differentiating partial seizure types?? (n00b question)

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Gretel

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I am having a (seemingly) simple question that I keep fighting myself over, and I have finally decided to lay my n00b colors on the table.

I have read many links on here, including the ones given to me in my introduction thread by very kind members; as well as articles, blogs, and such. My greatest debacle is (seemingly) very simple, but it's not something I can read in black and white. I need information and opinions of people with Epilepsy and people who have seizures.

Basically what I am wondering is... during a Complex Partial does one loose complete consciousness? Or can one have an altered consciousness during a Complex Partial, and have the ability of remembering and knowing his or her surroundings (to an extent)?

I keep reading that every persons seizure experience varies, but at the same time I am unclear of exactly what that entails?

Signed* Confused, and quite embarrassed.
 
From what i understand a complex partial basically means you are unaware-so you don't have to be unconscious on the floor or anything but if you are aware that you are having a seizure and what is going on, then that would be a partial seizure.

For example, my daughter has complex partials, and can not respond to us when she has them. She has no idea that anything happens to her once she comes too either. But the couple of times she has had partial seizures, it appeared she was hallucinating and trying to grab something. She could answer questions but was perhaps struggling with the answers a bit. Does that help?

Don't be embarassed. We all learn by asking. I have learned a ton here. You should be proud of yourself for trying to get the answers to your questions :)
 
chmmr has nailed it.

Simple Partial = fully conscious/aware
Complex Partial = impaired consciousness or awareness.
Generalized tonic-clonic = complete loss of consciousness.

I like to think of Complex Partials as a bit like sleepwalking -- the person can walk and talk, but they aren't necessarily in control of what they are doing or saying.
 
Basically what I am wondering is... during a Complex Partial does one loose complete consciousness? Or can one have an altered consciousness during a Complex Partial, and have the ability of remembering and knowing his or her surroundings (to an extent)?

I keep reading that every persons seizure experience varies, but at the same time I am unclear of exactly what that entails?

The prior two postings, I can completely agree with.

You question regarding the variation of seizures is broad, so I'm going to broaden my answer.
(I may be beating it too far down here, so bear with me)
Starting on a broad level, one person my suffer from complex partial seizures and another of tonic clonic seizures.
We can define the variations as being as wide as that or narrow it down.
For instance, experiences during simple partial seizures (aka auras) may be very similar or very different. I'm guessing this is what you are wondering about. One common experience during a simple partial seizure is a feeling of deja vu. Dizziness is also pretty common. I experience both of these. What others may experience can range from stomach aches, headaches, familiar smells, visual hallucinations, etc. One of, multiple of, or none of these may be present during a simple partial. Sometimes the situation can be recalled and other times it may not be.
During a complex partial seizure, some people may stay relatively still and some may go get a beer from the fridge and spike it.
Tonic clonic seizures may be very different.
Effects from the seizure may leave some feeling awful and others may feel completely normal, possibly oblivious to the fact that they have had a seizure.
As you can see there are many answers to a question that you probably had no idea how broad it is. Feel free to ask something more specific.

There was absolutely nothing silly about the questions you have asked and you have no reason to be embarrassed.
 
complex partials and I are quite the team. I have complex partials more than the other two I get, semi partials and rarely gran mals. when the complex partials hit me I guess one would call me conscious... as I see it I guess I leave our world to the point I can see others but I can not hear anything and looking at anyone or anything, I have no idea who or what I see. usually when they hit me I am away 30 seconds to two minutes. like I really know... I step away and then come back. but the one thing I do remember is that I could see things in this world. Anyhow, that is how I see a complex partial. hope that helped a bit.
 
I've suffered from SP, which are actually auras, CPs and generalized TC seizures. During a complex partial seizure, I don't lose full consciousness like I do in a TC seizure. I'm in an altered state of consciousness. Folks tell me that when they speak to me, I just stare at them and I may or may not speak. But if I do speak, it is mumbled gibberish. I have a faraway look in my eyes, they can tell I'm "not here". I don't understand anything they say, although I do hear them. Usually I stay in one place when these happen. They last for 1-2 minutes and I won't remember much when I come out of the seizure. Sometimes I'm fine and sometimes I do have a post-ictal headache.
 
