First Aid for Focal Impaired Awareness (complex partial) Seizures
Focal impaired awareness seizures were formerly called complex partial or psychomotor seizures. This means that the person may look awake but they aren't able to respond fully, may be confused, or not remember events. They are not fully unconscious though. The word focal means that they start in one area of the brain or one group of one side of the brain. Many focal seizures have some type of automatic behaviors, called automatisms, during them.
The chance of seriously hurting yourself during a focal seizure with impaired awareness is small. Single and brief focal seizures do not damage the brain. Long or repeated ones may cause slight but lasting memory loss. More serious brain injury is rare, unless the seizure leads to seizure emergencies, such as status epilepticus.
What to Do
- Speak quietly and in a reassuring manner. Some people may be able to hear during a seizure.
- Do not yell at the person or restrain them unless absolutely necessary to keep the person safe. They may be confused and react differently to emotional or physical stimulation.
- Keep the person safe. For example:
- Keep them away from hot objects, surfaces or fire.
- Keep them away from dangerous situations, equipment or places.
- Keep them from wandering or running in dangerous places.
- Other behaviors during these focal seizures may cause worry, but are usually not dangerous. These include screaming, kicking, ripping up papers, disrobing, sexual-like movements, and, rarely, masturbation. Stay next to the person when these occur and prevent injury.
- If someone is known to have unusual automatic movements, guide them in a quiet and reassuring manner to a more private place if possible.
- Work with your health care provider about specific ways to lessen embarrassing effects of a focal seizure.
- The greatest danger of an unexpected seizure occurs when the person is driving a car or operating dangerous equipment.
- People with seizures that impair consciousness or control of movement should avoid these activities as directed by their physician or state driving laws.
- In some cases, potentially dangerous equipment can be used safely if adequate precautions are taken.
What else can be done?
- If the person has a vagus nerve stimulator (VNS), use the magnet to help stop the event.
- Follow the person’s Seizure Action Plan on what to do and when to give rescue medications for clusters or repeated seizures.
- Seek medical help according to the person’s Seizure Action Plan.
- If the plan isn’t available, get emergency help if:
- If the seizure is prolonged (more than 5 to 10 minutes of impaired consciousness with automatisms),
- If there are two or more impaired awareness seizures without return of consciousness between seizures.
- If the person is injured.
- If the seizure occurred in water.
- If the person doesn’t return to their usual state.
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