Epilepsy - What are the symptoms?

Types of seizures

It's important to work out what type of seizure you or your child is having. This is because:

• Some treatments work best for certain types of seizures
• Your seizure pattern (the type of seizure you get and how often they happen) may suggest what's causing the epilepsy.

Seizures are usually divided into two main groups according to where they start in the brain and what happens to you during them:[1]

• Partial seizures (doctors sometimes call these focal seizures)
• Generalised seizures.

But not all seizures can be grouped under these headings, especially those in babies. Doctors call these unclassified seizures.

Partial (focal) seizures: how they affect you

In a partial (focal) seizure, only part of the brain is affected. Symptoms depend on what that part of the brain does. (To learn more, see The parts of the brain and what they do.)

Partial seizures can be divided into simple partial seizures or complex partial seizures.[1] 'Simple' means the person doesn't black out. 'Complex' means the person passes out or becomes less aware of his or her surroundings. Epilepsy that causes partial seizures is sometimes called focal epilepsy and partial seizures are sometimes called focal seizures. This is because they start from a particular focus (which means area) of the brain.

Here's a summary of the main symptoms. Click on the links below to read more about how each type of seizure looks and feels.

• Simple partial (focal) seizures: During this type of seizure, you remain aware of what's going on. The muscles in your arms, legs and face may become stiff, and your limbs may twitch on one side of your body. You may have unusual sensations, such as strange smells, distorted vision, a rising feeling in your stomach, changes in emotion, or a feeling of fear or déjà vu.[1]
• Complex partial (focal) seizures: With this type of seizure, you often have a warning sign (an aura) before the seizure starts, and you may become less aware of your surroundings. You may not answer when called or you may pass out. Some people start fidgeting, walking around or doing something over and over again, like chewing or smacking their lips (doctors call these automatisms).[1]

Sometimes partial seizures spread throughout the brain. If this happens, you may have a generalised seizure (often a tonic-clonic seizure).

Generalised seizures: how they affect you

These affect your whole brain. During most of these seizures, the person passes out (loses consciousness). These are the main types of generalised seizure.[1] [2] Click on the links below to read more about how each type looks and feels.

• Tonic-clonic seizures: A tonic-clonic seizure causes a mixture of symptoms, including stiffening of the body and jerking of the arms and legs. The person blacks out, and may bite their tongue or wet themselves.
• Absence seizures: The person appears to be staring blankly into space, unaware of his or her surroundings. Muscles may jerk or twitch, and the eyes may flutter. These seizures pass very quickly. They usually last only three seconds to 10 seconds.
• Myoclonic seizures: The upper body, arms or legs jerk or twitch as if they are being shocked. This may happen once or more than once. People tend not to black out during these seizures.
• Atonic seizures: The muscles suddenly relax, which makes the person fall down without warning or drop his or her head forward. The person blacks out.

Sometimes doctors say a person has an epilepsy syndrome. An epilepsy syndrome is when you have a number of particular symptoms at the same time. An epilepsy syndrome may include more than one type of seizure. There are many epilepsy syndromes, but some are very rare. Children are more likely than adults to have an epilepsy syndrome.[4] To learn more, see Epilepsy syndromes.

Knowing which type of epilepsy syndrome you or your child has can help your doctor decide on the best treatment. It can also help work out if the epilepsy will change in the future and whether it can be passed on from parent to child.