A 42-year-old man experiences episodes of blank looks and confusion. Which best describes the type of seizure he is having?

The type of seizure described in the scenario is best characterized as focal impaired awareness. This classification aligns with the symptoms of blank looks and confusion experienced by the individual. During these types of seizures, patients may have altered awareness of their surroundings, which is evident in the man's confusion and the blank stares.

Focal impaired awareness seizures originate in one hemisphere of the brain and can lead to a lack of responsiveness. The individual may not be fully aware or able to respond during the episode, which is consistent with the symptoms presented. After the seizure, the person may not remember what occurred, further emphasizing the impaired awareness aspect.

In contrast, focal (aware) seizures would typically involve retained consciousness and awareness, meaning the individual would not exhibit confusion or blank stares. Tonic-clonic seizures are characterized by a generalized convulsion involving loss of consciousness and muscle stiffening, which does not match the described symptoms. Absence seizures, while they do involve brief lapses in consciousness leading to "blank" looks, occur more commonly in children and usually consist of shorter, non-convulsive episodes without confusion postictally. Thus, the nature of the episodes and the confusion experienced strongly support the classification of focal impaired awareness seizures.