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Focal seizures

When an epileptic seizure starts in one side of the brain, it’s called a focal onset seizure or a focal seizure. Both terms mean the same thing. Until recently these seizures were called partial seizures.

What are the main types of focal seizure?

There are 2 main types of focal seizure.

Focal aware seizures

During a focal aware seizure, you stay fully aware of what’s happening around you. This type of seizure used to be called a simple partial seizure.

Focal impaired awareness seizures

If your awareness of what’s happening around you is affected at any time during your seizure, it’s called a focal impaired awareness seizure. This type of seizure used to be called a complex partial seizure.

What happens during a focal seizure?

What happens to you during a focal seizure depends on which part of the brain the seizure happens in. This is because different areas of the brain control movements, body functions, feelings and reactions. Some people experience just one symptom during a focal seizure, while others experience several.

The symptoms of focal seizures can be split into 2 groups. Symptoms that involve movement are called motor symptoms. Symptoms that don’t involve movement are called non-motor symptoms. Here are some examples:

Motor symptoms

Non-motor symptoms

  • Part of your body, for example one arm, going stiff
  • Part of your body going limp or ‘floppy’
  • Rhythmic jerking in part of your body
  • Brief, irregular jerks in part of your body
  • Your head and eyes turning to one side
  • Lip smacking, repeated swallowing or chewing
  • A jerking movement that starts in one part of your body – usually your hand or face – and then spreads bit by bit to other parts of your body
  • Having repeated movements such as rocking, pedalling or pelvic thrusting
  • Undressing
  • Running or walking
  • Feelings of fear, anxiety, anger or pleasure
  • Changes to your vision, hearing, smell or taste
  • Having sensations of being hot or cold
  • Seeing or hearing things that aren’t there (hallucinations)
  • Feeling like your body is distorted
  • Feeling like part of your body is missing or doesn’t belong to you
  • Feeling or being sick
  • Changes to breathing, heart-rate or skin tone
  • Feeling like what’s happening has happened before (deja vu)
  • Difficulty processing language

 

How long do focal seizures last?

Most focal aware seizures are brief, lasting between a few seconds and 2 minutes. Focal impaired awareness seizures usually last between one and 2 minutes.

What happens after a focal seizure?

What happens after a focal seizure varies from person to person. You might feel fine after a focal seizure and be able to get back to what you were doing straight away. Or you might feel confused or tired for some time afterwards. You might need to sleep.

Some people find they have temporary weakness or can’t move part of their body after they’ve had a seizure. This is called Todd’s paresis or Todd’s paralysis. It can last from a few minutes up to 36 hours, before going away.

How can someone help me during a focal seizure?

You might not need any help from people around you during a focal seizure, especially if it’s brief and you’re aware of what’s happening. But if you’re not aware of what you’re doing you might need help to guide you away from danger and keep you safe. See our first aid information, or ask them to take our short online course which shows them what to do when someone has a seizure.

See this information with references

If you would like to see this information with references, visit the Advice and Information references section of our website. If you are unable to access the internet, please contact our Epilepsy Action Helpline freephone on 0808 800 5050.

Code: 
B037.04

Epilepsy Action would like to thank Professor Helen Cross, The Prince of Wales’s Chair of Childhood Epilepsy and Honorary Consultant in Paediatric Neurology at UCL Institute of Child Health and Great Ormond Street Hospital for Children, for her contribution to this information.

Professor Cross has declared no conflict of interest.

This information has been produced under the terms of The Information Standard.

  • Updated July 2017
    To be reviewed July 2020

Comments: read the 33 comments or add yours

Comments

Hello, Epilepsy Action. This is a test.

Submitted by Graham Goodwin on

I had Meningitis when I was 2. I'm now 52 and developed Epilepsy 7 years ago. I've heard that there is a link between having had meningitis as a child and epilepsy in later life. Do you have any information about this? Thanks.

