In partial seizures the electrical disturbance is limited to a specific area of one cerebral hemisphere (side of the brain). Partial seizures are subdivided into simple partial seizures (in which consciousness is retained); and complex partial seizures (in which consciousness is impaired or lost). Partial seizures may spread to cause a generalized seizure, in which case the classification category is partial seizures secondarily generalized.
People who have simple partial seizures do not lose consciousness during the seizure. However, some people, although fully aware of what’s going on, find they can’t speak or move until the seizure is over.
They remain awake and aware throughout. Sometimes they can talk quite normally to other people during the seizure. And they can usually remember exactly what happened to them while it was going on.
However, simple partial seizures can affect movement, emotion, sensations, and feelings in unusual and sometimes even frightening ways.
Emotions: A sudden feeling of fear or a sense that something terrible is about to happen may be caused by a simple partial seizure in the part of the brain which controls those emotions.
In rare cases, partial seizures can produce feelings of anger and rage, or even sudden joy and happiness.
Sensations: All five senses — touch, hearing, taste, smell, and sight — are controlled by various areas of the brain.
Simple partial seizures in these areas can produce odd sensations such as a sense of a breeze on the skin; unusual hissing, buzzing or ringing sounds; voices that are not really there; unpleasant tastes; strange smells (also usually unpleasant); and, perhaps most upsetting of all, distortions in the way things look.
For example, a room may suddenly seem narrower, or wider, than it really is. Objects may seem to move closer or get farther away. Part of the body may appear to change in size or shape.
If the area of the brain involved with memory is affected, there may be disturbing visions of people and places from the past.
Sudden nausea or an odd, rising feeling in the stomach is quite common. Stomach pain also may, in some cases, be caused by simple partial seizures.
Episodes of sudden sweating, flushing, becoming pale, or having the sensation of gooseflesh are also possible.
Some people even report having out of body experiences during this type of seizure. Time may seem distorted as well.
In many ways, our usual, comfortable sense of familiar things and places may be disrupted by a simple partial seizure.
Well-known places may suddenly look unfamiliar. On the other hand, new places and events may seem familiar or as if they’ve happened before, a feeling called déjà vu.
Simple partial seizures can also produce sudden, uncontrolled bursts of laughter or crying.
Complex partial seizures affect a larger area of the brain than simple partial seizures and they affect consciousness.
During a complex partial seizure, a person cannot interact normally with other people, is not in control of his or her movements, speech or actions; doesn’t know what he or she is doing; and cannot remember afterwards what happened during the seizure.
Although someone may appear to be conscious because he or she remains standing with eyes open and moving about, it will be an altered consciousness - a dreamlike, almost trancelike state.
A person may even be able to speak, but the words are unlikely to make sense and he or she will not be able to respond to others in an appropriate way.
Although complex partial seizures can affect any area of the brain, they often take place in one of the brain’s two temporal lobes. Because of this, the condition is sometimes called “temporal lobe epilepsy.”
“Psychomotor epilepsy” is another term doctors may use to describe complex partial seizures.
Typically, a complex partial seizure starts with a blank stare and loss of contact with surroundings.
This is often followed by chewing movements with the mouth, picking at or fumbling with clothing, mumbling and performing simple, unorganized movements over and over again.
Sometimes people wander around during complex partial seizures. For example, a person might leave a room, go downstairs and out into the street, completely unaware of what he or she was doing.
In rare cases, a person might try to undress during a seizure, or become very agitated, screaming, running or making flailing movements with his arms or bicycling movements with his legs.
Other complex partial seizures may cause a person to run in apparent fear, or cry out, or repeat the same phrase over and over again.
Actions and movements are typically unorganized, confused and unfocused during a complex partial seizure.
However, if a complex partial seizure suddenly begins while someone is in the middle of a repetitive action – like dealing cards or stirring a cup of coffee – he or she may stare for a moment then continue with the action during the seizure, but in a mechanical, unorganized kind of way.
Partial seizures take many forms and medical treatment does not always control them. People who live with frequent complex partial seizures may face many challenges. One involves personal safety.
Things like fire, heat, water, heights, certain machinery and sharp objects are all potential hazards when people are unaware of what they’re doing and don’t feel pain.
However, there may be ways to reduce obvious risks. For example:
- Using a microwave oven for cooking instead of a gas or electric range;
- Taking plates to the oven or stove to serve oneself to avoid having to carry pans of hot food or liquid;
- Using a regular knife for carving, not an electric knife or, if possible, leaving the carving to someone else;
- Keeping electric mixers and other electric appliances far away from the sink or source of water;
- Setting the water heater low enough to prevent scalding during a seizure and taking sit down showers if drop attacks are frequent;
- Making sure open fires have guards and that electric or other space heaters can’t be tipped over;
- Not smoking and not carrying lighted candles or hot ashes from the fireplace through the house;
- Limiting ironing as much as possible;
- Padding sharp corners and carpeting floors.
Although some risks can be limited, others are accepted with partial seizures as part of living a normal life.
Every day, people living with this type of epilepsy go to work, take care of their children, take part in sports, ride buses, cross busy streets, go on escalators, wait for trains and – perhaps most difficult of all – risk having a seizure in front of a public that too often does not understand.
Dealing with the reactions of others may be the biggest challenge of all for people with complex partial seizures. That’s because many people find it hard to believe or accept that behavior which looks deliberate may not be.
Lack of public understanding has led to people with complex partial seizures being unfairly arrested as drunk or disorderly, being accused by others of unlawful activity, indecent exposure or drug abuse – all because of actions produced by seizures.
Such actions may even be misdiagnosed as symptoms of mental illness, leading to inappropriate treatment and, in some cases, commitment to an institution.