partial epilepsies


Summary: Conditions characterized by recurrent paroxysmal neuronal discharges which arise from a focal region of the brain. Partial seizures are divided into simple and complex, depending on whether consciousness is unaltered (simple partial seizure) or disturbed (complex partial seizure). Both types may feature a wide variety of motor, sensory, and autonomic symptoms. Partial seizures may be classified by associated clinical features or anatomic location of the seizure focus. A secondary generalized seizure refers to a partial seizure that spreads to involve the brain diffusely. (From Adams et al., Principles of Neurology, 6th ed, pp317)

Top Publications

  1. Mathiak K, Mathiak K, Wolanczyk T, Ostaszewski P. Psychosocial impairments in children with epilepsy depend on the side of the focus. Epilepsy Behav. 2009;16:603-8 pubmed publisher
    ..The cognitive disturbances beginning in childhood may lead to the stronger emotional impairments observed in adults with left hemispheric seizures. ..
  2. Mukherjee S, Tripathi M, Chandra P, Yadav R, Choudhary N, Sagar R, et al. Cardiovascular autonomic functions in well-controlled and intractable partial epilepsies. Epilepsy Res. 2009;85:261-9 pubmed publisher
    ..Refractoriness may lead to an alteration in cardiovascular autonomic regulation, which might be a predisposing factor for SUDEP. ..
  3. Gaillard W, Chiron C, Cross J, Harvey A, Kuzniecky R, Hertz Pannier L, et al. Guidelines for imaging infants and children with recent-onset epilepsy. Epilepsia. 2009;50:2147-53 pubmed publisher
    ..When available, MRI is preferred to CT because of its superior resolution, versatility, and lack of radiation. ..
  4. Kasperaviciute D, Catarino C, Heinzen E, Depondt C, Cavalleri G, Caboclo L, et al. Common genetic variation and susceptibility to partial epilepsies: a genome-wide association study. Brain. 2010;133:2136-47 pubmed publisher
    b>Partial epilepsies have a substantial heritability. However, the actual genetic causes are largely unknown...
  5. Tsai J, Yen D, Hsih M, Chen S, Hiersemenzel R, Edrich P, et al. Efficacy and safety of levetiracetam (up to 2000 mg/day) in Taiwanese patients with refractory partial seizures: a multicenter, randomized, double-blind, placebo-controlled study. Epilepsia. 2006;47:72-81 pubmed
    ..Adjunctive LEV therapy, <or=1,000 mg twice daily, was significantly more effective than placebo and was generally well tolerated in Taiwanese adults with treatment-resistant partial-onset seizures. ..
  6. Yankovsky A, Andermann F, Mercho S, Dubeau F, Bernasconi A. Preictal headache in partial epilepsy. Neurology. 2005;65:1979-81 pubmed
    ..Migrainous features were found in four. After surgery, all seven seizure-free patients and two with rare seizures were free of PIHA. It may be a useful lateralizing sign in patients with TLE. ..
  7. Chiron C, Tonnelier S, Rey E, Brunet M, Tran A, D Athis P, et al. Stiripentol in childhood partial epilepsy: randomized placebo-controlled trial with enrichment and withdrawal design. J Child Neurol. 2006;21:496-502 pubmed
  8. Bénar C, Grova C, Kobayashi E, Bagshaw A, Aghakhani Y, Dubeau F, et al. EEG-fMRI of epileptic spikes: concordance with EEG source localization and intracranial EEG. Neuroimage. 2006;30:1161-70 pubmed
    ..This could reflect an increase of metabolism linked to the presence of slow waves, which suggests that fMRI is a new source of information on the mechanisms of spike generation. ..
  9. Salek Haddadi A, Diehl B, Hamandi K, Merschhemke M, Liston A, Friston K, et al. Hemodynamic correlates of epileptiform discharges: an EEG-fMRI study of 63 patients with focal epilepsy. Brain Res. 2006;1088:148-66 pubmed
    ..These findings provide important new information on the optimal use and interpretation of EEG-fMRI in focal epilepsy and suggest a possible role for EEG-fMRI in providing new targets for invasive EEG monitoring. ..

