Dravet syndrome is a severe form of epilepsy characterized by seizures appearing in infancy. Focal impaired-awareness seizures (formerly known as complex partial seizures) are a type of seizure that occurs in Dravet syndrome patients.
What are focal impaired-awareness seizures?
Focal impaired-awareness seizures are partial seizures that start in one area of the brain, as opposed to generalized seizures that seem to start in all parts of the brain without an identifiable point of origin.
Focal impaired-awareness seizures usually last one to two minutes. They may start as a simple partial seizure, which can be seen as a warning sign. During a simple partial seizure, the individual is still alert and able to interact. They may have jerking of the extremities, tingling, eyes or head rolling to one side, and a fearful look on the face.
When the simple partial seizure develops into a focal impaired-awareness seizure, the person loses awareness and stares blankly. The awareness might be only partially impaired. The person’s ability to respond is usually reduced, but he or she might still be aware of what is happening.
Focal impaired-awareness seizures can be accompanied by involuntary movements such as lip-smacking, rubbing of the hands, and chewing movements.
A focal-impaired awareness seizure can spread to both sides of the brain and become a generalized focal to bilateral tonic-clonic seizure. During a tonic-clonic seizure, the muscles become stiff, the pupils enlarged, the heart rate slow, and the breathing shallow. This is followed by whole-body jerking movements.
Activities that raise the body temperature should be avoided because they can trigger seizures in Dravet syndrome patients. A ketogenic diet also may help decrease the frequency of seizures.
Anticonvulsants (also know as antiepileptics) that are taken daily can reduce the incidence and intensity of seizures. Commonly used anticonvulsants in Dravet syndrome are Topamax (topiramate), Depacon (sodium valproate), Diacomit (stiripentol), and Onfi (clobazam).
What to do when a focal impaired-awareness seizure occurs
The involuntary movements during a focal impaired-awareness seizure may include walking. For individuals where this is the case, safety precautions should be in place. This includes, for example, keeping the doors shut when the patient is home alone.
When a focal impaired-awareness seizure occurs, first aid measures can help keep the situation under control. This includes remaining calm and staying with the individual until the seizure is over. Any objects that could be harmful should be removed. If the seizure develops into a focal to bilateral tonic-clonic seizure and lasts for more than five minutes, an ambulance should be called.
It is essential to have a seizure management plan that describes exactly what to do when a seizure occurs.
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