Submitted by Elaine McElhatton on

Hi Elaine

 

Yes, an infection such as meningitis can cause epilepsy to develop at any age. You might want to contact Meningitis Now in case they have more specific information.

 

Regards

 

Cherry  

Epilepsy Action Helpline Team

Submitted by rich on

Can anyone inform on abdominal seizures.

Submitted by Deborah Ravago on

Hi, my son is 9 and has not yet been diagnosed. He started having seizures 5 years ago. Over time I am starting to piece together what I think are partial seizures which sometimes turn into generalized seizures. there are many days though, almost everyday where he complains of not feeling right, mostly he gets spells of extreme nausea, sometimes he goes pale and feels like he's going to loose consciousness but he doesn't, and sometimes he has visual disturbances, his vision goes blurry sometimes and he just can't see right, sometimes he describes it like the thing he's looking at looks like it is raised off of the table. So if he was looking at his book on the table he feels a weird sensation in his brain kind of like electricity and then the book looks like it's closer to his face than it is. He said it's hard to explain. When this happens it only lasts seconds. When the nausea type happens it can lasts minutes. So what I am wondering is if these are partial seizures, and what type of partial seizure is it. Many times after he comes out of a generalized seizure he gets extremely sick and throws up a few times over a few hours and then starts feeling better and sometimes a headache around the forehead area follows. I am trying to find out exactly what type of seizure he's having and exactly what part of the brain is being effected which causes him to have those bouts of vision disturbances and at other times the nausea. All his eegs and his mri looked normal, so no help there. I appreciate any help with diagnosing this, as his neurologist just wanted to put him on a broad spectrum type medication, and I haven't yet because I would prefer knowing for sure what type of seizure he is having before starting him on meds. Thanks for your help!

Submitted by Lindsay on

Hi Lindsey

Thanks for your message. I can understand you must be worried about your son and you want to know what type of seizures he’s having.

From what you’ve described, it sounds like your son could be having partial seizures, also called focal seizures. There’s also a type of childhood epilepsy called Panayiotopoulos syndrome that can have symptoms similar to the ones you’ve described.

The symptoms of seizures can vary depending on what lobe of the brain is affected. But even if your son’s seizures can be diagnosed as happening in a particular lobe of the brain it’s unlikely this would change the decision of what medicine to prescribe. This is because there aren’t any epilepsy medicines that are targeted to treat seizures occurring in a specific lobe of the brain. Most epilepsy medicines either treat focal or generalised seizures, or are designed to treat both.

Many parents find the decision about whether or not to let their child take epilepsy medicine difficult. But for most children with epilepsy, the benefits of taking medicine outweigh the potential negatives. This is because seizures can be unpleasant for the child and can be dangerous. And if they happen frequently they can affect learning. Have you tried talking to your son’s neurologist about your concerns? They should be able to answer any questions about your son’s treatment, and explain why they think the medicine they want to prescribe is right for him.

Grace

Epilepsy Action Helpline Team

Submitted by rich on

Hi, I have quite similar symptoms to your son and my Nuero just did the same, recommend me to start the meds even tye MRi and ref result came back normal,but I’m not keen on start the meds before I find out what is causing it.my Nuerologist seemed not very supportive at all, just saying sometimes it just happens at any age without a reason...
Feel so pointless to see the neurologist after all :(

Submitted by LUCY W on

My partner makes fish like movements with his mouth & says he's not aware & often wonders why his jaw hurts! Could this be a form of epilepsy? He refuses to go to the Drs! Any advice would be greatly appreciated please.

Submitted by Cheavey on

Hello Cheavey

 

I am not able to say whether what your partner is experiencing is a seizure. It is possible for a person to have lip smacking movements and altered levels of consciousness during a seizure though. The short videos in our first aid information show you some examples of what may happen to a person during a seizure.

 

It would be worth your partner talking to his GP about what has happened, although I can hear he does not want to at the moment. If he does decide to talk to the GP, then the GP may refer him to a specialist doctor, usually a neurologist. You can find out more about how epilepsy is diagnosed on our website by following the link included in this message.

