Understanding partial onset seizures (focal seizures)

  • January 8, 2024
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Man having a partial onset seizure while working

Partial onset seizures - which are also known as focal seizures - are the most common kind of epileptic seizure. For every five people with epilepsy, three have partial seizures - according to the National Library of Medicine

If you, or someone you know, have partial onset seizures, it can be really helpful to learn a bit more about them, how they are treated and what their symptoms are. 

A change in name

In 2017, the International League Against Epilepsy updated the names used for different kinds of seizure to give them more accurate descriptions. Partial onset seizures were officially renamed as ‘focal seizures’. This is because the seizure activity begins in one specific focal point in the brain. 

Many people who were diagnosed before 2017 still think of their seizures using the old names. It’s fine to use the old names if you’re more comfortable with them, but it’s helpful to learn the new names too. If your treatment team starts using the new names and you’re not 100% sure you understand, ask them to clarify. 

Unsure about the names? We’ve published a glossary of new and old terms for seizure types

What is a partial onset seizure?

An epileptic seizure is when there is an abnormal surge of electrical activity in the brain. For some people, the electrical activity begins at one specific place. This means they are having a partial onset seizure. 

For other people, the abnormal electrical activity happens all across the brain at the same time. These people have generalized seizures. Sometimes, a partial onset seizure can spread across the brain and become a generalized seizure.

Partial onset seizures can have different symptoms to generalized seizures. They may also be treated in different ways. 

Partial onset seizure symptoms

Different parts of your brain are in charge of activity in different areas of your body. So, the kinds of partial onset seizure symptoms you have will depend on where in the brain the seizure starts.

For example, if the seizure affects the part of the brain which controls the movement of your limbs, then your symptoms may include twitching in your arms. If the seizure begins in part of your brain which affects speech, then you may make unusual noises.

There are a couple of different types of partial onset seizure and they can have different symptoms

Simple partial seizures (also known as focal aware seizures)

In a simple partial seizure (which is sometimes known as an ‘aura’), symptoms may include:

  • Remaining conscious throughout the seizure. You will be aware of what is happening and can remember the event.  
  • Strange, hard to describe feelings.
  • A ‘rising’ sensation in your stomach.
  • Deja vu - feeling like something has already happened.
  • Stiffness or twitching in your arms or hands or other parts of the body.
  • Tingling feelings.
  • Strange smells or tastes.
  • Intense feelings of happiness or fear.

Complex partial seizures (also known as focal impaired awareness seizures)

Symptoms of complex partial seizures include:

  • Losing your sense of awareness.
  • Random, uncontrolled body movements such as rubbing your hands, moving your arms in a cycling motion, or picking at clothes or objects.
  • Making strange noises.
  • Smacking your lips.

Treating partial onset seizures

There are several different kinds of treatment for partial onset seizures. 

  • Medication: Anti seizure medicine is normally the first method that doctors use to treat partial onset seizures. There are several different kinds of medicine that may be used to stop or reduce the number of seizures you have. For about one third of people, medication does not prevent their seizures (this is known as ‘refractory epilepsy’).
  • Medical devices: Certain medical devices can be implanted in your body to help treat epilepsy. They send small electrical pulses into your brain and this can help reduce the number of seizures you have, and make them less severe. These include vagus nerve stimulation, deep brain stimulation (DBS) or responsive neurostimulation (RNS).
  • Diets: Certain diets such as the high fat and low carbohydrate ketogenic diet can also help to treat partial onset seizures. 

Treatment: Your guide to the main epilepsy treatment options

Getting the support you need for partial onset seizures

Everybody's experience of having partial onset seizures is unique to them. For some people, treatment such as neurostimulation or epilepsy medication can help bring their seizures under control. For others, more support is needed and they may need to try a few different treatments before finding a solution that works for them.

It is really valuable to work closely with your doctor to get the best treatment for you. You can use Epsy to record when you have seizures, set medication reminders, and then send this information to your treatment team so they have the most detailed information about your partial onset seizures as possible. Try Epsy today.

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