Living with complex partial seizures

Do you sometimes lose awareness, make movements you don’t control then feel confused and forgetful? These could be complex partial seizure symptoms.

Complex partial seizures (also known as focal seizures with impaired awareness) are the most common type of epileptic seizure. Here is what you need to know about diagnosis, treatment and living with complex partial seizures.

What are complex partial seizures?

Epilepsy is a condition that causes seizures. This is when a sudden surge of electrical activity in your brain makes you behave in unusual ways which you cannot control.

There are many different types of seizure. In a complex partial seizure, the electrical activity will begin in one specific area of your brain. You will not be aware of what is happening during the complex partial seizure itself. 

This type of seizure can be dangerous because you won’t know what is happening around you. This could put you in dangerous situations especially if you are driving, walking near a busy road or cooking food, for instance. It is therefore important to get your seizures diagnosed and treated.

Complex partial seizure symptoms

There are several different complex partial seizure symptoms. These include:

• You will not be aware of what is happening to you during the seizure and will not respond to people asking questions
• The seizures usually last for one to two minutes 
• You may make unusual movements, noises or smack your lips
• Once the seizure has finished you may feel confused and tired for the rest of the day.

Depending on which part of your brain the seizure begins in, your behavior might look different:

• Starting in the temporal lobe: This is the most common type. Complex partial seizure symptoms beginning in the temporal lobe will make you have automatisms. This means that your mouth or hands will make repetitive movements that have no purpose. They normally last around 2 minutes.

• Starting in the frontal lobe: Around 3 people in 10 with complex partial seizures have this kind. These seizures are normally shorter (lasting around 30 seconds) and often happen while you are asleep. They may cause you to make noises or move parts of your body in certain ways, such as making movements as if you were pedaling a bicycle. 

Understand seizures: Learn the difference between generalized and focal seizures

Complex partial seizure diagnosis

Complex partial or focal impaired awareness seizures can be difficult to diagnose. If you think you might be having complex partial seizure symptoms you should speak to an epilepsy specialist. They will diagnose what is happening by:

• Taking a medical history
• Use an EEG to monitor electrical activity in the brain
• Use an MRI to see if there is any brain damage
• They may take blood samples

If possible, bring a video of your seizures to the appointment with your doctor. 

Complex partial seizure treatment

Complex partial seizures are normally treated using one of the following methods:

• Anti-Epileptic Drugs (AED’s): Medications help control seizures for about two thirds of people with epilepsy. There are a variety of options and some may be used in combination.
• Brain surgery: Some seizures can be controlled or eliminated by removing  the part of the brain responsible for the seizures, or severing connections to restrict the spread of the seizure. 
• Implantable medical devices: Sometimes surgery is not possible because it would risk damaging vital parts of the brain. Medical device implants can provide an alternative way of controlling seizures and reducing their severity.
• Diet: Certain diets such as the keto diet restrict carbohydrates and can help control seizures, including focal impaired awareness seizures

Learn more: Guide to the main epilepsy treatment options

Living with complex partial seizures

Because people with complex partial seizures lose awareness of what is happening around them, you may not be able to do certain activities such as driving, operating heavy machinery or swimming until your seizures are reliably controlled. 

However if you are able to control your seizures with AEDs, a device or diet, you may be allowed to start doing these activities again in future. . 

Outlook for people living with complex partial seizures

If your seizures can be controlled with medication or a medical device, many people with complex partial seizures are able to lead a normal life. 

Besides following your personal treatment plan, you might also find it useful to record any seizures that you have as well as complex partial seizure triggers in Epsy. This can help you better understand your condition and manage your treatment.