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Partial seizures as the name implies start from a part of the brain, though they may also spread throughout the whole brain, becoming a secondary generalized seizure. Partial seizures may involve changes in awareness, movement or feeling, and, depending on whether awareness is affected, may be further subdivided into simple and complex.

Simple partial seizures affect a small area of the brain, starting from one of the four lobes in one hemisphere but do not affect a person’s consciousness or awareness. Although unable to control movements or to stop the seizure, the person remains conscious and may even be able to describe to someone else what is going on. Most simple partial seizures involve unusual sensations - the size or shape of things may look distorted, or the person may ’see’ people or things that are not there. He may hear strange sounds or have a feeling that what is happening around him has somehow happened before. On the other hand, familiar surroundings may suddenly seem unfamiliar. He or she may feel an odd sensation in the stomach or on the skin. A simple partial seizure can also affect feelings, for example causing fear, dread, a sense of impending doom, anger, or, on the other hand, joy or elation. These seizures are also sometimes called simple partial sensory seizures, and may also form the aura, or warning, of a further seizure, which happens if the seizure activity spreads over both halves of the brain (hemispheres) so that the person loses consciousness, when the seizure is known as a secondary generalized seizure. A simple partial seizure may also spread and become a complex partial seizure.

The reason for the sometimes frightening sensations involved in simple partial seizures (or auras) is that unusual electrical activity is taking place in parts of the brain that control seeing, hearing, memory or sensation. Seizures which start in the parietal lobe may produce brief tingling in the arms or legs, or pins and needles down one side of the body, while if the occipital lobe is involved, visual disturbances may result such as seeing flashing lights. Frontal lobe seizures may involve body movements such as sudden thrashing of the body, bicycling movements of the legs, sudden stiff extension of an arm, or even crying out and running.

Temporal lobe seizures are the most common kind and involve most of the intense and complex changes of consciousness, including fear, panic, hallucinations and intensification of everyday experiences. The often visionary nature of these experiences has led to some interest in the creative or spiritual side of temporal lobe epilepsy (TLB), and some of the literature looks at how these experiences have been expressed in poetry and painting by many people, some of them famous - Dostoevsky and Van Gogh are the classic examples.

Complex partial seizures do affect a person’s consciousness or awareness. Sometimes a simple partial seizure may spread quickly to the areas which affect consciousness and develop into a complex partial seizure; sometimes, complex partial seizures will happen without any warning or aura.

A complex partial seizure is one in which the electrical disturbance has spread far enough over the brain so that the person is unaware of events while the seizure is happening. They typically appear to be in a kind of trance or daze, or go through a series of movements over which they have no control, such as staring, chewing, pulling at clothing or walking around, looking confused or dazed; sometimes a person may mistakenly be thought drunk. Although the seizure lasts for only a minute or two, full awareness of the surroundings may not return for some time afterwards.

After a seizure ‘Automatisms’ (or ‘post-ictal automatisms’, meaning after a seizure) are sometimes used to describe behaviour after a seizure, such as taking a walk or going to bed - the person may look purposeful but has in fact no awareness of what they are doing, and will have no recollection of it afterwards.

Some people suffer confusion and irritability after seizures, together with memory loss not just for the seizure but sometimes for events just before. Headache and tiredness, sometimes extreme, are other common reactions. Some people may also experience weakness, especially down one side of the body.

Nocturnal seizures The brain is more susceptible to developing seizures during sleep, and some people only have seizures when asleep or dozing. Sometimes seizures in sleep may be reduced by increasing the evening dosage of anti-epileptic medication, though this should only be done under your doctor’s guidance.