What Is a Partial Seizure? | Epilepsy

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The partial seizures are seizures that start in one part of the brain, in one area, and then spread. They can start in half the brain, they can start just in one lobe of the brain, or they can start in one discrete area. it's important to decide whether these are really generalized seizures or whether they're partial seizures because it helps with our management with medication. Partial seizures can either have impairment of consciousness associated with them, or the person can be totally alert and talking during the whole seizure, so that can be something that's a very simple, sort of jerking. And I think what's interesting is, depending upon where the seizure starts, is what symptom the patient might have. So we've talked about deja vu, a patient having repeated deja vu feelings, or a funny smell, would give you a sense of where the seizure is starting. Or weird memories, or confusion, or mumbling, can give you a clue of where the seizure is starting in the brain. And then what the next symptom is, give them an idea of where the seizure is spreading to. So you can tell a lot by listening to the patient's story and having them tell what they feel, or what their family members see. So, again, complex-partial, impairment of consciousness. Simple-partial can be something as quick as just a little jerk or a funny feeling in the arm or the leg. But then the complex-partial get more involved. They can have something called automatisms as well, and we can tell from the automatisms where they start from. A classic automatism is the picking at your clothing. So somebody can look confused, zoned-out, sort of picking at the clothing. And this is an automatic behavior that happens and yet the patient doesn't really even know is happening. There's also complex-partial seizures that are associated with the nose wipe. There are ones with deja vu, as Steve was saying. There are ones with a feeling of anxiety that may masquerade as a psychiatric issue, so there are lots of different types of partial seizures and it's important to look at what they look like, what the patient feels before it, which is called an aura, and what shows up on the EEG when the testing is done.