Partial (focal) seizure Health Article

Expectations (prognosis)

The outlook is largely determined by the underlying cause of the focal seizures. Patients who have recurrent seizures that are not due to a temporary condition (e.g., a drug side effect or infection) have a chronic condition called epilepsy.

Seizures that occur singly or in a closely associated group are commonly triggered by an acute condition such as brain injury and may occur as an isolated incident, or they may develop into a chronic seizure disorder. Seizures within the first 2 weeks of a brain injury do not necessarily mean that a chronic seizure disorder will develop. EEG and MRI findings may help determine whether the condition is likely to become chronic.

Death or permanent brain damage from seizures is rare, but either can occur if the seizure is prolonged or if many seizures occur in close proximity (status epilepticus).

Serious injury can occur if the seizure happens while the person is driving or operating dangerous equipment. These activities may be restricted for people with poorly controlled seizure disorders.

Infrequent seizures, however, need not severely restrict lifestyle. Work, school, and recreation do not necessarily need to be restricted, but precautions should be taken to reduce risks if a seizure should occur.

Complications

• Generalized seizures
• Epilepsy (recurrent seizures)
• Prolonged or closely occurring seizures (status epilepticus)
• Injury from falls, bumps, biting self
• Injury caused by a seizure during driving or operating machinery
• Aspiration pneumonia
• Permanent brain damage (stroke or other damage)
• Side effects of medications (with or without observable symptoms)
• Complications of surgery
• Women who choose to get pregnant should inform their doctor in advance for appropriate adjustments in medications (many of the anti-epileptic medications can cause birth defects)

Calling your health care provider

Call your local emergency number (911) if this the first time a person has had a seizure or a seizure is occurring in someone without a medical ID bracelet (instructions explaining what to do). In the case of someone who has had seizures before, call the ambulance for any of these emergency situations:

• This is a longer seizure than the person normally has, or an unusual number of seizures for the person
• Repeated seizures over a few minutes
• Repeated seizures where consciousness or normal behavior is not regained between them (status epilepticus)

Call your health care provider if any new symptoms occur (including possible side effects of medications):

• Drowsiness, restlessness, confusion, sedation
• Nausea/vomiting
• Rash
• Loss of hair
• Tremors or abnormal movements
• Problems with coordination
• Fevers, infections

Prevention

Treating the underlying disorders may reduce the risk of further seizures. In most cases, the seizures may not be preventable.

Avoid head injury by wearing helmets during risky activities, and avoid illegal drug use or excessive alcohol intake.

References

Goetz, CG. Textbook of Clinical Neurology. 2nd ed. St. Louis, Mo: WB Saunders; 2003.

Marx J. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis, Mo: Mosby; 2002.