green cacti

Types of Epileptic Seizures

Epilepsy is not the same for everybody. There are many different types of epileptic seizures, each with unique symptoms, and each demanding its own treatment plan.

Focal Seizures (Partial Seizures)

Simple partial epileptic seizures

  • Confined to a small part of the brain
  • Individuals have normal awareness of their surroundings
  • May experience the jerk of an arm or hand

Complex partial epileptic seizures

  • Confined to a larger region of the brain than simple partial seizures
  • Impaired level awareness about surroundings
  • Usually involves the temporal lobe
  • Symptoms:
    • Glassy stare and lack of response
    • Inappropriate or confused responses to questions
    • Sitting, standing, or walking aimlessly
    • Lip smacking or chewing motions
    • Unusual vocal sounds
    • Fidgeting

Partial seizures with secondary generalization are focal seizures that spread to both sides of the brain causing a grand mal convulsion. Except for beginning locally and spreading, partial seizures look the same as the generalized tonic-clonic seizure, described below. Many families describe a complex partial seizure as the patient’s “small seizure” and the convulsions that result from secondary generalization as “big seizures.”

Generalized Epileptic Seizures

Generalized Epileptic Seizures

  • Start on both sides of the brain at once
  • Genetic or hereditary underlying cause
  • Generalized seizures include:
    • Absence seizures
    • Tonic-clonic seizures
    • Myoclonic seizures
    • Atonic seizures (also called drop attacks)

Absence Seizures (Petit Mal Seizures)

  • Brief, short duration
  • Staring spells with no motor movements are key feature
  • Usually shorter than complex partial seizures
  • May have a look of confusion or of being “out of it”
  • Normal functioning returns quickly
  • Most common in children

Generalized Tonic-Clonic Seizures (Grand Mal Seizures)

  • Dramatic convulsions
  • Characterized by total body stiffening and a cry or vocalization
    • Tonic phase
  • Rhythmic jerking of the body occurs about 30 seconds later
    • Clonic phase
  • Confusion or drowsiness for minutes to hours after

Myoclonic Seizures

  • Sudden, brief, almost instantaneous jerks of the body or parts of the body
  • Children with infantile spasms have clusters of myoclonic jerks that tend to occur when they awaken

Atonic Seizures or Drop Attacks

  • Brief seizures, short duration
  • Cause an unexpected and rapid fall to the ground
  • Can result from tonic (stiffening) or atonic (sudden loss of tone) events
  • Difficult to treat
  • High risk of injury

Disorders that Mimic Epileptic Seizures

Neurologists must distinguish between spells that are epileptic seizures (and require treatment with anti-epilepsy medication or surgery) and spells from another cause (that require a completely different treatment plan). The possible causes tend to vary with age. In infancy, some other causes of seizure-like spells include:

  • Breath-holding spells
  • Apnea
  • Gastroesophageal reflux (Sandifer’s syndrome)

In later childhood:

  • Sleep disorders
  • Tic disorders
  • Behavioral inattention
  • Migraines
  • Hyperekplexia (startle attacks),
  • Episodic dyskinesias or ataxias

In teenagers and adults:

  • Syncope (fainting)
  • Psychogenic seizures (stress-related seizures)
  • Sleep disturbances
  • Sleep apnea
  • Cardiac rhythm disturbances
  • Migraines