Focal seizures with temporal lobe features occur, most are associated with retained awareness, although focal impaired awareness seizures may occur. Seizures are usually mild and infrequent and mainly have cognitive features, with illusions (auditory or visual, e.g. distortion of sound or light), hallucinations or deja vu. Hallucinations may occur alone or in combination with autonomic features. Emotional features, for example fear, may also be seen. Sensory features are common, and may be diffuse (not localized), consisting of numbness or tingling. Epigastric aura are not seen.
Focal to bilateral tonic-clonic seizures occur in two thirds of patients, often before treatment. When these occur they are infrequent.
Other seizure types are not expected.