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Epilepsy (Focal)

Focal Epilepsy

What is epilepsy? — Epilepsy is a condition that causes people to have repeated seizures. Seizures are caused by abnormal electrical activity in the brain. Seizures can make you have convulsions (sudden shaking episodes), pass out, or move or behave strangely. Epilepsy can start at any age.
What are the symptoms of a seizure? — There are different kinds of seizures. Each causes a different set of symptoms. Most seizures last only a few seconds or minutes.
Children who have "tonic-clonic" or "grand mal" seizures often pass out, get stiff, and then have jerking movements. Other types of seizures cause less dramatic symptoms. For instance, some children have shaking movements in just 1 arm or in a part of their face. Other children suddenly stop responding and stare for a few seconds.
Sometimes, people can tell that they are about to have a seizure. They have a certain feeling or smell a certain smell just before the seizure. This feeling or smell is called an "aura."
If my child has seizures, will he or she need tests? — Yes. The doctor will do tests to learn more about the seizures and to check whether they are caused by epilepsy. (Not all seizures are caused by epilepsy.) Your child will probably have an:
EEG – An EEG measures electrical activity in the brain (figure 1).
MRI or CT scan – These tests create pictures of the brain.
How is epilepsy treated in children? — Epilepsy in children is usually treated with anti-seizure medicines. These medicines can't cure epilepsy, but they can help prevent seizures. There are different anti-seizure medicines. The right one for your child will depend on the type of seizures he or she has, and on other factors.
Anti-seizure medicines usually work well to prevent seizures. But if they don't control your child's epilepsy, your doctor might talk with you about other possible treatments. These can include:
A special diet that your child can follow
Brain surgery
A device called a "vagus nerve stimulator" that goes in the chest to help control seizures
What should I know about anti-seizure medicines? — You should know that:
These medicines can cause side effects. They can make your child feel tired or dizzy, or cause other problems. Let your doctor know about any side effects your child has. Your doctor can work with you to find the best medicine and dose for your child. You should also let your doctor know right away if your child gets a new rash. This can be a serious side effect.
Anti-seizure medicines can affect other medicines your child takes. Also, other medicines can keep anti-seizure medicines from working well. Be sure to tell your doctor if you child is already taking other medicines, and let your doctor know any time your child starts any other new medicines.
Your child might need regular blood tests to check the amount of anti-seizure medicine in his or her body.
Will my child need anti-seizure medicines for the rest of his or her life? — Probably not. Many children outgrow their epilepsy and stop having seizures when they are teens or young adults. But don't ever stop your child's anti-seizure medicine without talking to your doctor.
How can I keep my child from having more seizures? — To help keep your child from having more seizures, you can make sure that he or she:
Takes his or her anti-seizure medicines exactly as directed – Stopping or changing your child's medicines raises his or her chances of having a seizure. If your child has any problems with the medicines, talk with your doctor. You should also let him or her know if you can't afford the medicines. There are often ways to solve these problems.
Gets enough sleep – Not getting enough sleep raises your child's chances of having a seizure.
Eats a healthy diet
Does not drink alcohol or use drugs
Can my teen drive if he or she has epilepsy? — Each state and country has its own rules. To be allowed to drive, your teen will probably need to be seizure-free for a certain amount of time. He or she might also need the doctor's permission.
When should I call the doctor or nurse? — Your child's doctor will make a plan with you telling you when to call him or her. In general, call the doctor or nurse if your child has more seizures than usual or if the seizures last longer than usual.
Some seizures are a medical emergency. If your child has a seizure that lasts longer than 5 minutes, or if he or she has repeated seizures over a few minutes, call for an ambulance (in the US and Canada, dial 9-1-1).
What else should I do if my child has epilepsy? — You should:
Have your child wear a medical bracelet.
Ask your child's doctor what to do if your child has a seizure.
Talk to your child's school about his or her epilepsy. Tell them which symptoms to watch for and how to treat them. Also, let them know if your child needs to avoid any activities.
Have your child talk to a counselor if he or she feels sad or worried.
Talk with your teen about how to stay safe.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 16569 Version 6.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.

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