More Information


  1. Glauser T, Ayala R, Elterman R, Mitchell W, Van Orman C, Gauer L, et al. Double-blind placebo-controlled trial of adjunctive levetiracetam in pediatric partial seizures. Neurology. 2006;66:1654-60 pubmed
    ..Levetiracetam adjunctive therapy administered at 60 mg/kg/day is efficacious and well tolerated in children with treatment-resistant partial seizures. ..
  2. Lu Y, Bagshaw A, Grova C, Kobayashi E, Dubeau F, Gotman J. Using voxel-specific hemodynamic response function in EEG-fMRI data analysis. Neuroimage. 2006;32:238-47 pubmed
    ..The results suggest that the fixed HRF methods may not be the most appropriate for the analysis of epileptic activity with EEG-fMRI, and the deconvolution method may be a better choice. ..
  3. Yamauchi T, Kaneko S, Yagi K, Sase S. Treatment of partial seizures with gabapentin: double-blind, placebo-controlled, parallel-group study. Psychiatry Clin Neurosci. 2006;60:507-15 pubmed
    ..Favorable tolerability of gabapentin was confirmed also in a Japanese population, consistent with previous global studies. ..
  4. Kataoka H, Ueno S. Cerebral polyopia and palinopsia in a patient with occipital lobe epilepsy. Epilepsy Behav. 2009;14:684-6 pubmed publisher
    ..Both phenomena occurred in the same patient and share an epileptic mechanism. In our patient, visual perseveration was part of an epileptic aura, developed when either the object or the patient moved, and diminished with gabapentin. ..
  5. Ottman R, Rosenberger L, Bagic A, Kamberakis K, Ritzl E, Wohlschlager A, et al. Altered language processing in autosomal dominant partial epilepsy with auditory features. Neurology. 2008;71:1973-80 pubmed publisher
    ..However, our fMRI and magnetoencephalography data suggest that individuals with ADPEAF have functional impairment in language processing. ..
  6. Bauer J, Klingmuller D. [Which antiepileptic drug for men with epilepsy? A critical epileptological and andrological review]. Nervenarzt. 2008;79:1407-12, 1414-5 pubmed publisher
    ..Based on current data, lamotrigine and valproate are the AED of choice. These AED have little or no effect, respectively, on SHBG and exert no negative effects on sexual steroid hormones in men. ..
  7. Kida Y, Yoshimoto M, Hasegawa T. [Radiosurgery of hypothalamic hamartomas]. No Shinkei Geka. 2008;36:225-32 pubmed
    ..In conclusion, radiosurgery can play a role in treating hamartomas since neurological outcome and seizure control are apparently improved. ..
  8. Orta D, Chiappa K, Quiroz A, Costello D, Cole A. Prognostic implications of periodic epileptiform discharges. Arch Neurol. 2009;66:985-91 pubmed publisher
    ..3-0.67). In patients with PLEDs, the absence of clinical seizures at the time of detection and presumed acute etiology are associated with death, whereas a nonneoplastic etiology was associated with a good clinical outcome. ..
  9. French J, Costantini C, Brodsky A, von Rosenstiel P. Adjunctive brivaracetam for refractory partial-onset seizures: a randomized, controlled trial. Neurology. 2010;75:519-25 pubmed publisher
    ..7%; BRV 2.6%). This interventional study provides preliminary Class I evidence that adjunctive BRV was efficacious and well-tolerated in patients aged 16-65 years with POS. ..
  10. Katramados A, Burdette D, Patel S, Schultz L, Gaddam S, Mitsias P. Periictal diffusion abnormalities of the thalamus in partial status epilepticus. Epilepsia. 2009;50:265-75 pubmed publisher
    ..The thalamus likely participates in the evolution and propagation of partial seizures in SE. ..
