Focal Or Partial Epilepsy: Causes, Symptoms And Treatment

We know as “epilepsy” a group of disorders of the nervous system that is characterized by the predisposition to suffer episodes of abnormal electrical activity in the brain that cause seizures and other symptoms. Sometimes other brain alterations associated with epilepsy also appear, such as delays in cognitive development.

In this article we will describe The causes, symptoms and treatment of focal or partial epilepsythe most common subtype of this disease, which is defined by the alteration of electrical activity in limited regions of the brain.

What is focal epilepsy?

The different types of epilepsy are differentiated by different clinical dimensions. One of the most relevant is the degree of generalization of the electrochemical dysfunction from a cerebral point of view; In this sense, the fundamental divergence is that between focal or partial epilepsy and generalized epilepsy.

We speak of partial epilepsy when there is a clear predominance of partial seizures. This means that the episodes of dysfunction of brain activity, the cause of seizures, begin in a specific area of ​​the brain, although they can later spread to this entire organ. When this phenomenon occurs we speak of “secondary generalization.”

On the contrary, Generalized or “grand mal” seizures affect the entire brain, or a large part of it, from the moment they begin. Generalized epilepsy is associated to a greater extent than focal epilepsy with the appearance of the epileptic aura, a set of prodromes that include alterations in sensory perception or psychological confusion.

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In the literature we can also find references to the involvement of one or both hemispheres when distinguishing between focal and generalized epilepsy. Loss of consciousness and an epileptic aura are more characteristic of generalized seizures, although they can also occur in partial seizures, especially if they affect a large brain region.

Symptoms of partial seizures

Sometimes focal epileptic seizures affect the level of alertness, consciousness and memory, and can also influence observable behavior. In these cases We talk about focal or complex partial seizures.while if there are no alterations in memory and consciousness is maintained, they are considered simple focal seizures.

Another relevant difference is that the epileptic aura is more common in complex seizures than in simple ones. Symptoms and signs of focal epilepsy They can also vary greatly depending on which brain regions are affected.

The most common phenomena associated with partial seizures are the following:

Besides Symptoms depend on which brain lobes are affected. If the crisis occurs in the frontal lobe, strange movements and difficulties speaking may appear; if in the storm, fear, automatisms and déjà vu; if in the parietal, tactile sensations and distortions in perception; and if they occur in the occipital, dysfunctions and sensations in the eyes.

As we have said previously, some partial seizures spread to the rest of the brain after starting in a specific region of it; It is this last aspect that gives them the consideration of focal points. The size of the brain area affected by the electrical alteration influences the degree of significance of the symptoms.

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Causes of this type of epilepsy

Partial epilepsy is the most common type of this disease. It is especially common in elderly people (around 65 years of age or older), and the presence of cerebrovascular disorders or brain tumors is a very relevant risk factor.

It is common for focal epilepsy, especially when it begins in adulthood, to appear as a consequence of different factors that damage the brain. Among these stand out ischemic strokes, head injuries, tumors and brain infections. In other cases the cause of focal epilepsy is unknown.

In children, it is more common that the cause does not occur as a consequence of factors such as these, but rather is of a primary nature; In these cases we speak of “idiopathic epilepsy”. It is worth mentioning the existence of benign childhood focal epilepsy, which is characterized by the presence of focal seizures, their relative mildness, and their disappearance during adolescence.

Treatment of this alteration

Generally, epilepsy, both focal and generalized, is managed through pharmacological treatments. Common antiepileptic medications include gabapentin, lamotrigine, topiramate, valproate, and oxcarbazepine. It can also be very useful to adopt a ketogenic diet (low in carbohydrates and high in protein).

In some severe cases of focal epilepsy it may be advisable to carry out surgical intervention to prevent greater risks or reduce interference with life. This type of surgery consists of remove the part of the brain with which epilepsy is associated so that the episodes of dysregulation of brain electrical activity disappear.

However, the variability of treatments is high; When their manifestation is particularly benign, epilepsy spectrum disorders may not have significant consequences or require any type of treatment.