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Seizure Disorder, Focal

Charles J. McClure, DO and Noel Dunn, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

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

  • Generalized seizures involve bilateral cerebral cortex from the seizure...

DIAGNOSIS

  • Seizure activity usually stereotyped

  • Duration: seconds to minutes, unless status epilepticus develops; status epilepticus may present as focal/generalized convulsions/altered mental status wi...

TREATMENT

GENERAL MEASURES

  • Ask the patient to maintain a seizure diary.

  • Note potential triggers, such as stress, sleep deprivation, drug use, discontinuation of alcohol/benzodiazepines, menses.

MEDICATION

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 systematic review. J Neurol....

ADDITIONAL READING

  • Falco-Walter JJ, Scheffer IE, Fisher RS. The new definition and classification of seizures and epilepsy. Epilepsy Res.  2018;139:73–79. [View Abstract on OvidMedline]

  • Gavvala JR...

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 or localization-related seizures have previously been referred to as partial seizures.

  • Focal seizures originate from a discrete focus limited to one hemisphere in the cerebral cor...

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