If either of you would like to talk about what happened, or if we can be of any more help, please feel free to get in touch.

Karen
Epilepsy Action Advice & Information Team

Submitted by rich on

Baby cried late at birth. He had seizers on 2nd day. Then from 1month till now 4th month he is having seizers quite frequently. Doctor advised phenobarbital and livitracitam syr. But the seizers are not in control. He is having quite frequent seizer. Is it curable in long term. What would happen long term. Please advise if it would be cured at he adult age.

Submitted by Uttam Das on

Hi Uttam

It must be very difficult to watch this happening to your baby and have all those questions.

It can be difficult to make an accurate diagnosis of exactly what is happening for a baby. Our information on epilepsy in babies will tell you more about this.

Until the doctors can be sure about what is happening for your son, it won’t be possible to say what might happen for him in the future.

If your baby is diagnosed with a particular childhood epilepsy syndrome, then we will be able to give you more information about these.

Regards

Cherry, Epilepsy Action Helpline Team

Submitted by Cherry@Epilepsy... on

Hi there
My son had a brain abscess in his right frontal lobe when he was 9 years old (6 years) ago. He had an operation, and subsequently developed Epilepsy. (Tonic clonic & complex partial seizures.)
His seizures have been well-controlled with Phenytoin. He is now 15, and has suddenly been displaying some really strange behaviour. He has these "episodes" in which he "checks out" and forgets where he is and what he's doing. He is still completely conscious, can speak (albeit rather aggressively) and move normally. He does something completely random, and then "comes back", can recall everything, but doesn't know why he did it. For example, we went to a school concert, and he suddenly (aggressively) decided that he wasn't going to sit with the family. He plonked himself down next to a stranger a few rows down from us. After a few minutes, he turned to find us and came back to join us. He said that he had no idea as to why he'd done that.
This week, in the first lesson of the day, he turned and ran out of school, thinking it was hometime. Confused, he found himself sitting on the pavement outside school, and had to go back in and try to explain. There have been other incidents as well.
Is this a type of seizure? Please help! Worried Mum :(

Submitted by Rose S on

Hi Rose

It’s not surprising that that feels worrying for you and for your son.

I think it might be a good idea to get back in touch with the neurologist about this.

He might need some more tests doing, or an alteration of his epilepsy medicine.

Regards

Cherry  

Epilepsy Action Helpline Team

Submitted by rich on

Hi. I hope someone can maybe answer a couple questions, if not I'm reaching out to see if others have same experience. Its just been discovered that my 15-year-old daughter has what a neurologist says are focal seizures. They're very brief and no one has really seen them happen, but this is being diagnosed based on HER experience. I believe her, but I'm fearful to put her on the meds straight away, wondering if there's ANY possibility it's something else. She's had a normal EKG and EEG. She has an MRI for this friday, but doc says she would diagnose this even if that comes back normal. So, I'm very hesitant. My daughter is basically experiencing static feelings in her head and then feeling a sway and like she's going to pass out, but doesn't and feels displaced from her body. She's had multiple respiratory colds this year. Could this be as simple as an inner ear problem? Doctor does not think it's syncopy and all blood work has come back normal as well. Is there any reason for me to doubt this diagnosis based on just a clinical workup from my daughter's description? These only happen once or twice every few weeks (6-7 total within 2 months)...no pattern. The doc already wants her on meds and I'm just kind of reeling from the idea this is what it is.

Also, she has been extremely tired lately. Falling asleep during church, after school and very lethargic at other random times. She doesn't typically sleep during the day. She's a teenager, has been her monthly cycle, so I kind of chalk it up to that, but it does seem abnormal lately. Could this have anything to do with seizures? She says she doesn't feel anything different, other than very tired with these last two sleeping episodes.

Any guidance appreciated.

Submitted by Heather Tudor on

Hi

That’s a difficult situation to be absolutely sure about. 