  11. Miyajima T, Kumada T, Kimura N, Mikuni T, Fujii T. [Sulthiame treatment for patients with intractable epilepsy]. No To Hattatsu. 2009;41:17-20 pubmed
    ..Therefore, we conclude that sulthiame is an effective and safe antiepileptic drug for the treatment of intractable epilepsy. ..
  12. van Mil S, de la Parra N, Reijs R, van Hall M, Aldenkamp A. Psychomotor and motor functioning in children with cryptogenic localization related epilepsy. NeuroRehabilitation. 2010;26:291-7 pubmed publisher
    ..Also, performance on the m-ABC was significantly lower than the reference values. The better the child's performance on the simple reaction time measurements, the better the performance on the m-ABC. ..
  13. Novy J, Stupp R, Rossetti A. Pregabalin in patients with primary brain tumors and seizures: a preliminary observation. Clin Neurol Neurosurg. 2009;111:171-3 pubmed publisher
    ..PGB appears to have a promising effectiveness in this setting, even as a monotherapy. Based on these results we embarked on a prospective controlled trial. ..
  14. Conant K, Thibert R, Thiele E. Epilepsy and the sleep-wake patterns found in Angelman syndrome. Epilepsia. 2009;50:2497-500 pubmed publisher
    ..Results were consistent with those of prior studies assessing sleep in AS. Severity of epilepsy and use of anticonvulsant drugs may be related to a higher degree of sleep disturbance in this population. ..
  15. Verrotti A, Parisi P, Loiacono G, Mohn A, Grosso S, Balestri P, et al. Levetiracetam monotherapy for childhood occipital epilepsy of gastaut. Acta Neurol Scand. 2009;120:342-6 pubmed publisher
    ..Monotherapy with LEV was effective and well tolerated in patients with COE-G. Nevertheless, prospective, large, long-term double-blind studies are needed to confirm these findings. ..
  16. Wroe S, Yeates A, Marshall A. Long-term safety and efficacy of zonisamide in patients with refractory partial-onset epilepsy. Acta Neurol Scand. 2008;118:87-93 pubmed publisher
    ..Flexible dosing with zonisamide demonstrated a good safety profile and sustained efficacy in the long-term adjunctive treatment of refractory partial epilepsy. ..
  17. Yoshinaga H, Kobayashi K, Endo F, Ishizaki Y, Wakai M, Ohtsuka Y. Abnormal fast activity in infancy with paroxysmal downwards gaze. Brain Dev. 2009;31:435-41 pubmed publisher
    ..As a risk factor for developing WS, we propose the clinical symptom of PDG with characteristic occipital AFA visible in the EEG, both of which represent damage to the occipital region including the optic radiation. ..
  18. Bourgeois M, Di Rocco F, Roujeau T, Boddaert N, Lelouch Tubiana A, Varlet P, et al. [Epilepsy and focal lesions in children. Surgical management]. Neurochirurgie. 2008;54:362-5 pubmed publisher
    ..Early surgery must be considered in children because of the benefits of seizure control on the developing brain and the risk of secondary epileptogenesis. ..
  19. Jansen J, Vlooswijk M, Majoie H, de Krom M, Aldenkamp A, Hofman P, et al. White matter lesions in patients with localization-related epilepsy. Invest Radiol. 2008;43:552-8 pubmed publisher
    ..Furthermore, the automated WML detection algorithm using a regional Z-score analysis can successfully segment and quantify the WML on FLAIR images. ..
  20. Rajneesh K, Binder D. Tumor-associated epilepsy. Neurosurg Focus. 2009;27:E4 pubmed publisher
    ..Further understanding of the mechanisms of tumor-associated epilepsy may lead to new types of treatments targeted at perilesional tissue alterations. ..
  21. Chern J, Patel A, Jea A, Curry D, Comair Y. Surgical outcome for focal cortical dysplasia: an analysis of recent surgical series. J Neurosurg Pediatr. 2010;6:452-8 pubmed publisher
    ..This likely explained the improved surgical outcome for this group of patients. These reports also documented the increased utilization of functional imaging, but their efficacy needs to be verified with further studies. ..