Many things about epilepsy are unclear, such as what causes it, what the most effective treatments are, why the medications work (when and if they do) and so on. Sadly, even the descriptions of seizure types are defined somewhat differently depending upon whom you ask or where you look. The broadest categories are simple and generalized. Partial seizures affect only a part of the brain, so only certain actions are disrupted. A generalized seizure pretty much takes the entire brain completely "offline" for the duration of the seizure. Generalized seizures can be further divided into tonic, clonic, tonic-clonic, or atonic depending on how the body is affected. Wikipedia has a pretty fair discussion of that, and some of the above posts addressed it, so I won't go into it any more here.
Partial seizures are more nebulous and it seems to me that there is a continuum of symptoms. The understanding I have arrived at after 30 years of reading and pondering and talking to people is that with simple partials the disruptions are pretty much all sensory. I copied and pasted sperlo's comments on how those are:
One common experience during a simple partial seizure is a feeling of deja vu. Dizziness is also pretty common. I experience both of these. What others may experience can range from stomach aches, headaches, familiar smells, visual hallucinations, etc. One of, multiple of, or none of these may be present during a simple partial.
Sometimes people will equate simple partial seizures with auras. The definition I like best is that an aura is a simple partial that develops into a generalized seizure. If it doesn't precede a generalized seizure, it ain't an aura. I did a quick google search and that seems to be the predominant definition. They also talk about auras preceding migraine headaches.
With complex partials, a sticking point in the definition seems to be the level-of consciousness issue. Most of the definitions I have seen refer to an alteration of consciousness, not a loss of it. I have lots of complex partials, and I remain fully aware of almost everything. I have driven during them (though I don't like to!) ridden a bike, walked, talked to people, look at the clock to see what time it is so I can enter is in my seizure diary, etc. Pretty much the ONLY alteration of consciousness I have is that I am completely unaware that I will be smacking my lips throughout the seizure. Even when I think about it during the seizure I am not aware of it. (My internal dialogue: "I'm having a seizure. I'm eating dinner. It's 3:47. Am I smacking my lips now? Nope, I guess not because I can't feel that I am. No one will notice that I'm having a seizure.") Right about then, someone in my family will tell me that I'm having a seizure, and when I ask how they new they will tell me that I was smacking my lips and looking a little spacey and turning pale. I've even taken to putting a finger on my lips to see if I can feel them smacking. I don't feel anything, but I suppose I could be doing it anyway. That's how my consciousness is altered. It's different for others, as you have seen. Physically, the seizures make me really fatigued. I recently wrote a thread about how after over 30 years, I finally saw myself having a seizure. It was really interesting, if a bit disturbing. Here is the link:
http://www.coping-with-epilepsy.com/forums/f23/finally-saw-myself-having-seizure-22861/
I know I wrote a lot and I hope it helped some. You can see how definitions differ and you will probably arrive at your own best definition for yourself in time.

Onward!
 
What arnie said about complex partial seizures fits what happens with me, as well as how my seizure specialist defined complex partial. Mine are nocturnal, and provided it has woken me up sufficiently I, too, can describe "exactly" what happens during a complex partial seizure and can look at the time to see when it happened. Because of the complexity and pattern of motor movements, and the fact that I recall some things incompletely - like hearing my voice but not knowing what my vocalization was, or when my dr. has questioned me about the seizure I realize there are gaps in my recollection ("you say this movement occurred, then that one, but something must have happened in between", and I have no idea). And during my recent video EEG I was able to describe "exactly" what happened during the seizures . . . minus the lip movements. Interestingly exactly as happened to you, arnie.
 
Sometimes people will equate simple partial seizures with auras. The definition I like best is that an aura is a simple partial that develops into a generalized seizure. If it doesn't precede a generalized seizure, it ain't an aura. I did a quick google search and that seems to be the predominant definition. They also talk about auras preceding migraine headaches.
With complex partials, a sticking point in the definition seems to be the level-of consciousness issue. Most of the definitions I have seen refer to an alteration of consciousness, not a loss of it. I have lots of complex partials, and I remain fully aware of almost everything. I have driven during them (though I don't like to!) ridden a bike, walked, talked to people, look at the clock to see what time it is so I can enter is in my seizure diary, etc. Pretty much the ONLY alteration of consciousness I have is that I am completely unaware that I will be smacking my lips throughout the seizure. Even when I think about it during the seizure I am not aware of it. (My internal dialogue: "I'm having a seizure. I'm eating dinner. It's 3:47. Am I smacking my lips now? Nope, I guess not because I can't feel that I am. No one will notice that I'm having a seizure.") Right about then, someone in my family will tell me that I'm having a seizure, and when I ask how they new they will tell me that I was smacking my lips and looking a little spacey and turning pale. I've even taken to putting a finger on my lips to see if I can feel them smacking. I don't feel anything, but I suppose I could be doing it anyway. That's how my consciousness is altered.

