Complex partial seizure
Alerts and Notices
Synopsis
Seizures may be accompanied by automatisms such as repetitive, stereotyped movements of the orofacial or hand muscles. Altered consciousness can manifest in a variety of ways, such as perseveration, daydreaming, a feeling of déjà vu, laughter, or decreased awareness. Patients have no memory of the events that occurred during the seizure. Events typically last 1-3 minutes and may be followed by postictal confusion. Postictal weakness or aphasia may also occur. Seizures can persist and result in status epilepticus.
Causes include tumor, encephalitis or autoimmune encephalitis, vascular malformations or other vascular etiologies, and heterotopias. This type of seizure can start in childhood or adulthood, with a higher incidence in adults over age 60. Prognosis is variable and may depend on the underlying etiology.
Codes
ICD10CM:G40.209 – Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, without status epilepticus
SNOMEDCT:
4103001 – Complex partial seizure with impairment of consciousness
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Transient ischemic attack
- Migraine and migraine variants, migraine aura
- Movement disorders – dystonia, tremor, myoclonus, hemifacial spasm
- Trigeminal neuralgia
- Cardiac disorders (eg, arrhythmias)
- Gastrointestinal disorders (see gastroesophageal reflux disease)
- Hypoglycemia or other metabolic abnormalities
- Panic attacks
- Psychosis
- Psychogenic nonepileptic events
- Daydreaming
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Therapy
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References
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Last Reviewed:07/13/2017
Last Updated:08/09/2017
Last Updated:08/09/2017