  22. Laurent Vannier A, Toure H, Vieux E, Brugel D, Chevignard M. Long-term outcome of the shaken baby syndrome and medicolegal consequences: a case report. Ann Phys Rehabil Med. 2009;52:436-47 pubmed publisher
    ..From a medicolegal point of view, signaling the child to legal authorities allows protection of the child, but also conditions later compensation if sequelae compromise autonomy. ..
  23. Saussele T. [Lacosamide. A new antiepileptic drug as adjunctive therapy in patients with partial-onset seizures]. Med Monatsschr Pharm. 2008;31:374-7 pubmed
    ..Reduction of seizure frequency could be demonstrated in several clinical studies in patients with partial-onset seizures who received lacosamide in addition to other antiepileptic drugs. ..
  24. Korsnes M, Hugdahl K, Bjørnaes H. An fMRI case study of visual memory in a patient with epilepsy: comparison before and after temporal lobe surgery. Brain Struct Funct. 2009;213:457-62 pubmed publisher
    ..It is suggested that maintenance of memory performance from pre- to post-surgery might be due to functional reorganization in the brain, as evidenced in the fMRI data. ..
  25. Rodrigo S, Oppenheim C, Leclerc X, Soto Ares G, Pruvo J, Meder J. [Structural MRI in adult partial epilepsy]. Neurochirurgie. 2008;54:191-6 pubmed publisher
    ..MRI is also accurate in detecting the other major epilepsy etiologies (vascular malformations and cicatricial lesions). Presurgical MRI is relevant since it provides a high-resolution study of the brain. ..
  26. Yalcin A, Toydemir H, Celebi L, Forta H. Panayiotopoulos syndrome with coincidental brain lesions. Epileptic Disord. 2009;11:270-6 pubmed publisher
    ..None of our patients had seizures under antiepileptic treatment. Children with Panayiotopoulos syndrome may have static MRI brain findings which are likely to be coincidental and do not affect prognosis. ..
  27. Nune G, DeGiorgio C, Heck C. Neuromodulation in the Treatment of Epilepsy. Curr Treat Options Neurol. 2015;17:375 pubmed publisher
    ..However, the most compelling feature of TNS is that it is not implanted but rather applied to the skin with transdermal electrodes, typically at night. ..
  28. Cukiert A. Vagus Nerve Stimulation for Epilepsy: An Evidence-Based Approach. Prog Neurol Surg. 2015;29:39-52 pubmed publisher
  29. Duning T, Kellinghaus C, Mohammadi S, Schiffbauer H, Keller S, Ringelstein E, et al. Individual white matter fractional anisotropy analysis on patients with MRI negative partial epilepsy. J Neurol Neurosurg Psychiatry. 2010;81:136-9 pubmed publisher
  30. Surges R, Henneberger C, Adjei P, Scott C, Sander J, Walker M. Do alterations in inter-ictal heart rate variability predict sudden unexpected death in epilepsy?. Epilepsy Res. 2009;87:277-80 pubmed publisher
    ..No HRV parameter was associated with SUDEP. Thus, although altered HRV might be involved in SUDEP, HRV parameters are not clear-cut predictors for SUDEP. ..
  31. Montassir H, Maegaki Y, Ohno K, Ogura K. Long term prognosis of symptomatic occipital lobe epilepsy secondary to neonatal hypoglycemia. Epilepsy Res. 2010;88:93-9 pubmed publisher
    ..This study indicates that epilepsy secondary to neonatal hypoglycemia is intractable during infancy and early childhood with frequent status epilepticus but tends to decrease in older age. ..
  32. Ozlen F, Asan Z, Tanriverdi T, Kafadar A, Ozkara C, Ozyurt E, et al. Surgical morbidity of invasive monitoring in epilepsy surgery: an experience from a single institution. Turk Neurosurg. 2010;20:364-72 pubmed publisher
    ..2% (n=3). Based on our experience, intracranial electrode implantation is an effective and safe method with extremely low morbidity rate, especially in experienced hands. ..
