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Partial complex seizure

Overview Symptoms Treatment Prevention
Alternative Names:
Seizure - complex; Complex seizure
You should write down details of the seizure so you can report them to the health care provider. Include the date and time of the seizure, how long it lasted, which body parts were affected, the type of movements or other symptoms, possible causes, and other factors noted.

Emergency treatment may not be required unless the seizure becomes generalized or consciousness is lost -- call an emerency number (such as 911) if you have any questions. First-aid measures should be performed as appropriate, including protecting the patient from injury during the seizure, preventing the patient from inhaling vomit or mucus into the lungs, protecting the patient's airway, or assistance with breathing.

Complex partial status epilepticus is a condition in which partial complex seizures recur frequently in minutes. It is characterized by changes in mental status, decreased alertness, confusion, decreased responsiveness, and automatic behaviors. It may be very difficult to diagnose and may require and EEG to confirm.

Diazepam (Valium) given intravenously is the primary treatment for status epilepticus of any type. Other medications may be given (as with the status epilepticus of a generalized tonic-clonic seizure).

Treatment of the causes may stop the seizures from recurring in the future. This may include medication, surgical repair of tumors or brain lesions, or other treatments.

An isolated seizure with an obvious avoidable trigger (such as fever or toxic reactions) is treated by removing or treating the precipitating factor.

An isolated seizure without an obvious cause (examination and EEG are normal, and no abnormalities appear on other testing) may not require treatment.

Oral anticonvulsants (anti-seizure medications) may prevent or reduce the number of future seizures. Response varies, and medication and dosage may have to be adjusted repeatedly.

An isolated seizure with abnormal findings on an EEG or other tests is treated with anticonvulsant medications such as phenytoin, carbamazepine, phenobarbital, or valproic acid. Multiple, repeated seizures are often treated with phenytoin or carbamazepine for long-term, preventive use. Other medications include levetiracetam, oxcarbazepine, gabapentin, lamotrigine, topiramate, and Gabitril.

During followup appointments, the physician would probably want to review the need for drugs at least yearly. Drugs may need to be continued indefinitely. Plasma drug-level monitoring is important for continued control of seizures and keeping side effects to a minimum.

Pregnancy, lack of sleep, skipping doses of medications, use of drugs and medications or alcohol, or illness may cause seizures in a person with a previously well controlled seizure disorder.

The patient may be advised to wear informational jewelry or cards (such as Medic-Alert) to help ensure prompt medical treatment if a seizure occurs.
Expectations (prognosis):

Seizures can occur as a single isolated incident, at closely repeated intervals (recurrent multiple seizures), or at various intervals (episodic, paroxysmal). Seizures that recur with little or no observable cause are most commonly associated with seizure disorders (epilepsy). This is a chronic, lifelong condition.

Seizures that occur singly or in a closely associated group are commonly caused by an acute condition such as brain injury. They may occur as an isolated incident, or they may develop into a chronic seizure disorder. Seizures within the first two weeks of a brain injury do not necessarily mean that a chronic seizure disorder will develop.

A seizure-free period may mean that medications may be reduced or eliminated. Medications should be changed only under the supervision of the health care provider.

Death or permanent brain damage from seizures is rare, but either can occur if the seizure is prolonged or many seizures occur soon after each other.

Serious injury can occur if the seizure happens while the person is driving or operating dangerous equipment. These activities may be restricted for people with poorly controlled seizure disorders. Infrequent seizures may not severely restrict lifestyle. Work, school, and recreation do not necessarily need to be restricted.

  • aspiration pneumonia
  • complications of surgery
  • injury caused by seizure during driving/operating machinery
  • injury from falls, bumps, biting self
  • injury to others
  • performance of crimes or antisocial acts during seizure
  • permanent brain damage (stroke or other damage)
  • progression to generalized seizures
  • prolonged seizures, closely occurring seizures (status epilepticus)
  • psychosis (can develop in some individuals)
  • recurrent seizures (epilepsy)
  • side effects of medications (with or without observable symptoms)
  • women choosing to become pregnant should alert their doctor in order to adjust medications prior to pregnancy as many of the anti-epileptic medications cause birth defects
Calling your health care provider:
Go to the emergency room or call the local emergency number (such as 911) if the seizure lasts longer than usual for the person. In addition, repeated seizures are an emergency situation if consciousness or normal behavior is NOT regained between them. (This is called status epilepticus.)

Call your health care provider if this is the first time the person has had seizures, if this is a new type of seizure for the person, or if any new symptoms occur, including possible side effects of medications:
Central nervous system
Central nervous system

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