Complex partial seizures

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Read about causes and symptoms of complex partial seizures and how they are treated.

Key points

  • The symptoms of a complex partial seizure depend on the part of the brain that is affected. They involve some loss of consciousness and may include rhythmic jerking of the hand or arm, feelings of nausea or fear, drooling, vomiting and involuntary movements such as blinking or swallowing.
  • Complex partial seizures come in many forms, but an individual child will usually have the same seizure pattern each time.
  • Causes of complex partial seizures include brain tumours, head injuries and malformations in part of the brain.
  • If your child is having a seizure, guide them away from hazards, restrain them only if their safety is in danger, and, after the seizure, explain what happened and give them time to recover.

Complex partial seizures start in one part of the brain but usually affect other parts of the brain that involve alertness and awareness. The symptoms of a complex partial seizure depend on which part of the brain is affected, but they usually involve impaired consciousness. A child who is experiencing a complex partial seizure may seem to be aware of their surroundings, and may move or speak, but will be confused or unaware of what is actually going on.

What are other terms for complex partial seizures?

Other terms for complex partial seizures include:

  • psychomotor epilepsy
  • temporal lobe epilepsy.

How can you tell if your child has complex partial seizures?

Complex partial seizures

Complex partial seizures appear different from person to person, depending on the affected area of the brain. However, an individual child will usually have the same seizure pattern every time.

It can be hard to identify complex partial seizures in a baby or a young child up to five or six years old, because their nervous systems are less developed than those of older children and adults. A child of this age may suddenly stop what they are doing and their hand or arm may jerk rhythmically, and holding the arm will not stop the jerking. They may raise one or both arms or move their head to one side and, in rare cases, their eyes may look to one side.

Auras, such as a feeling of fear or nausea, are very common before complex partial seizures. If the child is not old enough to speak, they may run to their mother and cling to her.

A child may have automatisms during a complex partial seizure, such as:

  • chewing, lip-smacking, gulping, swallowing or spitting
  • eye blinking, head turning or raising one arm
  • hand movements, including picking at the air or at their clothing, gestures, rapid “pill-rolling” movements, grasping at objects
  • rubbing genitalia.

The child may also have autonomic symptoms, such as vomiting or retching, drooling, rapid heartbeat or breathing, or going pale.

After the seizure, the child will be confused, and may have no memory of events just before or after the seizure.

How many other children have complex partial seizures?

Complex partial seizures are one of the most common seizure types. Between 8% and 31% of children with epilepsy have complex partial seizures.

What causes complex partial seizures?

Complex partial seizures may start in any lobe of the brain and spread to other areas. They are often symptomatic and can result from head injuries, brain tumours, or malformations. Complex partial seizures can also be idiopathic; they occur in some syndromes such as BECTS or BECOS.

How are complex partial seizures treated?

The treatment for complex partial seizures depends on the underlying cause. In some cases, such as a brain tumour, surgery will probably be advised as the first course of treatment. In other cases, the doctor will prescribe an anti-epileptic drug. If the child continues to have seizures while taking medication, it may be possible to surgically remove the affected area of the brain. This option depends on how close the seizure focus is to essential areas of the brain, such as the speech, language, and motor areas.

What should I do when my child has a complex partial seizure?

What to do in this situation depends on the individual child; let other people know what works for your child. Your child may wander around or perform automatisms (repetitive, apparently purposeful movements). They may react unpredictably if you speak to them or touch them. If your child is having a complex partial seizure:

  • If they are walking or running around, try to be a barrier. Guide them gently away from hot or sharp objects and stairs, as they could hurt themselves or fall.
  • Don’t restrain them unless it is absolutely necessary (if they are in an unsafe situation), as they may strike out or try to run away.
  • If you need to touch them, approach them cautiously from the side and speak to them so that they don’t feel threatened.
  • In some cases, once the seizure is over, they may be confused or tired. Quietly explain what happened and where they are. Give them time to rest and recover.

What is the outlook for a child with complex partial seizures?

The outlook for a child with complex partial seizures depends on the underlying cause of the seizures. They tend to be more drug-resistant than other types of seizures, remission rates are poorer, and some studies suggest that people with uncontrolled complex partial seizures have poor psychosocial outcomes. However, it is still possible for a child with complex partial seizures to do well.

Last updated: February 4th 2010