Complex partial seizures represent events of focal cerebral onset which characteristically manifest with a variety of motor, sensory, or behavioral alterations. The "aura" sometimes preceding a seizure is thought to represent an initial sensory symptom produced by focal seizure activity and is often described as a foul odor or taste.
Although motor activity during a complex partial seizure may remain focal, more complex activities or automatisms may occur, including fumbling movements of the hands or walking. Lip smacking or guttural sounds are often evident. Transient somnolence or confusion may follow an event.
This variety of epilepsy was once known as "temporal lobe" seizures, although advances in electroencephalography have confirmed that complex partial seizures may arise from other areas of the brain as well. Neuroimaging should be performed in all cases, since focal structural lesions or neoplasms of the central nervous system underlie complex partial seizures in a minority of cases. In most cases, however, CT or MRI of the brain is normal.
A variety of anticonvulsant agents may be effective for treatment, including carbamazepine, phenytoin, and valproic acid. Epilepsy surgery should be considered when seizures are medically intractable and EEG monitoring suggests consistent seizure onset from a surgically amenable site.
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Created: July 25, 1995