Aims Focal seizures refer to the electrical and clinical manifestations of seizures that arise from one portion of the brain. The electroencephalogram (EEG) typically indicates a localised discharge over the area of onset. The aim of this study is to know the clinical profile and possible underlying causes of focal epileptic seizures among children.

Methods A cross sectional prospective hospital-based study was conducted at neurology out patients clinics from February 2014 to February 2015 on 86 patients with clinical diagnosis of focal epileptic seizures aged from 3 months to 18 years. A designed questionnaire has been administered and it includes detailed history, examination and Investigation. Treatment type, duration and short term effect were reported.

Results Right sided focal motor seizures were the most common presentation. Neurological examinations correlate with seizure laterality. Seizure types were simple partial seizures in 31 patients (36%), complex partial seizures in 32 patients (37.2%), simple partial seizures evolving to generalised in 9 patients (10.5%) and complex partial seizures evolving to generalised in 14 patients (16.3%).Focal epileptic seizure types were Benign Epilepsy of Childhood with Centrotemporal Spikes (BECTS) in 16 patients (35.5%),frontal lobe epilepsy in 11 patients (24.4%),childhood epilepsy with occipital paroxysm in 3 patients (6.66%),multi focal seizures in 3 patients (6.66%) and parietal focal seizures in 2 patients (4.44%) in addition to others (22.22%). The correlation between seizure semiology and EEG findings was found to be of no statistical significance (p value .280).The underlying causes of focal epilepsy according to brain image findings were idiopathic in (42.9%), symptomatic in (57.1%), of which 15 (34%) had brain atrophy, 12 (27.3%) had vascular thrombosis and ischaemic encephalopathy, 5 (11.4%) had meningoencephalitis, 2 (4.5%) had neurocutaneous syndrome, in addition to others. Full response to treatment occurred in 34 (39.5%), decrease in frequency and duration of seizures occurred in 35 (40.7%) while 15 (17.4%) showed no response to treatment.

Conclusion The most common type of focal seizures is complex partial seizures and most of the seizures were temporal in origin. EEG yield need more trained personnel in paediatric EEG.