  33. Yang Z, Liu X, Qin J, Zhang Y, Bao X, Chang X, et al. A study on epileptic negative myoclonus in atypical benign partial epilepsy of childhood. Brain Dev. 2009;31:274-81 pubmed publisher
    ..Various combinations of valproate, benzodiazepines, and corticosteroids are relatively effective for treating ENM that occurs in ABPE. ..
  34. Sarkis R, Loddenkemper T, Burgess R, Wyllie E. Childhood absence epilepsy in patients with benign focal epileptiform discharges. Pediatr Neurol. 2009;41:428-34 pubmed publisher
    ..There was concurrence of generalized spike and wave discharges in these patients. It is unclear whether this is related to a common pathophysiologic factor. ..
  35. Khanlou N, Mathern G, Mitchell W, Salamon N, Pope W, Yong W, et al. Cortical dysplasia with prominent Rosenthal fiber formation in a case of intractable pediatric epilepsy. Hum Pathol. 2009;40:1200-4 pubmed publisher
    ..This case is unique among several hundred cortical resection specimens that we have studied, including numerous cases of severe cortical dysplasia. ..
  36. Tribut O, Bentué Ferrer D, Verdier M. Suivi thérapeutique pharmacologique du felbamate. Therapie. 2010;65:35-8 pubmed publisher
    ..Potentially fatal side effects can be caused by felbamate (aplastic anemia, acute liver failure), which limits its use because they are dose-independant. ..
  37. Wei Z, Gordon C, Bergey G, Sacks J, Anderson W. Implant Site Infection and Bone Flap Osteomyelitis Associated with the NeuroPace Responsive Neurostimulation System. World Neurosurg. 2016;88:687.e1-6 pubmed publisher
    ..The RNS device may benefit from reducing technical risk factors that are associated with postoperative bone and soft tissue infections. ..
  38. Zia Ul Haq M, Prakash R, Akhtar S. Mirtazapine precipitated seizures: a case report. Prog Neuropsychopharmacol Biol Psychiatry. 2008;32:1076-8 pubmed publisher
  39. Daley M, Siddarth P, Levitt J, Gurbani S, Shields W, Sankar R, et al. Amygdala volume and psychopathology in childhood complex partial seizures. Epilepsy Behav. 2008;13:212-7 pubmed publisher
    ..In pediatric CPS, left amygdala involvement may reflect effects of the neuropathology underlying comorbid affective or anxiety disorders on amygdala development rather than effects of ongoing seizures. ..
  40. Plummer C, Wagner M, Fuchs M, Vogrin S, Litewka L, Farish S, et al. Clinical utility of distributed source modelling of interictal scalp EEG in focal epilepsy. Clin Neurophysiol. 2010;121:1726-39 pubmed publisher
    ..Distributed source modelling demonstrates clinical utility for the routine work-up of unilateral BFEC of the typical Rolandic variety, and unilateral MTLE secondary to hippocampal sclerosis. ..
  41. Peltola J, Coetzee C, Jiménez F, Litovchenko T, Ramaratnam S, Zaslavaskiy L, et al. Once-daily extended-release levetiracetam as adjunctive treatment of partial-onset seizures in patients with epilepsy: a double-blind, randomized, placebo-controlled trial. Epilepsia. 2009;50:406-14 pubmed publisher
    ..Ten percent of patients randomized to LEV XR experienced freedom from POS. These results support the clinical value of this new LEV XR formulation. ..
  42. Chassagnon S, Hawko C, Bernasconi A, Gotman J, Dubeau F. Coexistence of symptomatic focal and absence seizures: video-EEG and EEG-fMRI evidence of overlapping but independent epileptogenic networks. Epilepsia. 2009;50:1821-6 pubmed publisher
    ..Whether the patient had distinct epileptic syndromes or distinct electrographic patterns from the lesional trigger remains debatable. ..