Simple partials are auras. Whenever I've had generalized seizures, I've had a CP first with an aura before that. How can you be having a CP seizure and no one will notice? I've been told that I "smack my lips" during the seizure, too. But I do not remember. And how can you drive while having a CP? The last time I had a CP while driving, I drove into a fence and 911 was called. One really should not be driving while experiencing CP seizures. Those you are describing sound to me more like SP seizures. People do notice CP seizures.

http://www.epilepsy.com/epilepsy/seizure_complexpartial

These seizures usually start in a small area of the temporal lobe or frontal lobe of the brain. They quickly involve other areas of the brain that affect alertness and awareness. So even though the person's eyes are open and they may make movements that seem to have a purpose, in reality "nobody's home." If the symptoms are subtle, other people may think the person is just daydreaming.

Some people can have seizures of this kind without realizing that anything has happened. Because the seizure can wipe out memories of events just before or after it, however, memory lapses can be a problem.

Some of these seizures (usually ones beginning in the temporal lobe) start with a simple partial seizure. Also called an aura, this warning seizure often includes an odd feeling in the stomach. Then the person loses awareness and stares blankly. Most people move their mouth, pick at the air or their clothing, or perform other purposeless actions. These movements are called "automatisms" (aw-TOM-ah-TIZ-ums). Less often, people may repeat words or phrases, laugh, scream, or cry. Some people do things during these seizures that can be dangerous or embarrassing, such as walking into traffic or taking their clothes off. These people need to take precautions in advance.
 
Hi Cint, I said I only think my family doesn't notice, but they always do because of the lip smacking, which I am totally unaware of. I think one manifestation of my seizures is the thought that people don't notice. Other than that my consciousness and motor skills don't really get impaired so I can continue doing complex activities. On days when I'm feeling seizurey I won't drive, though, or work with power tools.
I don't want to beat the aura/simple partial thing to death, but in the post you cited, it pretty much says what I did, that "some of these seizures [I assume they are referring to generalized seizures] start with a simple partial seizure. Also called an aura, this warning seizure . . . " which is saying that when a simple partial is a precursor to a generalized seizure it's called an aura.

Carry on!
 
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I have "simple partial and complex partial seizures evolving to generalized seizures". My exact diagnosis.

I always have had just the simple partial or the simple partial seizure first as an aura. Mine start as an intense fear deep in my lower stomach and as it gos upward everything begins to look really clear, then I have dejavu and as it continues to go up I feel like I am going out of my body then everything goes blank. Usually I go into a Complex partial then. I never remember anything except maybe a bit or piece of coming in or out but someone has to tell me what has happened. I am in control of my body functions though unless or until it turns into a generalized seizure.

In my complex partial seizures apparently from what my friends and family tell me I smack my lips and "bat" my lashes quickly, lick I have something in my eyes.
 
I am SO grateful for all of the replies (and very descriptive replies!).

And the first couple of replies is what I am having trouble understanding.

It seems I keep reading that a person experiencing a Complex Partial is unaware of the seizure is or has happened, but was not "knocked out on the floor".

But my experience with (what would I think would be a CP) is something different. For example....

I feel as if nothing is real, and I do not recognize anything or anyone, yet I feel like its "familiar" (which is the greatest percentage of my SP with bright colors and stomach uneasiness/nauseousness). Then it's like I "step back" even further from myself, and at that point I do not have much control. I will wander aimlessly when I am in public, when I am still I will pick at my clothes and lips, smack and lick my lips, and when I am home I will get up from what I was doing, walk around, and look and rummage for things that I don't even know what I am looking for.

However I am aware it is happening. Usually at first (for the first few seconds, like when I start to get up or wander) I don't know that I started. But after I start I know exactly what is happening.

So considering I am aware does that classify it as a Simple Partial?

That's my question on the "altered" consciousness. Because I am aware, I am just not "all there".

Thank you for the personal stories! That is exactly why I came here. I seem to relate to a few experiences. I know my last question is very, very broad. I am learning every day!


Sent from my iPhone using Tapatalk
 
Altered consciousness is just that: altered, changed, a little different. It does not mean that you have lost consciousness or are unaware of anything. Some people can be more aware of things, others less, but they are usually still aware and responsive to some degree, even while doing things like lip smacking of which they are unaware.
 
I usually only have simple and complex partial seizures. I do have TC, but it is very rare.

During a simple I won't black out. Sometimes I'll be talking, knowing exactly what I'm saying but it isn't what's coming out of my mouth. Things in the room won't look right, it seems like the couch should be on the other side of the room instead of where it is. I'll get dizzy or confused about what I'm doing. A few days ago I had one while I was in the bathroom on the toilet. I started to get dizzy and couldn't figure out what I was in the bathroom for. Some people will smell things, I don't.

