American Board of Internal Medicine (ABIM) Certification Practice Exam

Which of the following conditions is associated with altered sensorium and behaviors classified as automatisms?

1. Frontal lobe seizures

2. Complex partial seizures

3. Simple partial seizures

4. Generalized tonic-clonic seizures

The correct answer is: Complex partial seizures

Complex partial seizures are characterized by altered consciousness and can include automated, repetitive behaviors known as automatisms. These behaviors may involve actions such as lip-smacking, fumbling, or other non-purposeful movements, which occur while the individual is in a confused or altered state of awareness. This seizure type typically arises from the temporal lobe, particularly affecting memory and emotional processing, and often results in a lack of awareness of the environment during the episode. The presence of automatisms is a prominent feature that distinguishes complex partial seizures from other types, as individuals might not remember the event after it occurs. In contrast, frontal lobe seizures may cause more focal motor activities and changes in behavior but do not commonly present with automatisms. Simple partial seizures maintain awareness and typically do not produce automatisms, as consciousness remains intact. Generalized tonic-clonic seizures involve a loss of consciousness and convulsive activity but are characterized by different kinds of motor manifestations rather than the automated behaviors seen in complex partial seizures.