  43. Aydin S, Dag E, Ozkan Y, Erman F, Dagli A, Kilic N, et al. Nesfatin-1 and ghrelin levels in serum and saliva of epileptic patients: hormonal changes can have a major effect on seizure disorders. Mol Cell Biochem. 2009;328:49-56 pubmed publisher
    ..Saliva and serum nesfatin-1 levels from patients with PGE and partial epilepsies who were continuing antiepileptic drugs were also 10-fold higher than control values...
  44. Badawy R, Macdonell R, Jackson G, Berkovic S. The peri-ictal state: cortical excitability changes within 24 h of a seizure. Brain. 2009;132:1013-21 pubmed publisher
    ..Increased excitation precedes the seizure by hours and there is a similar period of decreased excitability following a seizure. ..
  45. Basu S, Pooniya V, Kumar A, Das B. Down syndrome with cerebral arteriovenous malformation. Ann Trop Paediatr. 2009;29:61-5 pubmed publisher
    ..A 2-year-old girl with DS presenting with right-sided hemiparesis and right partial seizures is reported. Computerised tomographic scan of the brain demonstrated features of cerebral arteriovenous malformation. ..
  46. Van Gompel J, Stead S, Giannini C, Meyer F, Marsh W, Fountain T, et al. Phase I trial: safety and feasibility of intracranial electroencephalography using hybrid subdural electrodes containing macro- and microelectrode arrays. Neurosurg Focus. 2008;25:E23 pubmed publisher
    ..More research is required to show whether hybrid electrode recordings will improve localization of epileptic foci and tracking the generation of neocortical seizures. ..
  47. Heiman G, Kamberakis K, Gill R, Kalachikov S, Pedley T, Hauser W, et al. Evaluation of depression risk in LGI1 mutation carriers. Epilepsia. 2010;51:1685-90 pubmed publisher
    ..These findings suggest that the increase in depressive symptoms in affected individuals from these families is related to epilepsy or its treatment rather than to LGI1 mutations per se. ..
  48. Gao Q, Hua L, Wang J, Fan C, Deng W, Li B, et al. A Point Mutation in SCN1A 5' Genomic Region Decreases the Promoter Activity and Is Associated with Mild Epilepsy and Seizure Aggravation Induced by Antiepileptic Drug. Mol Neurobiol. 2017;54:2428-2434 pubmed publisher
    ..The antiepileptic drug-induced seizure aggravation in this patient suggests clinical attention for mutations or variations in noncoding regions that may affect SCN1A expression. ..
  49. Sances G, Guaschino E, Perucca P, Allena M, Ghiotto N, Manni R. Migralepsy: a call for a revision of the definition. Epilepsia. 2009;50:2487-96 pubmed publisher
  50. Thurtell M, Mohamed A, Lüders H, Leigh R. Evidence for three-dimensional cortical control of gaze from epileptic patients. J Neurol Neurosurg Psychiatry. 2009;80:683-5 pubmed publisher
  51. Watanabe K, Kobayashi K, Endoh F, Yoshinaga H, Ohtsuka Y. [Lamotrigine add-on therapy for childhood-onset refractory epilepsy: comparison of the efficacy between 3 months and 6 months after initiation]. No To Hattatsu. 2011;43:453-8 pubmed
    ..Positive psychotropic effects in daily activities were seen in 28 patients (56%). These effects appeared regardless of the change in seizure frequency with doses that were smaller than maintenance doses. ..
  52. Besle J, Fischer C, Bidet Caulet A, Lecaignard F, Bertrand O, Giard M. Visual activation and audiovisual interactions in the auditory cortex during speech perception: intracranial recordings in humans. J Neurosci. 2008;28:14301-10 pubmed publisher
  53. Eross L, Bagó A, Entz L, Fabó D, Halasz P, Balogh A, et al. Neuronavigation and fluoroscopy-assisted subdural strip electrode positioning: a simple method to increase intraoperative accuracy of strip localization in epilepsy surgery. J Neurosurg. 2009;110:327-31 pubmed publisher