Partial complex seizure
Alternative names:
complex seizure; seizure - complex
Treatment:
Record details of the seizure to report 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. First-aid measures should be performed as appropriate, including protection from injury, prevention of aspiration of vomit or mucus into the lungs, and protection of the 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.
Diazepam (Valium) given intravenously is the primary treatment for status epilepticus of any type. Other medication may be given (as with the status epilepticus of a generalized tonic-clonic seizure).
Treatment of the causes may stop the occurrence of seizures. This may include medical treatment of disorders, surgical repair of tumors or brain lesions, or other treatments.
An isolated seizure with an obvious avoidable trigger (such as fever, toxic reactions, etc.) is treated by removing or treating the precipitating (trigger) 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) 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 usually treated with phenytoin or carbamazepine for long-term, preventive use.
Follow-up includes review of 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 reduction of side effects.
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.
Wearing informational jewelry or cards (such as Medic-Alert) may be advised to aid in obtaining prompt medical treatment if a seizure occurs.
Expectations (prognosis):
Seizures can occur as a single isolated incident, at closely repeated (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 indicate that reduction or elimination of medications may be possible. 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 in close proximity. 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.
Complications:
- 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)
Calling your health care provider:
Call your health care provider if this is the first time the person has had seizures.
Call your health care provider if this is a new type of seizure for the person.
Go to the emergency room or call the local emergency number (such as 911) if the seizure lasts longer than 2 to 3 minutes or if repeated seizures occur (over any amount of time). Repeated seizures over a few minutes, or repeated seizures where consciousness is not regained between them (status epilepticus) is an emergency situation.
Call your health care provider if any new symptoms occur, including possible side effects of medications:
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