Understanding Automatisms in Seizure Disorders

Definition and Examples of of Automatism

Automatisms occur in epileptic seizures.
Automatisms occur in epileptic seizures. murat sarica/Getty Images

Automatisms are purposeless and repetitive movements associated with impaired awareness. The type of automatism and the nature of it — whether it's complex or so simple that it may be missed — is highly variable. In epilepsy, automatisms may occur in complex partial seizures, as well as some absence seizures.

Technical Definition of Automatisms

According to the International League Against Epilepsy (ILAE) Task Force, an automatism is "a more or less coordinated, repetitive, motor activity usually occurring when cognition is impaired and for which the subject is usually amnesic afterward."

Automatisms in Complex Partial Seizures

A complex partial seizure is a partial seizure with impairment of consciousness that commonly involves automatisms. Most complex partial seizures involve the temporal or frontal lobe of the brain, but they can affect the parietal and occipital lobe. These seizures can begin as a simple partial seizure — meaning the person is aware and conscious — and then progress to a complex partial seizure, or it can begin as a complex partial seizure with a loss of consciousness.

The characteristics of a complex partial seizure, including the type of automatism, depend on the area of the brain where the abnormal electrical activity is occurring. Examples of automatisms that may occur in complex partial seizures include:

  • Repetitive tapping
  • Movements of the mouth, such as lip smacking, chewing, mumbling, swallowing, gulping, or spitting
  • Repetitive hand movements, like grasping, fumbling, and searching movements
  • Picking or fumbling at clothes or objects
  • Rapid blinking
  • Repeat words or phrases, grunting
  • Complex acts like shuffling cards
  • Dramatic acts like laughing, crying, screaming or removing clothes

Automatisms Can Help Localize a Seizure

Some automatisms are more likely in certain types of seizures. For example, sexual automatisms, like pelvic thrusting, and bilateral leg automatisms, like pedaling or bicycling movements, are more common in frontal lobe epilepsy than temporal lobe epilepsy. Automatisms of the mouth and hands, on the other hand, are more common in temporal lobe epilepsy.

Automatisms can also provide clues in determining whether a seizure is occurring on the right or left side of the brain. For instance, automatisms that occur on one side of the body typically indicate that the seizure began on that same side of the brain.

Automatisms in Absence Seizures

Automatisms are commonly seen in childhood absence seizures, which is a seizure characterized by a child spacing out. According to a 2009 study in JAMA on children with absence seizures, automatisms were more likely in longer seizures and with hyperventilation. In addition, while automatisms tended to be similar for an individual child, they were not present in all their seizures.

How Do I Know if I'm Having Automatisms with My Seizures?

Write down the behaviors you engage in during a seizure, which you probably need a spouse or other witness to tell you. Review these with your neurologist and see if there is a pattern. The presence or absence and type of automatisms may help determine the focus and type of your seizures.


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Blume WT el al. Glossary of descriptive terminology for ictal semiology: report of the ILAE task force on classification and terminology. Epilepsia. 2001 Sep;42(9):1212-8.

Epilepsy Foundation. (2013). Complex Partial Seizures

Rudzinski LA & Shih JJ. The classification of seizures and epilepsy syndromes. Continuum (Minneap Minn). 2010 Jun;16(3 Epilepsy):15-35.

Sadleir LG, Scheffer IE, Smith S, Connolly MB & Farrell K. Automatisms in absence seizures in children with idiopathic generalized epilepsy. Arch Neurol. 2009 Jun;66(6):729-34.

DISCLAIMER: The information in this site is for educational purposes only. It should not be used as a substitute for personal care by a licensed physician. Please see your doctor for diagnosis and treatment of any concerning symptoms or medical condition.