Seizure Disorder, Focal



  • Seizures occur when abnormal synchronous neuronal discharges in the brain cause transient cortical dysfunction.
  • Focal or localization-related seizures have previously been referred to as partial seizures and originate from a discrete focus limited to one cerebral hemisphere.
  • Focal seizures are further divided into aware versus unaware and motor versus nonmotor.
  • Presence of impaired awareness is defined as the inability to respond normally to exogenous stimuli due to altered awareness and/or responsiveness:
    • Focal seizures with impairment of awareness (formerly “complex partial seizures”)
    • Focal seizures without impairment of awareness (formerly “simple partial seizures”)


Focal seizures occur in 20/100,000 persons in the United States.

Etiology and Pathophysiology

  • Focal seizures begin when a localized seizure focus produces an abnormal, synchronized depolarization within a neuronal network limited to one cerebral hemisphere; it may stay discretely localized or be widely distributed throughout that hemisphere.
  • The area of cortex involved in the seizure determines the symptoms; for example, an epileptogenic focus in motor cortex produces contralateral motor symptoms.
  • Most common etiologies vary by life stage:
    • Early childhood: developmental/congenital malformation, trauma
    • Young adults: developmental, infection, trauma
    • Adults 40 to 60 years of age: cerebrovascular insult, infection, trauma
    • Adults >60 years of age: cerebrovascular insult, trauma, neoplasm

Benign rolandic epilepsy, has an autosomal dominant inheritance pattern

Risk Factors

  • History of traumatic brain injury (TBI)
  • Thiamine-deficient formula

Commonly Associated Conditions


There's more to see -- the rest of this topic is available only to subscribers.