Partial seizures, simple or complex, are controlled by the function of the brain area in which they occur
  • Complex partial seizures last 1 to 2 minutes.
  • These seizures may have an aura (or warning). 
  • Complex Partial Seizures include automatisms (such as lip smacking, picking at clothes, fumbling), unaware of surroundings or may wander.
  • Many treatment options are available including medicines, diet, surgery and devices.

Here’s a typical story: "Susan's seizures usually occur while she's asleep. She makes a grunting sound, as if she's clearing her throat. Then she'll sit up in bed, open her eyes, and stare. She may clasp her hands together. If I ask her what she's doing, she doesn't answer. After a minute or so, she lies down and goes back to sleep."

What is a complex partial seizure?

  • These seizures usually start in a small area of the temporal lobe or frontal lobe of the brain. They quickly involve other areas of the brain that affect alertness and awareness. So even though the person's eyes are open and they may make movements that seem to have a purpose, in reality "nobody's home." If the symptoms are subtle, other people may think the person is just daydreaming.
  • Some people can have seizures of this kind without realizing anything has happened. The seizure can wipe out memories of events just before or after it.
  • Some of these seizures (usually ones beginning in the temporal lobe) start with a simple partial seizure.
  • Then the person loses awareness and stares blankly.
  • Most people move their mouth, pick at the air or their clothing, or perform other purposeless actions. These movements are called "automatisms" (aw-TOM-ah-TIZ-ums).
  • Less often, people may repeat words or phrases, laugh, scream, or cry. Some people do things during these seizures that can be dangerous or embarrassing, such as walking into traffic or taking their clothes off. These people need to take precautions in advance.
  • Complex partial seizures starting in the frontal lobe tend to be shorter than the ones from the temporal lobe. The seizures that start in the frontal lobe are also more likely to include automatisms like bicycling movements of the legs or pelvic thrusting.
  • Some complex partial seizures turn into secondarily generalized seizures. They usually last between 30 seconds and 2 minutes. Afterward, the person may be tired or confused for about 15 minutes and may not be return to normal function for hours.
  • As for many other kinds of seizures, the outlook depends on whether the cause is known. They may be outgrown or controlled with medication. If medication is not effective, some can be eliminated by epilepsy surgery.
Partial seizures are the most common type of seizure experienced by people with epilepsy.

Who is at risk for complex partial seizures?

Anybody can get them. They may be more likely in people who have had a head injury, brain infection, stroke, or brain tumor but most of the time the cause is unknown.

How can I tell if someone is having a complex partial seizure and how often will they happen?

Complex partial seizures sometimes resemble daydreaming or absence seizures :

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Questions to Ask

Daydreaming

Seizures

How frequent are the episodes?

Not frequent.

Complex partial: Rarely more than several times per day or week.
Absence: Could be many times per day.

In what situations do they occur?

Boring situation.

Any time, including during physical activity.

Do they begin abruptly?

No.

Usually yes. Some complex partial seizures begin slowly with a warning.

Can they be interrupted?

Yes.

No.

How long do they last?

Until something interesting happens.

Complex partial: Up to several minutes.
Absence: Rarely more than 15-20 seconds.

Does the person do anything during the episode?

Probably just stares.

Complex partial: Automatisms are common.
Absence: Just stares.

What is the person like immediately after the episode?

Alert.

Complex partial: Confused.
Absence: Alert.

What happens after a complex partial seizure?

When a complex partial seizure ends, the person may be tired or confused for about 15 minutes and may not be fully normal for hours. First aid may be necessary if an injury has occurred.

How are complex partial seizures diagnosed?

Careful observation should make the diagnosis pretty certain in most cases. An EEG is a helpful test that can help make the diagnosis.

How are complex partial seizures treated?

There are several medications that can help prevent complex partial seizures. For persons with epilepsy, surgery, vagus nerve stimulation and diet therapy are all available for the treatment of chronic complex partial seizures.

What should I do if I think, my child, loved one or myself may have complex partial seizures?

If you think your child, loved one or yourself may be having complex partial seizures, let your doctor know your concerns right away. Untreated complex partial seizures can lead, to injury, memory impairment and in rare cases death.

Authored by: Joseph I. Sirven, MD | Orrin Devinsky, MD on 7/2013
Reviewed by: Joseph I. Sirven, MD | Patricia O. Shafer, RN, MN on 3/2014
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What It Looks Like...

Harold's spells begin with a warning; he says he's going to have a seizure and usually sits down. If I ask him how he feels, he just says 'I feel it.' Then he makes a funny face, a mixture of surprise and distress. During the seizure he may look at me when I call his name but he never answers. He just stares and makes odd mouth movements, as if he's tasting something. Sometimes he'll grab the arm of the chair and squeeze it. He may also pull at his shirt as though he's picking lint off of it. After a few minutes, when he's coming out of it, he asks a lot of questions. He never remembers his 'warning' or these questions. The seizures make him tired; if he has two in the same day, he often goes to sleep after the second one.

First Aid
First Aid for Complex Partial Seizures
  • Do not restrain the person
  • Remove dangerous objects from the person's path
  • Calmly direct the person to sit down and guide him or her from dangerous situations. Use force only in an emergency to protect the person from immediate harm, such as walking in front of an oncoming car
  • Observe, but do not approach, a person who appears angry or combative
  • Remain with the person until he or she is fully alert
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