Focal onset seizures (FOS), also known as partial onset seizures, are a type of seizure that occurs when there’s abnormal electrical activity on one side of the brain. They may be classified as:
- Focal onset aware seizures (formerly known as simple partial seizures) – a person with this seizure type is aware of the seizure their consciousness is unaltered
- Focal onset impaired awareness seizures (formerly known a complex partial seizures) – a person may be unaware of the seizure.
While these seizures generally occur in the temporal lobe of the brain, they may originate in other regions as well and their symptoms vary from repetitive involuntary movements (such as lip-smacking) to confusion and memory loss. The exact cause of this seizure type remains unknown but can be due to head injuries, genetics, infections, or metabolic disorders.
In this webinar, attendees will learn the:
- Common causes and triggers of FOS.
- Diagnostic criteria for the two types of FOS.
- Current treatments and therapeutic options for those living with FOS.
- Outlook for patients with FOS and their loved ones.
Speaker
Pavel Klein, MD is the Director of the Mid-Atlantic Epilepsy and Sleep Center in Bethesda, MD, and an Adjunct Associate Professor of Neurology at George Washington University. Dr. Klein’s clinical research includes novel treatments of epilepsy, dietary treatments of epilepsy in adults, prevention of epilepsy after traumatic brain injury, the effect of sex and stress hormones on epilepsy, and women with epilepsy.
Q&A Transcript
Are there any things to consider for a female who is planning
pregnancy and is currently on Felbamate and Clobazam medications?
That’s a very tough question. So the question, if I understand it correctly, is really asking what is the danger of number one, Felbamate and Clobazam to the baby, number two, of stopping those medications to the mother? The answer is very difficult, basically not known. So for Felbamate, we really do not have enough information to say whether it has the potential to damage the baby or not. For Clobazam, the data so far doesn’t show any red flags. So for Clobazam it’s not extensive data, but there is data and it has shown no red flags. Generally speaking, if you’ve had epilepsy that has been uncontrolled and has required medications that have not so commonly used like Felbamate, then the most important consideration is what would happen to your epilepsy if you change the medications. If there’s a possibility that your epilepsy would get worse, then my advice would be not to change the medications.
It’s a very difficult question, but we think that there are certain medications where we know there is a potential for risk to the fetus. These medications are valproate or Depakote, two names for the same medication, phenobarbital, and then to a lesser degree some other medications like Topiramate and others. With the exception of these two medications, valproate and phenobarbital, the most important consideration is still the control of seizures during pregnancy because if you have a generalized seizure during pregnancy, there is potential for harm to both yourself and the baby. That is of paramount importance. The other thing to consider is to plan for the pregnancy well in advance and consult with your doctor, whoever he or she is, a healthcare provider, but do it in advance so that you’re not caught unawares.
What are your thoughts on cord blood stem cells as an experimental treatment for epilepsy?
Really exciting and really unknown. There is a number of studies that are looking at this in animals as [inaudible 00:52:25]. There’s a large number of studies. There’s one human study that’s not looking at directly at stem cells, but is looking at taking cells, manipulating them to become new neurons with specific function and then injecting those neurons in part of the brain to see whether they could modify seizures. It’s a very exciting area and there really isn’t any information at the moment.
After a traumatic brain injury that causes focal motor seizures, is it common for a person to develop additional types of focal seizures decades later?
Yes, it can. I don’t know whether I would say common because it hasn’t been mapped out, but can it occur, it can. So when you have the injury, I mentioned before that the brain adapts. The primary purpose of brain adaptation is to clear the debris and repurpose the brain to take over the functions of the part of the brain that was destroyed. In the plastic changes, there may be missteps that may lead to seizures. If those seizures happen, the seizures themselves, as well as adaptation to the injury, may alter other parts of the brain remote from the area where the seizures occurred. So not uncommonly, you may start with an injury in frontal or parietal lobe and just like you said, decades later, have seizures that are occurring in both there and in temporal lobe.
The information contained herein is provided for general information only and does not offer medical advice or recommendations. Individuals should not rely on this information as a substitute for consultations with qualified healthcare professionals who are familiar with individual medical conditions and needs. CURE Epilepsy strongly recommends that care and treatment decisions related to epilepsy and any other medical condition be made in consultation with a patient’s physician or other qualified healthcare professionals who are familiar with the individual’s specific health situation.