Focal Seizures


What is a Focal Seizure?

Seizures occur when nerve cells in the brain send out sudden, excessive electrical signals. Focal seizures take place when these abnormal electrical signals occur in one or more areas on one side of the brain.

What are the symptoms?

The clinical features of focal seizures depend on the area of the brain that is affected. As one side of the brain controls the opposite side of the body, a seizure involving for example the right side of the brain would occur in the left side of the body. The opposite is true if the left side of the brain was involved, the right side of the body would be affected.

Clinical features of focal seizures:

  • Aura: Before focal seizures are obvious, your child may sense a seizure is about to happen. This “sense” or feeling is called an aura, also commonly identified as a “warning”. The aura reflects the initial seizure discharge. It may be a particular sensation such as a certain smell, an unpleasant taste or seeing flashing lights. It could also appear as an unusual feeling or as a hallucination.
  • Awareness may remain intact during focal seizures, which is then called “focal aware seizures” (previously called simple partial seizures). If awareness is impaired then the seizure is referred to as “focal unaware” (previously called complex partial seizures).
  • Motor seizures involves a contraction of a muscle or group of muscles that may be mainly  convulsive. This may involve jerking of the arms or legs on one side of the body (clonic seizures) or consist of forced turning of the head and eyes to one side or constant contraction of part of the body (tonic seizures).
    • Clonic seizures involve repeated rhythmic jerking of a muscle or a group of muscles on one side of the body. The body will look as if it is stiffening and relaxing in a rhythmic way. Clonic seizure cannot be stopped by restraining or repositioning of the arms or legs.
    • Tonic seizures involve increased muscle tone (stiffening) of a muscle or a group of muscles on one side of the body lasting for seconds to minutes.
  • Non-motor seizures include focal seizures that do not involve motor activity. This could be noticed as tingling or other unusual sensations on one side of the body (sensory seizures), an unusual feeling or experience such as unexplained fear, uncontrolled laughing or crying (emotional seizures) or an autonomic phenomena such as a racing heartbeat or stomach discomfort (autonomic seizures).
  • Focal seizure that becomes generalized: A focal seizure might begin on one side and then spreads to the entire body. Unless watched closely, a focal seizure might be so short that it is missed. It may look like your child has had a generalized (whole body) seizure.

What can you do?

The most important thing for you to do is to stay calm and follow these steps:

  1. Place your child on a soft surface, lying on their side. Do not restrain the child and do not put anything in their mouth.
  2. If your child vomits, turn them on their side. This will help keep the airway clear.
  3. Remove any furniture or sharp objects from the area.
  4. Look to see exactly how your child moves and how they respond to you so you can describe it later.
  5. Time how long the seizure lasts: - If the seizure lasts more than 5 minutes, call 999 right away for emergency services. Medicine can be given by the emergency medical team to stop the seizure.
  6. If your child loses color in their face (turns blue) for more than 3 minutes, call 999.

After the Seizure:

Your child may be a little irritable or not his/her usual self for a day or more, but this may be related to his or her illness. There is no need to change your lifestyle or the way you care for your child.

  • Your child can safely sleep in his/her own bed or crib
  • Remove extra pillows and soft toys from the bed. For a toddler, use a guard rail on the bed
  • If your child continues to be sick and has other signs of illness, continue to follow the doctor’s orders

How is it prevented?

Prevention of a seizure will depend on the cause. Medicine can help, but some children may still have seizures. If the doctor gives your child medicine, it is important that you give your child the medicine as instructed. It is also important to avoid other seizure triggers such as sleeping late every night.
If your child has a seizure, there are things you can do to keep your child safe. The main goal is to protect your child from injury.

Call Emergency Services (999) if:

  • The seizure lasts more than 5 minutes
  • The seizure causes any problems with breathing
  • Your child injured their head during the seizure
  • Your child has 2 seizures in a row, without much time between them
  • Your child has a seizure and does not wake up after the seizure stops
  • Your child has a seizure and is very confused after