Epilepsy is defined as recurrent seizures. So the consultant probably wants your daughter on the epilepsy medicine because of the number of seizures she has had.

But I can totally understand your concern about this. 

Here is our information about diagnosing epilepsy and about epilepsy medicines

It would be worth checking with the consultant about exactly why she feels  it would be best to start your daughter on epilepsy medicine at this point. One possible reason could be to prevent her having a tonic-clonic seizure

One option would be to wait and see what happens. If you are able to observe any of these episodes, or particularly if you were able to video any of them to show the doctor, that could feel like more conclusive evidence.

If your daughter is getting enough sleep at night and still feeling sleepy during the day, then that is also a concern. The only problem here is that so much can change for teenagers in terms of their physical and emotional wellbeing that it is sometimes hard to be exactly sure what to pay most attention to. But there is a possibility that she is having sleep seizures. This could explain her tiredness during the day.

I do hope you get to settle with a decision about the epilepsy medicine that feels right for you and your daughter.

Meanwhile here is our information for young people with epilepsy: https://www.epilepsy.org.uk/info/children-young-adults/young-people 

Regards 

Cherry  

Epilepsy Action Helpline Team

Submitted by rich on

I have simple focal seizures that seem to come on clusters and involve a rising from my stomach up through me body, ending in tingling in my fingertips. They normally last up to 2 minutes and then I am fine. I can go for 3/4 months with nothing and then have several. However this week I have had 5 seizures, 2 of which have lasted nearly 10 minutes and have been extremely painful in my chest and back. So much slow that the next morning I feel bruised in that area. I also had 2 when I was asleep which I have never had before. I am not on medication and don't really want to start taking anything. Do you think this is a sign that my seizures are getting worse ? Any advice would be appreciated as I must admit the 2 painful longer seizures have really scared me
Thank you for any help

Submitted by Linda P on

Hi Linda,

We can’t say for sure what is happening for you. But it would certainly be a good idea to talk to your GP about this.

Many people feel reluctant to start taking medicine. But epilepsy medicine is the way to control seizures. https://www.epilepsy.org.uk/info/treatment/anti-epileptic-drug-treatment

So you may want to have another talk with a neurologist about this.

Regards

Cherry  

Epilepsy Action Helpline Team

Submitted by rich on

my daughter has generlised epilepsy and is sayin her legs feel tired all the time and she can be walking and her legs just go in her and she falls over but she hasnt had a fit it just happens when shes walking to or from school and around the house is this because of the epilepsy or should i get her to see some one.

Submitted by sarah on

I have been diagnosed with a concussion, post traumatic vertigo, and constant right frontal lobe seizures. My seizures consist of staring for short periods of time, head rocking which usually then affects my shoulders, sometimes a bit violently, sudden violent jerks of head, neck, and shoulders, shaking of left or both hands which then travels up my arm/arms to my shoulders, and head. I can sometimes feel them coming, by feeling yucky, anxious, or dreadful. I am aware of what is happening during the seizures but am unable to speak. All of this on top of the effects of the concussion, and vertigo, I am basically at home. I do go to work, but am unable to go to crowed, loud places, because of the concussion and vertigo basically. I am taking medications for everything, but I have breakthrough seizures. I was taken off 1 vertigo medication which lasted for 3 days. All the symptoms returned so I am back on that medication and have had a bit of a relapse of all my symptoms. I would just like to know if or when I will get better. I haven’t found anything (which is difficult to read more than a paragraph at a sitting) about healing from seizures or vertigo. A concussion will heal on its own but not a set time. My quality of life has been nill since January of this year. Any positive news for me?

Submitted by Jayne Engel on

Hi Jayne

Thank you for your post. Its sounds like you’re having a difficult time due to health issues. I hope you are still seeing a doctor about this.

Many people with epilepsy respond well to treatment and epilepsy medicine helps them have fewer seizures. It’s not possible to say how long this will take. But for many people, it happens quickly. For others, it takes longer.

