Focal Seizures: The Daily PANCE Blueprint

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Focal Seizures: The Daily PANCE Blueprint

A 30-year-old male presents to the clinic and tells you that he has had uncontrollable and intermittent twitching of his left hand. It tends to then spread to the entire left arm after a couple of minutes. The twitching episode is followed by weakness in that arm. He denies any changes in consciousness or any other deficits. Which of the following is the most likely diagnosis?

A. Absence seizure
B. Complex-partial seizure
C. Simple-partial seizure
D. Myoclonic seizure
E. Essential tremor

Answer and topic summary

The answer is C. Simple-partial seizure

Focal seizures are essentially seizures due to the incorrect activation of neurons in just 1 cerebral hemisphere. Etiologies include genetics, tumors, electrolyte imbalances, drugs, infections, trauma, etc. They can be classified as simple partial (awareness intact) or complex partial (impaired awareness). Diagnosis is made with EEG. An MRI of the brain can be obtained to rule out a structural cause. Treatment is AEDs (e.g., lamotrigine, levetiracetam, phenytoin, carbamazepine, etc.) and managing the underlying cause.

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Covered under ⇒ PANCE Blueprint Neurology ⇒ Seizure disorders ⇒ Focal Seizures

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