Complex Partial Seizures (Psychomotor or Temporal Lobe Seizures)

Complex partial seizures occur when epileptic activity spreads to both temporal lobes.  They often occur after a simple partial seizure of temporal lobe origin.  They do not involve convulsions, but consciousness is impaired. The child will no longer response to questions after the seizure starts. Following the seizure, the child will have no memory of what went on.

Complex partial seizures often begin with a blank look or stare and then may progress to chewing or uncoordinated activity.  The child may appear unaware of the surroundings and may seem dazed. Some children sometimes perform meaningless bits of behavior, which appear random and clumsy (automatisms). They may pick at their clothes or try to take them off, walk about, pick up things  or mumble. They may appear afraid, and try to run and struggle.

Complex partial seizures usually last a few minutes (often 2-4), and they may be followed by a state of confusion that lasts even longer. Once the pattern of the seizures is established in a given child, it will usually be repeated with each subsequent seizure. Complex partial seizures sometimes resist anticonvulsant medication. In some children, they lead to tonic-clonic seizures.

Complex Partial Seizures are NOT:

Do NOT

SOME MEDICATIONS USED FOR COMPLEX PARTIAL SEIZURES

DEPAKENE® / EPIVAL® (VALPROATE / DIVALPROEX SODIUM) 

Depakene® / Epival® is the drug of choice for children with absence seizures who are also prone to tonic-clonic seizures. Often used for children who have seizures that are induced by flashing lights (photosensitivity). 

Can cause

Less Common Side-Effects

If individuals experience vomiting and nausea, it usually happens at the initiation of the treatment, then wears off.

The uncommon side effect most people are concerned about is hepatic (liver) failure (jaundice). The possibility of this is very slight. The deaths due to liver failure from this drug have almost always occurred in children under 2 years of age, and many of these children have had severe health problems along with epilepsy and been on multiple anti-epileptic medications. It is highly unlikely that your child will develop liver problems. If you see a loss of appetite and weight, however, or a yellow colour in the child's skin, you should call your doctor immediately.

Ask your doctor about getting regular Valproic acid levels taken (blood test).

DILANTIN  ® (PHENYTOIN)

Rarely used in children

Can cause:

FRISIUM ® (CLOBAZAM)

Used in combination with another anticonvulsant medication. A useful addition to the anti-epileptic medications for people with refractory or difficult to control seizures.

Can cause:

Less Common Side-Effects

Tolerance may develop after 1-6 months of administration and some patients cease to respond to the drug.

LAMICTAL ® (LAMOTRIGINE)

Broad-spectrum anti-convulsant

Can cause:

Less Common Side Effects:

***Labeling suggests this medication not to be used in children under the age of 18***

MYSOLINE ® (PRIMIDONE)

Less Common Side-Effects

Since Mysoline is partially changed to Phenobarbital in the body, it is not usually prescribed in conjunction with Phenobarbital.

NEURONTIN ® (GABAPENTIN)

Safety and efficacy in children are still under investigation

Can cause:

PHENOBARBITAL

Oldest established anti-epileptic medication

Can cause:

Less Common Side Effects

Children who show the sedative side effects of Phenobarbital may experience memory and cognitive problems. The abrupt discontinuation of Phenobarbital may lead to a sudden increase in seizures.

SABRIL ® (VIGABATRIN)

Often used as an add-on with other anticonvulsants.

Can cause:

Less Common Side Effects

TEGRETOL ® (CARBAMAZEPINE)

Can cause

Less Common Side Effects

With regular Tegretol ®, a wide daily fluctuation in blood levels of the drug is seen in some children. For this reason, it may be difficult to get the right dosage. The Tegretol-CR ® (controlled release) formulation, however, provides steady blood levels and many people find that the side effects are not as prevalent.  Tegretol ® is also available in a liquid (Tegretol ® Suspension) and in a chewable formulation (Chewtabs ­® - must be chewed completely to be effective).

TOPAMAX ® (TOPIRAMATE)

Currently recommended for people 18 years of age and older.

Can cause

Less Common Side-Effects

Should be taken with plenty of water; with or without food. May decrease the effectiveness of oral contraceptives; notify your physician if you are taking birth-control pills.

Should be withdrawn slowly to minimize the potential of increased seizure frequency.

July 4, 2002