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Questions To Ask Your Doctor About Focal Seizures

Updated on March 11, 2021
Medically reviewed by
Evelyn O. Berman, M.D.
Article written by
Nyaka Mwanza

Download the Doctor Discussion Guide PDF

If you have been diagnosed with a focal seizure disorder, that is the first and most important step to managing epilepsy. Accurately diagnosing the type of seizures you have and understanding what happens to you during a seizure are critical elements to ensuring you receive the most effective, high-quality health care possible.

You will want to learn as much about your condition as you can. You are a primary player on your seizure treatment team. Your personal expertise is necessary to diagnose, understand, and manage your seizure disorder.

Become an Expert on Your Own Epilepsy Experience

Understanding your diagnosis is the first step in treating and managing your seizures. The better you understand your seizure diagnosis, the better you can help your doctor understand and treat you.

How Does A Doctor Accurately Diagnose Focal Seizures?

Diagnosing a person’s seizures can be tricky. An accurate seizure diagnosis relies, in part, on identifying the way seizures start and how a seizure affects one’s mind and body. Diagnosing seizures requires some level of direct observation.

Seizure diagnosis also involves a detailed medical history and medical tests. To determine what part of the brain is involved, an epilepsy specialist may monitor brain activity and capture any abnormal electrical activity via computerized tomography (CT), electroencephalogram (EEG), or magnetic resonance imaging (MRI).

What Type of Seizures Do You Have?

There are many types of seizures. A focal onset seizure, or a focal seizure, starts on just one side of the brain. Formerly called “partial seizures,” focal onset seizures are the most common type of seizure diagnosed in people with epilepsy. In contrast, generalized seizures originate from both sides of the brain at the same time.

Focal seizures are further categorized based on their cognitive symptoms (whether a person is aware or unaware during a seizure) and physical symptoms (whether there is bodily movement or no movement). The types of focal seizures include:

One’s type of seizure can change over time. Your diagnosis may change as you and your doctors learn more information about your seizures and how they affect you.

What Does Treatment for Focal Seizures Look Like?

Your treatment for focal seizures should be a collaborative partnership between you and your doctors. This is known as a self-management approach. This approach to treatment, especially for a long-term chronic illness, emphasizes the central role of the individual and their family as part of the health care team. Communication with your health care team — both through asking questions and proactively informing them about your seizure experience — is a vital part of developing a treatment plan and a seizure-management plan.

Keep asking questions so that you get the right tests and treatment for your type of seizures and epilepsy. There is no one treatment that works for all types of seizures and types of epilepsy. Be your own greatest health advocate.

What Does Focal Seizure Treatment Entail?

The goal of epilepsy treatment is to achieve full seizure control, or to stop seizures with minimal side effects. Not everyone manages to become entirely seizure-free, however. Treatment seeks to reduce seizure frequency and seizure activity as much as possible. Your personalized medical regimen for focal seizures will likely include any combination of treatments from four categories: medication, diet, implanted devices, and surgery.

Antiseizure medication, also known as antiepileptic drugs (AEDs) are generally the first-line treatment for focal seizures. Seizures are controlled with monotherapy (just one AED), and around 60 percent of people with epilepsy respond to the first or second drug prescribed to them. Second-line treatment options include surgery, devices, and dietary therapy.

What Can Trigger Focal Seizures?

A trigger is anything that brings on a seizure. Knowing what your triggers are may help when managing seizures. Some common seizure triggers are stress, certain foods, flashing lights, or not getting enough sleep.

Seizures can occur in anyone at any time. Many times, seizures happen without any warning or signs. Other times, some people perceive seizure warning signs before they have a seizure. These may give clues as to whether a person is having a seizure and can help doctors determine if other treatments or medical tests are necessary.

Living With Focal Seizures

Living with epilepsy, a lifelong neurological condition, requires more than just knowing your type of seizures and what medicine to take. You need to learn how to respond to seizures in a variety of situations, adapt your day-to-day life to meet your health needs, and be prepared to handle whatever comes your way. This will allow you to be empowered with your illness and help you lead a more successful life.

What Can You Do at Home To Manage Focal Seizures?

Dietary therapy may help some people achieve seizure control. It can be particularly helpful when a person’s seizures have not responded or have stopped responding to other traditional treatments. Dietary therapy is usually used together with seizure medications. A ketogenic diet or a modified Atkins diet can be incorporated in a focal seizure treatment plan.

