Complex partial seizures (psychomotor seizures) are called "complex" because they impair consciousness and "partial" because they begin in a limited area of the brain. Most complex partial seizures are associated with some automatic behaviors, termed automatisms.

The chance of bodily injury during a complex partial seizure is small. Single and brief complex partial seizures do not damage the brain. Prolonged or repetitive complex partial seizures may cause slight but persistent memory loss, but more serious brain injury is rare.

During a complex partial seizure, the person usually becomes motionless and stares or makes automatic movements such as fumbling movements of the hands. When someone has a complex partial seizure, speak quietly and in a reassuring manner, because some persons have only partial impairment of consciousness and can react to emotional or physical stimulation. Do not yell at the person, or restrain him or her unless absolutely necessary, which is rare. The most important aspect of first aid during a complex partial seizure is to keep the person safe from harm. For example, burns can occur when someone unknowingly touches or falls on a hot object. During and after some complex partial seizures, the person may walk or, in rare cases, run. When this occurs where there is dangerous equipment, on a busy city street, near train tracks, or near high places such as a construction site, there is a potential for serious injury.

Other behaviors during complex partial seizures may cause concern, but are not dangerous to the patient or other people. These include screaming, kicking, ripping up papers, disrobing, sexual-like movements, and, rarely, masturbation. If someone is known to have unusual automatisms, he or she should be led in a quiet and reassuring manner-not forcibly-out of public places, such as an office or store. Specific strategies should be devised to minimize the embarrassing effects for individuals with such unusual complex partial seizures.

The greatest danger of an unexpected seizure occurs when the person is driving a car or operating dangerous equipment. Those with seizures that impair consciousness or control of movement should avoid these activities as directed by their physician or state driving laws. In some cases, potentially dangerous equipment can be used safely if adequate precautions are taken.

If the seizure is prolonged (more than 5 to 10 minutes of impaired consciousness with automatisms), or if there are two or more complex partial seizures without return of consciousness between seizures, then medical help should be sought. If the patient is known to have a pattern of prolonged or recurrent complex partial seizures, rectal diazepam (Diastat) can be administered at home by family members to stop the seizures. First aid for someone having a complex partial seizure is simple: keep the person away from dangerous situations, use restraint only if it is necessary for his or her safety, and seek medical help for prolonged or recurrent seizures.

Topic Editor: Steven C. Schachter, M.D.
Last Reviewed:12/15/06

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