Epilepsy is a neurological condition that causes recurrent seizures or involuntary, sudden, and uncontrolled bursts of uncontrolled electrical activity between the neurons (brain cells). Some people have seizures beginning in one area of the brain, which is known as focal epilepsy. It is more common in people who have head injuries, stroke, or brain tumours. We spoke to Dr Shiva Kumar R, Head and Senior Consultant Epileptology- Manipal Hospital, Sarjapur Road, Bengaluru, who explained focal epilepsy, its symptoms, causes, and treatment.
“Focal epilepsy is a common type of epilepsy seen due to aberrant electrical activity in a specific region of the brain”, said Dr Kumar. According to Brain and Behavior, Of those with epilepsy, up to 61% experience focal seizures. They are linked to a higher risk of harm and early death compared to the whole population.
Types of Focal Epilepsy
There are two clinical types of focal epilepsy:
Focal onset aware seizures
In focal onset aware or simple partial seizures, the seizure episode happens and the person remains conscious and is aware throughout the episode. “The affected person often presents with unusual movements, sensations, and emotions. These seizures exist for small durations typically lasting for a few seconds to a few minutes”, said Dr Kumar.
Focal onset impaired awareness seizures
In the focal onset impaired awareness seizures or complex partial seizures, there is altered consciousness or awareness during the seizure episode. Dr Kumar added, “The affected person often presents symptoms, such as purposeless repetitive movements and lack of appropriate response to their surroundings (amnesia). Such seizures last for longer duration than the focal onset aware seizures.”
Causes of Focal Epilepsy
Focal epilepsy has multifactorial causes like brain tumours, genetics or hereditary, infections, brain trauma, and many others. In some cases, the actual cause of focal epilepsy may remain undetermined. According to StatPearls, seizures with a recent onset of 25-30% are found to be induced or after another cause. The incidence of epilepsy is higher in younger and older age groups and rises gradually after the age of fifty.
Symptoms of Focal Epilepsy
Since seizures are caused by a disruption in the normal brain cell functioning due to the aberrant electrical activity in a specific part of the brain, the symptoms vary based on the affected region. Dr Kumar listed the commonly presented symptoms as follows:
- Motor Symptoms: Involuntary and repetitive jerking motions and stiff muscles confined to one side of the body
- Sensory Symptoms: Tingling numbness, distorted vision or warped vision, changes in perception, etc
- Autonomic Symptoms: Elevated heart rate, upset stomach, and excessive sweating.
- Cognitive Symptoms: Confusion, memory loss, or behavioural changes
Diagnosis For Focal Epilepsy
A precise diagnosis is essential for managing focal epilepsy effectively. “The location and potential reasons for aberrant brain activity are often determined by neurological tests, medical history analysis, and imaging investigations including MRIs and CT scans”, informed Dr Kumar. Electroencephalography (EEG) is another tool used to monitor electrical activity in the brain and helps determine the cause of seizures.
Treatment of Focal Epilepsy
The usual approach to managing focal epilepsy is a mix of medication, lifestyle changes, and occasionally surgical procedures. “Antiepileptic medications (AEDs) are frequently administered to treat seizures by balancing the brain’s electrical activity. However, not everyone responds well to medicine; in these situations, surgical treatments like neuro-stimulation or reconstructive surgery might be taken into consideration”, added Dr Kumar.
Managing Focal Epilepsy
Living with focal epilepsy requires lifestyle modifications in addition to medical care. Finding the best course of action for their unique situation requires patients and healthcare professionals to collaborate. Dr Kumar listed some of the management measures as follows:
- People who have been diagnosed with focal epilepsy are advised to avoid triggers that could cause seizures
- Engage in activities to manage your stress levels
- Get adequate sleep and stick to a regular sleep routine
Dr Kumar concluded, “It is crucial to raise awareness and compassion for those suffering from focal epilepsy. Understanding the intricacies of the brain may further enhance the integration of medical intervention to enhance the quality of life for individuals impacted by this illness.”[Disclaimer: The information in this article contains information provided by a registered healthcare professional expert and is for informational purposes. Hence, we advise you to consult your expert if you are diagnosed with epilepsy to get a treatment tailored to your needs.]