There are many different epilepsy medicines available, so it could be worth discussing with your epilepsy specialist if the medicine you are taking is right for you. If you are not under a specialist, you will need to ask your family doctor to refer you. This would usually be to a neurologist. The ideal would be to someone with a specialist interest in epilepsy, as there are many different neurological conditions, and neurologists tend to specialise in different ones.

When someone’s seizures don’t respond well to epilepsy medicine, and they have tried 2 or more different medicines, they should ideally be referred to a specialist epilepsy centre. The epilepsy specialist there could look into other treatment options for you.  They can review your treatment and look at other possible reasons for your seizures to still be happening.

For advice and information about your post traumatic vertigo you could contact Meniere’s UK.

Regards

Diane

Epilepsy Action Helpline Team                                                                                                            

Submitted by Diane-Epilepsy ... on

hell,been diagnosed with temperal lobe epilepsy for just over a year now ,been placed on lacosimide started on 50 mg twice dail the a hundred now 150 mg twice a day but they are not controlling my nocturnal episodes(which are a lot of bed movement shaking pedelling scracthing of pillows shouting falling out of bed getting mildly hurt sometimes and broken sleep. my episodes are getting more regular now).I was trying my best to hide these from doctor and neurologist to get my license back but have come to conclusion that i really need help. please any advice would be welcome.i will advise my doctor as soon as i can get in.please excuse spelling but its going the same way as my speech terrible,stuttering miss wording things that i dont even now that im doing it.plus i was a tattoo artist that three years ago lost his mojo with art,not picked a pen or pencil up since..aged 57 married.

Submitted by kevin davies on

Hello Kevin

It sounds like you have had a lot happen over the last few years. I appreciate it feels challenging for you to talk to your neurologist about this. 

I can also hear that you are finding this lack of seizure control difficult. For some people it can take time to find the right epilepsy medicine, and the right dose. Maybe you could have a chat with your neurologist about the seizures you are having and ask them to review whether Lacosimide is still the best treatment for you. It is possible that a review of your current treatment could have a positive effect on your life.

It is difficult to tell from your message whether you only have seizures in your sleep, or whether you have ever had one when you are awake. If you have only ever had seizures when you are asleep, it is possible that once you have a 12 months pattern of having only nocturnal seizures you may be able to get your driving licence back. If you have had seizures when you are awake and asleep you would need to be seizure free for 12months before you would be allowed to drive again. Whilst you are unable to drive because of your seizures, you are entitled to a free bus pass and disabled person’s railcard.

Living with epilepsy can be tough. It can take time to accept and build it in to your life. You may be interested in taking a look at our online self-management course Epilepsy and you. This aims to give you the skills and knowledge to manage your epilepsy and to get support from other people taking the course.

Our helpline team are also here to listen if you would like to talk to someone about your epilepsy. They can be contacted on 0808 800 5050 and are open Monday to Friday 8.30am to 5.30pm.

Karen

Epilepsy Action Helpline Team

Submitted by rich on

My daughter is 3 and was born with frontal lobe damage. She has been on keppra since she was 9 months old. It's stops the shaking but the only way we know that she has had a seizure is because she is visibly in pain then has Todd's Paralysis. Supposedly this subsides after a maximum of 48 hours, my daughter has been paralysed for 16 days after a seizure before now and the only time that she has recovered in less than 48 hours is when we have given her CBD oil.

Submitted by Gemma on

About 3 years ago I had a partial lobectomy to try and stop my complex partial seizures I was having about three violent seizures a week the surgery work wonders I thank God everyday but now I seem to be having these simple partial seizures they're not nearly as bad as my previous seizures I only get about four a month just makes me a little worried

Submitted by Dan Cunningham on

I think I just had a focal seizure an hour or so ago whilst I was sleeping. I constantly feel itchy after it (although I suspect it’s the anxiety) and my right arm feels numb and weak and I seem to have lost some sensation in it. It’s the same with my left arm except it’s less numb. This is the first time I’ve had one as usually my seizures are just absences lasting a few seconds and I’m usually completely fine after them. I had no idea what had happened to me after the seizure and reading this page helped me calm my nerves a lot and reading the comments made me realise I’m not alone. Thank you very much!

