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Adult Focal Epilepsies

Skidmore, Christopher T. MD

CONTINUUM: Lifelong Learning in Neurology: February 2016 - Volume 22 - Issue 1, Epilepsy - p 94–115
doi: 10.1212/CON.0000000000000290
Review Articles

ABSTRACT Purpose of Review: Focal epilepsy is the most common type of epilepsy in adulthood. This article discusses the seizure symptomatology, EEG findings, and imaging findings of the various forms of focal epilepsy. The majority of the article focuses on temporal and frontal lobe epilepsy as these represent the majority of focal epilepsies.

Recent Findings: While significant overlap exists in the clinical symptomatology of the focal epilepsies, detailed seizure descriptions can often provide useful clinical evidence to help establish an accurate diagnosis. EEG and MRI continue to serve as the main diagnostic tools for the diagnosis of focal epilepsy.

Summary: The various forms of focal epilepsy generate seizure presentations that are dependent on the anatomic structures that are involved in the seizure. By understanding the symptoms typically generated in each region of the brain, a better understanding of the possible seizure localizations can be made. Most forms of epilepsy have clear changes on EEG that permit accurate localization, but several pitfalls exist, which are discussed in this article. Imaging has revolutionized our ability to accurately identify lesions associated with epilepsy and increased our ability to localize seizures in the brain.

Address correspondence to Dr Christopher T. Skidmore, Thomas Jefferson University, 901 Walnut Street, 4th Floor, Philadelphia, PA 19107,

Relationship Disclosure: Dr Skidmore serves as a consultant for Upsher-Smith Laboratories, Inc, and has received research support from NeuroPace, Inc.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Skidmore reports no disclosure.

Supplemental digital content: Direct URL citations appear in the printed text and are provided in the HTML, PDF, and app versions of this article.

© 2016 American Academy of Neurology
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