Focal seizures and how to help
Focal seizures
Depending on a person’s level of awareness during the seizure, focal seizures are also known as:
- Focal aware seizures (previously called simple partial seizures)
- Focal impaired awareness seizures (previously called complex partial seizures)
Focal aware seizures
In focal aware seizures the person is responsive, aware and alert, and will usually know that something is happening and will remember the seizure afterwards.
Some people find focal aware seizures hard to put into words. During the seizure they may feel ‘strange’ but not be able to describe the feeling afterwards.
Focal aware seizures are sometimes called ‘warnings’ or ‘auras’ because for some people they develop into a tonic-clonic seizure.
Focal aware seizures can also happen on their own without developing into another seizure type.
Focal impaired awareness seizures
Focal impaired awareness seizures affect a bigger part of one side of the brain than focal aware seizures.
The person’s responsiveness is affected and they may be confused. They might be able to hear you but not fully understand or be able to respond to you. They may not react as they would normally. If you speak loudly to them they may think you are being aggressive and may react aggressively towards you. They may not remember the seizure afterwards.
Signs and/or symptoms
What happens during the seizure depends on which area of the brain is affected and what that part of the brain normally does, and whether the seizure spreads to affect other areas.
Some signs and symptoms involve movements such as jerking, muscles becoming limp, or repeated movements and some involve unusual feelings, thinking or sensations.
Some people experience just one symptom while others have several.
Depending on the area of the brain that is affected there are many symptoms including:
- Making lip-smacking, chewing or swallowing movements
- Repeatedly picking up objects or pulling at clothes
- Suddenly losing muscle tone and limbs going limp or floppy, or limbs suddenly becoming stiff
- Repetitive jerking movements that affect one or both sides of the body
- Making a loud cry, scream or random noise
- Making strange postures or repetitive movements such as cycling or kicking
- A ‘rising’ feeling in the stomach or déjà vu – feeling like you have ‘been here before’
- Unusual smell or taste
- An intense feeling of fear or joy
- A strange feeling like a ‘wave’ going through the head
- Stiffness or twitching in parts of the body such as an arm or hand
- Numbness or tingling in the arms and legs
- Visual disturbances such as coloured or flashing lights or hallucinations
Most focal seizures are short, lasting between a few seconds and two minutes, but may be longer for some people.
After a focal seizure some people feel fine but others feel confused or tired and may need to rest. It may be difficult to tell when the seizure has ended.
Treatment
You should:
- Help them to sit down in a comfortable position
- Guide them away from danger such as roads or open water
- Stay with them until they fully recover
- Be calm and reassuring
- Explain anything that they may have missed
You should not:
- Restrain them
- Act in a way that could frighten them, such as making abrupt movements or shouting at them
- Assume they are aware of what is happening or what has happened
- Give them anything to eat or drink until they are fully recovered
- Attempt to bring them around
Calling emergency services
Focal seizures do not normally need medical attention.
Call 999/112 and ask for an ambulance if:
- It is their first seizure
- The seizure lasts for more than 5 minutes
- They are seriously injured during the seizure or need urgent medical attention