Complex partial seizures

These may begin as a simple partial seizure or 'aura', or consciousness may be impaired from the beginning. Characteristic auras include epigastric sensations rising into the thorax and olfactory and gustatory hallucinations, elaborated auditory and visual hallucinations, complex changes in perception (e.g. micropsia, depersonalization), and psychic phenomena such as déjà vu. As discharge activity spreads, automatic behaviour may supervene or a generalized seizure may ensue. Complex partial seizures commonly arise from temporal, particularly mesial temporal, structures. Hence the obsolete term 'temporal lobe epilepsy'. They may also arise from the orbital and mesial frontal cortices. Complex partial status, previously known as temporal lobe status, is uncommon. It may present as an organic confusional state and may be mistaken for a florid psychosis. Electroencephalography will usually confirm the diagnosis.

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