Submitted by Muhammad on

My great gran daughter was diagnosed with focal epilepsy at 3 months old? I thought I would check see what it was and symptom only to see the only 2 she didn't have were the running around and the cloths one .But she is blind, has bowel problems and can't support her head, god knows what else will come along for her, hopefully nothing else

Submitted by Mary young on

My son has a brain malformation and symptomatic epilepsy. He’s just started with focal impaired awareness seizures which like his tonic colonics are prolonged. He’s not written up for emergency meds for this type in his care plan but at what point should I be very concerned that not resolving. One was a 40min seizure, at what point should I get an ambulance. I’ve spoken to epilepsy nurse but all very vague

Submitted by Rebecca Tugby on

Hi Rebecca

Although a focal seizure doesn’t have the same level of danger as a tonic-clonic one, it would still be a good idea to call an ambulance if it goes on longer than 30 minutes.

This is the guidance we’ve had from a neurologist. Hope that helps.

Regards

Cherry  

Epilepsy Action Helpline Team

Submitted by rich on

I have had 'episodes' regularly, but spaced out by up to 9 months since I can remember. I used to wake in the first hour of sleep and have a deep all encompassing fear and feel a restriction in my throat (the fear was as if I was the only person left on the planet). Over the past 6-7 years, this has progressed to a number of periods where I zone out for up to 4 hours but I am still aware of my surroundings, but it's as if my mind is constantly searching for the answer to a very important question, that is on the tip of my tongue and it takes over completely. I also experience very strong deja vu and have done all my life. I have been tested twice for TLE which came up negative (EEG and MRI). I had a long episode a few days ago and it has left me feeling weak and light-headed and scared it will happen again. I also suffer from severe but thankfully intermittent migraine.

Submitted by Daniel on

Hi Daniel

That sounds like a very frightening experience.

I don’t know whether or not you have epilepsy but it is worth knowing that it is entirely possible to have  a clear EEG and MRI and still have epilepsy. Here is all our information about diagnosing epilepsy.

You have had some information about what doctors think it isn’t. But I am guessing you want some answers about what might actually be causing this.

My suggestion would be to go back to your GP and ask to be referred again. If you would prefer not to see the same consultant then it may be possible to request a different one.

I do hope you get some answers soon.

Regards

Cherry  

Epilepsy Action Helpline Team

Submitted by rich on

Hi,
I have episodes of having a very horrible feeling that comes over me, a strong feeling of deja vu that makes me heave like im going to be sick. It only lasts a few seconds then its completely gone, Its affecting my memory quite badly. I forget directions to places ive been quite regularly, i can watch a film and then a short time later i can watch it again and its like ive never seen it before. I'd be really greatful if you could give me any opinions you have on the symptoms ive stated.
Thank you

Submitted by Clare Moule on

Hi

From what you’ve described it’s possible that you could be having focal seizures, however we’re not able to diagnose your symptoms. It would be a good idea to speak to your doctor about the episodes you’ve been having and the memory problems. If the doctor suspects you could have epilepsy, they should refer you to an epilepsy specialist. This is usually a neurologist with experience of diagnosing and treating epilepsy.

I hope this helps. If you need any further advice feel free to call our Epilepsy Action Helpline on 0808 800 5050, Monday to Friday 8.30am to 5.30pm.

Grace

Epilepsy Action Helpline Team

Submitted by rich on

Recently every day I’ve had like de ja vu visions when I try to think hard to recognise the people my mind goes blank I get confused after the 2minutes and I forget what I was doing my arms and legs start to ache and my head I just wanted to ask if I am getting a partial seizure will it get worse with time or will it get better? I am always worried and started to get anxiety 😭 I have a appointment at the hospital end of July

Submitted by Unknown on

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