A psychomotor seizure is an older term for what doctors now call a temporal lobe seizure, as it begins in one of the brain’s temporal lobes. During a seizure, a person may experience unusual feelings, sensations, and involuntary body movements.
Other recognized terms for a psychomotor seizure include a “limbic seizure” and “focal onset seizure.”
This article discusses the symptoms, types, causes, and treatments of psychomotor seizures.
Anyone can have a psychomotor seizure, but if a person has more than two, they might have temporal lobe epilepsy (TLE). TLE is the most common form of epilepsy and affects approximately
Psychomotor seizures and TLE usually begin when a person is between 10–20 years old. However, they can happen at any age.
Psychomotor or temporal lobe seizures only affect one part of the brain but may spread to others, becoming a generalized seizure.
These seizures may begin with a “prodrome,” a minor sign that a seizure might occur. A prodrome can present as irritability, anxiety, nervousness, a headache, or a personality change. It is not part of the seizure and does not happen to everyone. It might happen minutes, hours, or even days before a seizure and can help a person prepare.
During a psychomotor seizure, a person may experience symptoms that affect their movement, called motor symptoms, and can include:
- muscle twitches or spasms
- muscles becoming limp
- repeated automatic movements, such as fidgeting, rubbing hands, clapping, chewing, running, or walking
- suddenly crying or screaming
A person might also experience symptoms that do not affect their movement. These are called non-motor symptoms and may include:
- a change in automatic body functions, such as goosebumps, feeling hot or cold, or having a racing heartbeat
- a change in emotion or thoughts, such as feeling scared, anxious, or angry
- confusion or déjà vu
- a lack of movement
- visual disturbances
- altered taste and smell
A psychomotor seizure is a type of focal seizure, also known as a partial seizure, that affects one area of the brain. There are different subtypes of focal seizures. Their names describe a person’s awareness during the seizure.
Focal aware seizure
A focal aware seizure (FAS), previously known as a simple partial seizure, affects a small part of the brain. During a FAS, a person remains conscious and aware of what is happening around them. They usually last 1–2 minutes or less.
This type of seizure is sometimes known as an “aura,” or warning, because, for some people, it may develop into a different type of seizure.
Focal impaired awareness seizure
A focal impaired awareness seizure (FIAS), previously known as a complex partial seizure, affects a larger part of the brain. During a FIAS, a person may become confused and unable to respond to what is happening around them. They may not be able to hear or understand anything during the seizure. This type of seizure usually lasts up to 3 minutes.
After a FIAS, a person may experience after-seizure confusion,
Focal to bilateral tonic-clonic seizure
Focal seizures can spread from one side of the brain to the other and become a focal to bilateral tonic-clonic seizure. A person usually loses consciousness and begins to shake or convulse.
Almost 80% of psychomotor seizures occur when a person has mesial TLE (MTLE). Epilepsy occurs due to genetic causes or through complications of other medical events and diseases.
However, seizures can have many physical causes, which doctors call provoked seizures. A provoked seizure causes can include:
There is no single test to diagnose a psychomotor seizure, and there are multiple factors to consider.
If a person thinks they had a seizure, a doctor will ask for a detailed description, including their symptoms and what witnesses saw.
A doctor will then try to determine what caused the seizure. If they suspect another medical condition caused it, they will recommend tests to rule out or confirm that condition.
If a doctor thinks TLE caused a seizure, they will make a referral to a neurologist. A neurologist will perform several tests to provide a diagnosis for psychomotor seizures, such as:
- evaluating medical history
- a neurological exam
- an electroencephalogram (EEG), a test that can detect the electrical activity of the brain
- brain imaging scans, such as CT or MRI scans
Treatment for a psychomotor seizure will involve preventing and limiting seizures, depending on the cause.
If another medical condition causes a psychomotor seizure, a doctor will offer the appropriate treatment, such as dietary therapies for low blood sugar.
A neurologist may suggest various treatment options if TLE caused a psychomotor seizure, including:
- Seizure medications: This is the most common way to prevent seizures due to epilepsy. Doctors may prescribe drugs based on the types of seizures a person has.
- Epilepsy surgery: This often works best for people with persistent, uncontrolled seizures, drug-resistant epilepsy, or epilepsy in one part of the brain.
- Seizure devices: These are a good option for people who cannot have surgery or experience side effects with seizure medications.
- Seizure rescue therapies: These work best to stop seizures quickly and prevent an emergency. They are typically easy to use and work quickly. However, seizure rescue therapies, such as benzodiazepines, do not replace daily seizure medications or emergency medical care.
- Epilepsy centers: If a seizure caused by epilepsy is not under control after 3 months of treatment, a person may visit an epilepsy center or an epileptologist. An epileptologist is a neurologist who specializes in epilepsy.
Treatment for psychomotor seizures can reduce their occurrence and improve a person’s quality of life.
According to a 2020 study, 26 out of 112 people with TLE achieved seizure freedom after treatment with medication alone. The remaining 86 patients received a diagnosis of drug-resistant epilepsy.
45 people with drug-resistant epilepsy subsequently received surgical treatment, and 35 out of 45 achieved seizure freedom.
Psychomotor seizures, an older term for what doctors now call temporal lobe seizures, are a common presentation of temporal lobe epilepsy. They may also be due to causes other than epilepsy.
When experiencing a psychomotor seizure, a person may remain aware of what is happening around them or have impaired awareness and confusion.
It is possible to reduce the frequency of psychomotor seizures with medication, surgery, devices, and therapies.