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Focal Aware Seizure – Temporal Aura — SCE Neurology MCQ

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EasyEpilepsy & Seizure DisordersFocal Aware Seizure – Temporal AuraSCE Neurology

A 30-year-old woman presents with recurrent stereotyped episodes of an unpleasant rising sensation from her stomach to her throat, followed by fear and a feeling that her surroundings are familiar (déjà vu). Each episode lasts 30–60 seconds. She remains fully aware throughout. EEG shows right temporal sharp waves. What type of seizure is this?

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Correct answer: E — Focal aware seizure with autonomic and emotional symptoms — previously called 'simple partial seizure with experiential phenomena'

This is a classic mesial temporal lobe focal aware seizure (the patient retains awareness throughout). The epigastric rising sensation is the most common aura of temporal lobe epilepsy, reflecting activation of the insular cortex. Déjà vu results from hippocampal activation. Fear is an ictal emotion from amygdalar involvement. The 'focal aware' designation (ILAE 2017) replaces 'simple partial seizure'. A: The stereotyped nature and EEG findings distinguish from panic. C: Absence seizures have loss of awareness. D: Migraine aura lasts 5–60 minutes and marches. E: The EEG confirms epilepsy.

Reference: ILAE 2017 Seizure Classification; NICE NG217