These seizures are often characterized by an aura followed decreased
responsiveness and awareness of self and the environment (altered consciousness,
not loss of consciousness). The aura is often
emotional, olfactory or gustatory (i.e., an odd feeling, or unpleasant smell or
taste). During a CPS, the patient appears awake. There is no loss of
muscle tone, no convulsions, tongue biting or urinary incontinence. Hence, this
seizure type is difficult to recognize, especially for the non-neurologist.
Following the aura, a CPS often begins with a wide-eyed, motionless stare,
dilated pupils, and behavioral arrest. Once of the important clues of a CPS is
the presence of certain behavioral and motor manifestations, known as
automatisms, that occur during the seizure.
Automatisms can be described as involuntary, coordinated motor
activity/movements or behavior occurring during the state of clouding of
consciousness in the course of a CPS. Patients may continue their ongoing motor
activity or react to their surroundings in a semipurposeful manner.
Verbal automatisms range from simple
vocalizations, such as moaning, to more complex, comprehensible, stereotyped
speech.
Motor automatisms are classified as
simple or complex:
Simple motor automatisms
Oral automatisms (e.g., lip
smacking, chewing, swallowing)
Manual automatisms (e.g.,
picking, fumbling, patting)
Complex motor automatisms
(elaborate, coordinated movements involving
bilateral extremities; e.g., cycling movements of the legs and stereotyped
swimming movements) |