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Focal Aware Seizures

Reviewed by: Amy W. Anzilotti, MD
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What Is a Seizure?

A seizure (SEE-zhur) is unusual electrical activity in the brain. Normally, electrical activity in the brain involves neurons (nerve cells) in different areas sending signals at different times. During a seizure, many neurons fire all at once.

Seizures can happen in one or both sides of the brain. Depending on where a seizure happens, it causes changes in behavior, movement, or feelings. Focal seizures affect only one side of the brain. Generalized seizures affect the whole brain. Focal seizures are the most common type of seizures in people with epilepsy.

What Are Focal Aware Seizures?

Focal aware seizures (also called focal onset aware or simple partial seizures) is a seizure that happens while a person is awake and alert and aware of what is going on. During the seizure, the person may have movements, feelings, or sensations that are out of their control. They usually last less than 2 minutes.

What Are the Signs & Symptoms of a Focal Aware Seizure?

During a focal aware seizure, someone may:

  • have changes in their senses, such as smell, taste, or feeling
  • have muscle twitching (for example, in the arms or legs on one side of the body)
  • have head turning or eye movements
  • see flashing lights
  • sweat

What Is an Aura?

An aura is when someone has a focal aware seizure with these symptoms:

  • déjà vu (a feeling of already having been in the present situation)
  • an unusual smell or taste
  • seeing things like flashing lights
  • sudden, intense emotion (such as fear)
  • nausea or a rising sensation in the stomach

Sometimes focal aware seizures (including auras) can lead to a focal-to-generalized tonic-clonic seizure.

What Happens After a Focal Aware Seizure?

After a seizure, the person may feel confused or tired, or have a headache or other symptoms. This is called the postictal (post-IK-tul) phase. It usually lasts just a few minutes, but can be longer.

What Causes Focal Aware Seizures?

Many times, the cause of focal aware seizures is not known. Anyone can have focal aware seizures. Sometimes they run in families. Other causes include brain injury or infection. People with some types of medical conditions also can have focal aware seizures.

How Are Focal Aware Seizures Diagnosed?

If your child had a seizure, the doctor probably will want you to see a pediatric neurologist (a doctor who treats brain, spine, and nervous system problems). The neurologist will ask questions about what happened during the seizure and do an exam.

To find out the type of seizure, the doctor might order tests such as:

  • blood tests and urine (pee) tests to look for infections or illnesses
  • EEG to measure brain wave activity
  • VEEG, or video electroencephalography (EEG with video recording)
  • CAT scan, MRI, and PET/MRI scans to get very detailed images of the brain

How Are Focal Aware Seizures Treated?

Not everyone who has focal aware seizures will need treatment. If they do, medicine is the most common treatment. Other treatments are available if medicine doesn’t help.

Some children outgrow focal aware seizures.

How Can Parents Help?

Your doctor will help you create a plan for your child and talk to you about:

  • what medicines your child should take
  • if any “triggers” (such as fever, lack of sleep, or medicines) can make a seizure more likely
  • any precautions your child should take while swimming or bathing
  • whether your child should wear a medical ID bracelet
  • if it’s OK for your teen to drive
  • how to keep your child safe during a seizure. Share this information with caregivers, coaches, and staff at your child’s school.

If your child has another seizure, keep a record of:

  • when it happened
  • how long it lasted
  • what happened right before the seizure
  • what happened during and after the seizure

This information will help the doctor find the best treatment for your child’s seizures.

What Else Should I Know?

If your child has seizures, reassure them that they’re not alone. Your doctor and the care team can answer questions and offer support. They also might be able to recommend a local support group. Online organizations can help too, such as:

Reviewed by: Amy W. Anzilotti, MD
Date reviewed: July 2021