Common Seizure Types

Seizures are divided into two main groups: generalized and partial. Generalized seizures are said to involve the entire brain almost instantaneously. Some common generalized seizure types are simple absence attacks, myoclonic, tonic, atonic, and primary idiopathic generalized tonic-clonic seizures. By far the more common kind of seizures begin in one part of the brain and are classified as partial. These partial seizures may be simple or complex depending upon whether they involve a disturbance of consciousness.

Generalized Seizures

Absence (these seizures were called petit mal in the past): Absence seizures ordinarily occur in young children between the ages of four and ten, but may persist into adulthood. There is a brief loss of awareness, lasting usually from one to ten seconds. The patient stops, may stare, and there may be some eye blinking or mild facial twitching or mouth movements. There is no warning and consciousness is restored instantly. The patient is unaware of these seizures, and because they may occur 60 to 100 times a day, may be accused of being inattentive.

A child who is experiencing many of these seizures a day is unable to pay attention in school and may fail to learn. Since the patient doesn't fall and the signs are subtle, these seizures are often not diagnosed for a long time. Although many children with absence seizures will "outgrow" them about the time they go through puberty, they may persist beyond childhood. Absence seizures are frequently associated with generalized tonic-clonic seizures which often persist into adulthood.

Myoclonic, Atonic and Tonic seizures are relatively rare, but frequently very disabling. They are brief twitches or sudden falls because of abrupt increased or decreased muscle tone in the body. They may be very hard to treat. Usually there is not a prolonged disturbance of consciousness with these seizures.

Generalized Tonic-Clonic (old term grand mal): The patient suddenly gets stiff in all limbs and loses consciousness, and falls to the floor. A period of rhythmic jerking of the limbs, the so-called clonic phase, follows. The person may cry out, not from pain but from air forced out of the body by contractions of the chest muscles.

The patient's tongue or cheek may be bitten if it is caught between the teeth. Sometimes there is loss of bladder or bowel control. The patient does not breathe normally or may stop breathing during the seizure (which usually lasts less than a minute). When breathing returns it is usually labored and there is a lot of saliva. The patient usually regains consciousness slowly, and may be confused, sleepy, and often has a headache.

In primary generalized seizure there is no aura (for example, an odd smell, a feeling of a breeze on the skin, other strange feeling) or weakness of one side of the body or speech difficulty before it begins. If any of these symptoms occur first, they are a sign that the generalized tonic-clonic seizure started in one part of the brain and then spread. This is called a secondarily generalized seizure. Patients with these symptoms may require a different kind of treatment.

Partial Seizures

Complex Partial Seizures (old term temporal lobe or psychomotor): These seizures may be very brief or last several minutes. They are the most variable of all the seizures. There is a disturbance, but not complete loss of consciousness or a complete loss of tone. The person does not fall. He or she may look puzzled or confused, there may be chewing movements, senseless speech, wandering about aimlessly or picking at clothing. Seizures of this type are often preceded by an aura. which is actually the beginning of the seizure.

People may experience extremes of emotion (fear or pleasure), disturbances in thinking, or appear to be mentally deranged. When wandering unaware during seizures, they may struggle to get free if they are restrained, but do not usually display any kind of directed violence.

Simple Partial Seizures (focal motor, focal sensory or Jacksonian): People with this type of seizure remain fully conscious and aware throughout. What they experience is a sudden sensation or uncontrollable movement of a single part of the body, or movement that progresses along the body from hand to arm to face, eventually to involve one entire side of the body.

Secondarily Generalized Seizures: Either simple or complex partial seizures may secondarily generalize (spread) to involve the whole brain and become generalized tonic-clonic seizures.

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