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Focal Impaired Awareness Seizures

Reviewed by: Amy W. Anzilotti, MD
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What Is a Seizure?

A seizure (SEE-zhur) is unusual electrical activity in the brain. Normally, electrical activity in the brain involves neurons (nerve cells) in different areas sending signals at different times. During a seizure, many neurons fire all at once.

Seizures can happen in one or both sides of the brain. Depending on where a seizure happens, it causes changes in behavior, movement, or feelings. Focal seizures affect only one side of the brain. Generalized seizures affect both sides of the brain. Focal seizures are the most common type of seizures in people with epilepsy.

What Are Focal Impaired Awareness Seizures?

During a focal impaired awareness seizure (also called complex partial seizure), the person isn’t aware of what is going on around them. Theses seizures usually last 1–2 minutes.

What Are the Signs & Symptoms of a Focal Impaired Awareness Seizure?

Someone who’s having a focal impaired awareness seizure has a blank look on their face or might look like they’re daydreaming. They can’t respond to what is going on around them. They may also:

  • open and close their lips loudly or make chewing motions
  • pick at clothes
  • bicycle their legs
  • flail their arms
  • wander around

Sometimes, a focal impaired awareness seizure can begin as a focal seizure on one side of the brain, then spread to both sides. This is called a focal-to-generalized tonic-clonic seizure.

What Is an Aura?

Some people who have focal impaired awareness seizures have an aura before the seizure. An aura is a type of focal aware seizure where someone may have:

  • déjà vu (a feeling of already having been in the present situation)
  • an unusual smell or taste
  • seeing things like flashing lights
  • sudden, intense emotion (such as fear)
  • nausea or a rising sensation in the stomach

What Happens After a Focal Impaired Awareness Seizure?

After the seizure, the person may feel confused, tired, have a headache, or have other symptoms. This is called the postictal (post-IK-tul) phase. It usually lasts just a few minutes, but can be longer.

What Causes Focal Impaired Awareness Seizures?

Many times, the cause for focal impaired awareness seizures is not known. Sometimes seizures are genetic (run in families). Other causes include brain injury or infection. People with certain medical conditions can also have focal impaired awareness seizures.

How Are Focal Impaired Awareness Seizures Diagnosed?

If your child had a seizure, the doctor probably will want you to see a pediatric neurologist (a doctor who treats brain, spine, and nervous system problems). The neurologist will ask questions about what happened during the seizure and do an exam.

To find out the type of seizure, the doctor might order tests such as:

  • blood tests and urine (pee) tests to look for infections or illnesses
  • EEG to measure brain wave activity
  • VEEG, or video electroencephalography (EEG with video recording)
  • CAT scan, MRI, and PET/MRI scans to get very detailed images of the brain

How Are Focal Impaired Awareness Seizures Treated?

Not everyone who has focal impaired awareness seizures will need treatment. If they do, medicine is the most common treatment. If medicine doesn’t help, other treatments may include a ketogenic diet, vagus nerve stimulator therapy, or surgery.

Some children outgrow their seizures.

How Can Parents Help?

Your doctor will help you create a plan for your child and talk to you about:

  • what medicines your child should take
  • if any “triggers” (such as fever, lack of sleep, or medicines) can make a seizure more likely
  • any precautions your child should take while swimming or bathing
  • whether your child should wear a medical ID bracelet
  • if it’s OK for your teen to drive
  • how to keep your child safe during a seizure. Share this information with caregivers, coaches, and staff at your child’s school.

If your child has a seizure, keep a record of:

  • when it happened
  • how long it lasted
  • what happened right before the seizure
  • what happened during and after the seizure

This information will help the doctor find the best treatment for your child’s seizures.

What Else Should I Know?

If your child has seizures, reassure them that they’re not alone. Your doctor and the care team can answer questions and offer support. They also might be able to recommend a local support group. Online organizations can help too, such as:

Reviewed by: Amy W. Anzilotti, MD
Date reviewed: July 2021