During a complex I blank out and don't know anything that's going on or what I did during it. A good bit of times I will smack my lips. Sometimes I can't talk, words come out like baby talk, and other times I can. I may just stare at the wall. I'll pick up things and start to play with them. I had one the other day where I picked up the phone and told my husband, who was with me, that I needed to call him because I wasn't home, which I was. He kept trying to take the phone off of me but I wouldn't give it up so he let me have it. He decided I could just push numbers in and call someone, who knows who? I even went into the kitchen once, loaded the dishwasher then came back into the living room and sat down. Didn't know I had the seizure and loaded the dishwasher until I told my husband thanks for doing it and he told me he didn't.

Sometimes I'll have an simple partial (or aura) before I go into a complex and other times I won't.

Everyone is different about what they do during a seizure so just because someone does something doesn't mean you are going to do it too.
 
I don't want to beat the aura/simple partial thing to death, but in the post you cited, it pretty much says what I did, that "some of these seizures [I assume they are referring to generalized seizures] start with a simple partial seizure. Also called an aura, this warning seizure . . . " which is saying that when a simple partial is a precursor to a generalized seizure it's called an aura.

Arnie, please don't assume anything. I don't have generalized seizures anymore since I've had the VNS put in back in 1997. However, I still do have occasional SPs, which are precursors to CPs. And a simple partial is actually an aura. I didn't say it only happens before a generalized seizure. For me, the aura, or simple partial happens before the CP almost always. I can now stop the CP since I have the VNS, as long as I have the magnet handy.
 
But my experience with (what would I think would be a CP) is something different. For example....

I feel as if nothing is real, and I do not recognize anything or anyone, yet I feel like its "familiar" (which is the greatest percentage of my SP with bright colors and stomach uneasiness/nauseousness). Then it's like I "step back" even further from myself, and at that point I do not have much control. I will wander aimlessly when I am in public, when I am still I will pick at my clothes and lips, smack and lick my lips, and when I am home I will get up from what I was doing, walk around, and look and rummage for things that I don't even know what I am looking for.

However I am aware it is happening. Usually at first (for the first few seconds, like when I start to get up or wander) I don't know that I started. But after I start I know exactly what is happening.

So considering I am aware does that classify it as a Simple Partial?

When you feel as though you don't recognize anything, but know it is "familiar", that sounds like a sens of Jamais Vu. The "opposite" of Deja Vu. If I had to guess this is part of a simple partial.

Once you get to the point you feel you don't have that control, I'd guess that is a complex partial. Others may argue with that, but I'm willing to bet when you feel like you have "less control", I would bet you have less than you think you may.

I never had any sense of what was going on during a complex partial, but I have talked to others that believe they have, so I won't argue with the possibility.

Best guess, you are first experiencing the simple, but moving onto the complex partial once you "'step back' further into yourself".

Hope this gives you some insight.
 
Arnie, please don't assume anything. I don't have generalized seizures anymore since I've had the VNS put in back in 1997. However, I still do have occasional SPs, which are precursors to CPs. And a simple partial is actually an aura. I didn't say it only happens before a generalized seizure. For me, the aura, or simple partial happens before the CP almost always. I can now stop the CP since I have the VNS, as long as I have the magnet handy.

Arnie didn't make assumptions about your epilepsy, but about the text. He said I assume 'they' are talking about...and not I assume 'you' are talking about.
 
I suspect the word 'aura' may have become dated, or that it needs to be redefined. When I look up the word, what I get is that it precedes a seizure:"a subjective sensation or motor phenomenon that precedes and marks the onset of a neurological condition, particularly an epileptic seizure (epileptic a.) or migraine (migraine a.)" (http://medical-dictionary.thefreedictionary.com/epileptic+aura) We now know that what we call an aura is actually a kind of seizure, and that makes the whole thing ripe for confusion. We can't say that a seizure is a sensation that precedes a seizure. That's why I agree with Arnie when he says that we should call a simple partial an aura when it precedes a different kind of seizure (complex partial or tonic clonic.)
 
complex partials and I are quite the team. I have complex partials more than the other two I get, semi partials and rarely gran mals. when the complex partials hit me I guess one would call me conscious... as I see it I guess I leave our world to the point I can see others but I can not hear anything and looking at anyone or anything, I have no idea who or what I see. usually when they hit me I am away 30 seconds to two minutes. like I really know... I step away and then come back. but the one thing I do remember is that I could see things in this world. Anyhow, that is how I see a complex partial. hope that helped a bit.

What are semi partials?
 
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