Can Alternative Medicine Help Focal Seizures?

Some people with epilepsy try natural or alternative treatments. Some see improvements in their symptoms when they use therapies such as melatonin, acupuncture, herbal or nutritional supplements, medical cannabis, and mindfulness and meditation practices. When these therapies are used alongside prescribed treatments, they are considered complementary treatments. Always consult a doctor before beginning any new supplements or alternative therapies to avoid potentially harmful interactions with other medications.

What About Mental Health?

If you are living with epilepsy, you are at greater risk for certain mood disorders. Being diagnosed with and managing a chronic disease is stressful. Seizures themselves can affect a person’s behavior. In addition, side effects of medicines may complicate the picture. Make sure you pay attention to and prioritize your emotional and mental health. Consider meditating, journaling, art therapy, and cognitive behavioral therapy to help you understand and manage your emotional needs.

Download the Doctor Discussion Guide PDF

Questions To Ask Your Doctor

Understanding your diagnosis and treatment plan will help you be the best manager of your epilepsy. Start an open dialogue with those on your health care team. Below are some ideas for questions you can bring to your next appointment.

Diagnosis

  • Does my family’s health history have anything to do with my seizures?
  • What exams or tests do you need to diagnose my seizures?
  • Will I need more follow-up tests or exams?
  • Is there an underlying cause of my seizures?
  • What other information about my seizures do you need to make an accurate diagnosis?
  • How can I best record any additional information about my seizures?
  • What information can my family members help me capture about my seizures?
  • Can you recommend any educational resources about seizures and epilepsy?

Health Care Team

  • Who is a part of my treatment team (e.g., neurologist, epileptologist, primary care physician, dietician)? What role do they each play?
  • Who should I consider the primary doctor or point of contact for my seizure management?
  • How can I get in touch with my seizure health care team between appointments?

Treatment Plan

  • How do I know if my epilepsy treatment plan is working?
  • What if the first or second medication I try does not completely control my seizures?
  • What are the possible side effects of my medicine (e.g., problems with cognition, memory, or physical and sexual function)?
  • Could any of the medications I am taking interact negatively with one another?
  • Do any specific activities or situations cause my seizures?
  • How can I identify a seizure trigger?
  • What information should I be documenting about my seizures?

Complementary or Alternative Treatments

  • Would any alternative treatment be effective as part of my treatment plan?
  • Could adding acupuncture, supplements, or any other alternative or natural treatment interfere with my current treatments?
  • Have any of your other patients with focal seizures tried complementary therapies with any success?
  • Would you recommend any dietary changes to help manage my focal seizures?

Talk With Others Who Understand

MyEpilepsyTeam is the social network for people with epilepsy and their loved ones. On MyEpilepsyTeam, more than 91,000 members come together to ask questions, give advice, and share their stories with others who understand life with epilepsy.

Are you living with focal seizures? Do you have any advice about talking with your doctor? Share your experience in the comments below, or start a conversation by posting on your Activities page.

References

  1. Operational Classification of Seizure Types by the International League Against Epilepsy: Position Paper of the ILAE Commission for Classification and Terminology — Epilepsia | International League Against Epilepsy
  2. Working With Your Epilepsy Team — Epilepsy Foundation
  3. Focal Onset Aware Seizures (Simple Partial Seizures) — Epilepsy Foundation
  4. Focal Onset Impaired Awareness Seizures (Complex Partial Seizures) — Epilepsy Foundation
  5. Diagnosing Epilepsy — Epilepsy Foundation
  6. Managing Seizure Triggers — Epilepsy Foundation
  7. Warning Signs of Seizures — Epilepsy Foundation
  8. Understanding Seizures and Emergencies — Epilepsy Foundation
  9. Epilepsy-Self Management — Epilepsy Foundation
  10. Dietary Therapies for Seizures — Epilepsy Foundation
  11. Managing Your Epilepsy — Epilepsy Foundation
  12. Epilepsy / Moods and Behavior — Epilepsy
Evelyn O. Berman, M.D. is a neurology and pediatric specialist and treats disorders of the brain in children. Review provided by VeriMed Healthcare Network. Learn more about her here.
Nyaka Mwanza has worked with large global health nonprofits focused on improving health outcomes for women and children. Learn more about her here.

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