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Seizure Disorder, Focal

Noel Dunn, MD Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Seizures occur when abnormal synchronous neuronal discharges in the brain cause transient cortical dysfunction.

  • Focal or localization-related seizures have previously been referred to...

DIAGNOSIS

  • Duration: seconds to minutes, unless status epilepticus develops; status epilepticus may present as focal/generalized convulsions/altered mental status without convulsions.

  • Focal seizures wit...

TREATMENT

GENERAL MEASURES

Maintain a seizure diary, noting potential triggers, such as stress, sleep deprivation, drug use, discontinuation of alcohol/benzodiazepines, menses. 

MEDICATION

  • Current guidel...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Most states have restrictions on driving for those with seizure disorders.

  • Depending on seizure manifestation, may also recommend against activities such as swimmi...

REFERENCES

1
Brigo  F, Igwe  SC, Erro  R, et al. Postictal serum creatine kinase for the differential diagnosis of epileptic seizures and psychogenic non-epileptic seizures: a s...

ADDITIONAL READING

  • Gavvala  JR, Schuele  SU. New-onset seizure in adults and adolescents: a review. JAMA.  2016;316(24):2657–2668. [View Abstract on OvidMedline] ...

CODES

ICD10

  • G40.109 Local-rel symptc epi w simp prt seiz,not ntrct, w/o stat epi

  • G40.209 Local-rel symptc epi w cmplx prt seiz,not ntrct,w/o stat epi

  • G40.119 Local-rel symptc epi w simple part seiz, ntrc...

CLINICAL PEARLS

  • Focal seizures originate from a discrete focus limited to one hemisphere in the cerebral cortex and are further divided into aware versus unaware and motor versus nonmotor, depending o...

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