seizure or unexplained blackouts
- You experience strange sensory or emotional episodes
- You were previously diagnosed and your seizures change or increase
- Medications are not working or cause side effects