Understanding Focal Impaired Awareness Seizures: Dante’s story
Focal impaired awareness seizures, formerly called Complex Partial Seizures, are one of the most common seizure types in adults with epilepsy, yet often misunderstood. Because a person may appear awake but not fully aware, others might mistake the seizure for daydreaming or unusual behavior. This article explains what these seizures look like, how they happen, and how to support someone going through them. You’ll also meet Dante, a fictional young man whose experience shows what living with this seizure type can feel like.
Dr. Clotilda Chinyanya
11/27/20253 min read
Dante’s Story: “It’s Like My Brain Slips Away for a Minute”
Dante is 26, a graphic designer who loves bright colors and biking around the city. At work, he’s known for being focused and creative. But lately, his coworkers have noticed moments where he suddenly stops mid-conversation.
One morning during a team meeting, Dante is explaining a project when his voice fades out. His eyes remain open, staring ahead but they lose focus. His fingers rub against each other repetitively, like he’s rolling something imaginary. When his coworker asks if he’s okay, he doesn’t respond. It lasts less than 90 seconds, but to the team, it feels longer.
When Dante “returns,” he blinks rapidly and looks confused. He asks, “What were we talking about again?” He’s tired afterward, and he feels as though time skipped. There was a gap in his memory.
Before these episodes, Dante sometimes gets a strange warning: a sudden rush in his stomach, like a rollercoaster drop, or a powerful déjà vu sensation. But he never knows if that warning means a seizure is imminent.
When he finally sees a neurologist, Dante learns he has focal impaired awareness seizures. These are seizures that start in a specific part of the brain and interrupt his awareness. With education, lifestyle adjustments, and treatment using anti-seizure medications, he starts to regain control of his life and learns that he’s far from alone.
What Is a Focal Impaired Awareness Seizure?
A focal impaired awareness seizure (FIAS):
✔ Starts in one area of one side of the brain
✔ Involves changes in awareness or responsiveness
✔ Lasts 30 seconds to 3 minutes
✔ May leave the person tired or confused afterward
They used to be known as:
Complex partial seizures
Focal dyscognitive seizures
These seizures are extremely common especially in adults with epilepsy.
What Do They Look Like?
During these seizures, a person may:
Stare blankly
Move without purpose (called automatisms)
Be unable to answer or understand questions
Appear awake but “nobody is home”
Wander, walk into danger, or perform odd behaviors
Examples of automatisms:
Lip-smacking or chewing
Repeated blinking
Rubbing fingers or picking at clothing
Wandering aimlessly
Making repetitive sounds or words
Some people freeze completely and cannot move but are still partially aware.
Auras: When the Warning Is Part of the Seizure
Some people experience an aura first, technically a focal aware seizure.
Examples of aura sensations:
Sudden fear or anxiety
Smells or tastes that aren’t real
Strange visual distortions
Déjà vu or jamais vu
Rising sensation in the stomach
Tingling or numbness
The aura is the beginning of the seizure, not a separate event.
Where Do These Seizures Come From?
Most often:
Temporal lobe - emotions, memory, awareness
Frontal lobe - movement, behavior, decision-making
But they can also start in:
Parietal lobe (sensory changes)
Occipital lobe (visual changes)
Insular cortex (headache, nausea, tingling)
Seizure symptoms may hint at the brain location but testing is needed to know for sure.
How Are They Different from Daydreaming or Absence Seizures?
Feature FIAS. Daydreaming Absence Seizure
Duration 1–3 minutes Variable 10–20 sec
Awareness Reduced Normal Lost
Movements Automatisms common None Light blinking
Interruptible? No Yes No
Afterward Confusion, fatigue Normal. Normal
People often misjudge FIAS as:
❌ Not paying attention
❌ Being rude
❌ Acting strangely
Understanding prevents stigma.
What Causes Them?
Anyone can have them. Most of the time, the cause is unknown.
Possible contributors:
Head injury
Brain infections
Stroke
Tumor or lesion in the brain
Abnormal brain development
Metabolic issues
Genetic conditions
Some triggers can provoke seizures:
Lack of sleep
Stress
Alcohol
Illness or fever
Flashing lights (less common than people think)
Skipping anti-seizure medication
How Are They Diagnosed?
Doctors rely on:
Detailed seizure history
Witness descriptions
EEG to detect epileptic brain activity
MRI or imaging for structural causes
Bloodwork to check for metabolic issues
Diagnosis helps match the seizure type with the right treatment plan.
Treatment Options
Treatment goals:
✨ Stop seizures
✨ Reduce risks
✨ Maintain quality of life
Common approaches:
Anti-seizure medications / anti-epilepsy drugs
Lifestyle adjustments and seizure-trigger management
Diet therapy (such as ketogenic diet mostly for children)
Surgery when medication does not work and seizures come from one removable brain area
Vagus nerve stimulation for difficult-to-control cases
About half of people become seizure-free with the first medication tried.
Some need combination therapy or alternative treatments.
Safety and Seizure First Aid
Someone having a FIAS may look conscious but they are not in control.
Do:
✔ Stay with them
✔ Keep them safe from traffic, water, heat
✔ Speak calmly and gently
✔ Gently guide them away from danger
Do NOT:
❌ Try to hold them down
❌ Shout commands
❌ Give them food, drink, or medication during a seizure
Afterward, they may need:
Quiet space
Time to recover
Gentle orientation
Driving and Daily Precautions
People with FIAS may lose awareness unpredictably.
They may need to avoid:
Driving (state laws vary)
Swimming alone
Working at heights
Operating dangerous machinery
Cooking without supervision
A healthcare provider will review safety rules and legal requirements.
Living With Focal Impaired Awareness Seizures
The condition can impact:
Confidence
Employment
Relationships
Mental health
But with treatment, education, and support, many people like Dante live meaningful, vibrant lives.
Dante now:
✔ Takes medication consistently
✔ Communicates openly with friends and coworkers
✔ Plans ahead for safety
✔ Tracks triggers and auras
✔ Learns that asking for support is strength
“It doesn’t define me. It’s just part of my brain’s story.” Dante
Final Message
Focal impaired awareness seizures may be subtle, but their impact is real. Understanding how they work helps:
Reduce fear and misinformation
Improve safety
Build compassion
Support the millions living with epilepsy worldwide
Whether you are a person with seizures, a loved one, or simply someone who wants to learn, knowledge changes lives.
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