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Complex partial seizures

Clinical characteristics and differential diagnosis

Clinical Epilepsy Section, Experimental Therapeutics Branch, and the Epilepsy Branch, National Institute of Neurological and Communicative Disorders and Stroke, Bethesda, MD.

Videotape analysis of 163 complex partial seizures in 40 patients showed that the mean duration of the attack was 128 seconds. Automatisms occurred in 159 seizures (97%) and involved more than the face and arms in 132 (80%). Most automatisms were simple, stereotypic, or aimless movements. Postural tone increased in 24 seizures and decreased in 62. Clonic movements of the eyelids occurred in 19 attacks, and clonic movements of the extremities in 4. Only nine patients reported auras. Distinct ictal and postictal phases could be distinguished in 132 seizures (80%); in these, the mean ictal duration was 54 seconds and the mean postictal duration 89 seconds. Videotape analysis provides objective criteria by which complex partial seizures may be differentiated from other seizure types.

Address correspondence and reprint requests to Dr. Theodore, Epilepsy Branch, Federal Building, Room 114, NINCDS, Bethesda, MD 20205.

Presented in part at the thirty-third annual meeting of the American Academy of Neurology, Toronto, Canada, April 1981.

Accepted for publication December 29, 1982.