Focal Seizures with Retained Awareness

This type of seizure originates within one brain hemisphere and does not impair awareness or consciousness. During the seizure the person will be able to communicate and will remember the episode afterwards.

Some people have full awareness at the very beginning and then their seizure evolves, or spreads, and can result in a Focal Dyscognitive Seizure, or a generalized Tonic-Clonic Seizure.

Focal seizures take different forms in different people. The person’s sense may be distorted causing him/her to see, hear or smell things that are not real. S/he may also experience unusual feelings. All these symptoms are further classified into four categories:

1. Autonomic SeizuresExpand 1. Autonomic Seizures Section

These seizures are accompanied by autonomic symptoms or signs, such as abdominal discomfort or nausea which may rise into the throat (epigastric rising), stomach pain, the rumbling sounds of gas moving in the intestines (borborygmi), belching, flatulence and vomiting. This has sometimes been referred to as abdominal epilepsy. Other symptoms may include pallor, flushing, sweating, hair standing on end (piloerection), dilation of the pupils, alterations in heart rate and respiration, and urination. A few people may experience sexual arousal, penile erection, and orgasm.

2. Emotional and OtherExpand 2. Emotional and Other Section

Focal seizures which arise in or near the temporal lobes often take the form of an odd experience. One may see or hear things that are not there. One feels emotions, often fear, but sometimes sadness, anger, or joy. There may be a bad smell or a bad taste, a funny feeling in the pit of the stomach or a choking sensation. These seizures are sometimes called focal seizures of temporal lobe origin or temporal lobe auras.

3. MotorExpand 3. Motor Section

Other focal seizures include (clonic, jerking) convulsive movements. Jerking typically begins in one area of the body — the face, arm, leg, or trunk — and may spread to other parts of the body. These seizures are sometimes called Jacksonian motor seizures; their spread is called a Jacksonian march. It cannot be stopped so let the seizure run its course and end on its own.

4. Sensory SeizuresExpand 4. Sensory Seizures Section

Some focal seizures consist of a sensory experience. The person may see lights, hear a buzzing sound, or feel tingling or numbness in a part of the body. These seizures are sometimes called sensory seizures.

What are auras?Expand What are auras? Section

For some people, the first symptom of a seizure may be an aura. An aura is actually a focal seizure with retained awareness and is experienced as peculiar sensory or experiential phenomenon (such as deja vu).

Common aura descriptions:

  • butterflies in the stomach
  • flashes of light
  • odd noises (e.g. buzzing in the ear)
  • strange smells (e.g. burnt toast, rotten eggs)
  • a powerful emotion
  • dizziness

An aura may precede a focal dyscognitive seizure or a generalized convulsive seizure. People who experience auras can use them as a warning signal.

Children and Auras

It is helpful to teach the child about auras to help the child determine if s/he experiences them. When the child experiences an aura, s/he can take quick precautions to ensure safety and avoid potentially harmful situations.

First Aid

Comfort and reassure the person.