What the Seizures Look Like
Focal seizures - retained awareness
These seizures were previously called simple partial seizures and are often referred to as an ’aura’ or warning by the person experiencing them as they can precede a focal dyscognitive (previously complex partial) or tonic clonic seizure. There is no loss of awareness or consciousness and they are usually short-lived, lasting less than a minute.
Examples of symptoms are:
- Sensory – numbness, tingling or burning sensation in a region of the body
- Motor – jerking of a limb, twitching of the face
- Autonomic – blushing, pallor, increased heart-rate, nausea
- Psychic – deja'vu, hallucinations (visual, sound, taste or smell), emotions such as fear
Focal Dyscognitive Seizures
These seizures were previously called complex partial seizures and are also referred to as focal seizures with altered awareness. As mentioned awareness and responsiveness are altered, producing a vague, confused or dreamlike appearance. The person may respond, but often inappropriately, and display strange, random or repetitive behaviour. This behaviour commonly presents as chewing, fidgeting, taking off clothes, walking around or mumbling.
After the seizure, there is often a period of confusion and little, if any, memory of the event.
These seizures last approximately 30 seconds to three minutes.
Generalised Tonic Clonic Seizures
Generalised tonic-clonic seizures are sometimes called a fit or convulsion. They are the most universally recognised seizures.
They often begin with a sudden cry. If standing, the person will fall to the ground and lose consciousness.
The body becomes quite stiff (tonic) shortly followed by jerking of the muscles (clonic). Breathing is shallow or temporarily suspended causing the lips and complexion to look grey/bluish. Saliva (sometimes also blood if the tongue has been bitten) may come out of the mouth, and there may be loss of bladder control.
The seizure usually lasts approximately two minutes and is followed by a period of confusion, agitation and extreme tiredness. Headaches and soreness are also common afterwards.
These seizures almost always begin in childhood and are commonly mistaken for daydreaming and inattentiveness.
They are characterised by staring, loss of facial expression, unresponsiveness, cessation of activity and eye blinking or upward eye movements.
They start and end abruptly, and last approximately 2 to 10 seconds. Most people recover their mental function immediately and return to their previous activity, with no memory of the event.
Children who have absence seizures often have normal cognitive function and intelligence, although if the condition is not treated it can create gaps in learning due to the seizures occurring many times a day.
Other types of absence seizures include atypical absences seizures (absence seizures usually longer than 10seconds with partial responsiveness), as well as those with special features, myoclonic absences ( rhythmic myoclonic jerks of shoulders, arms and legs mouth with absences lasting 8-60 seconds) and eyelid myoclonia (1-2 second absence with upward eyelid/eyeball jerk).
These are brief but significant muscle jerks which usually involve the upper body but can involve the lower or whole body. The person may drop or spill what they are holding or fall off a chair. There is no impairment of consciousness, but if several seizures occur over a short period of time the person may feel slightly confused or drowsy. These seizures frequently occur shortly after awakening.
This group also includes the rarer myoclonic atonic seizures (the loss of muscle tone is proceeded by a myoclonic jerk) and the myoclonic tonic seizures (an increase in muscle tone is associated with this seizure).
These are a brief stiffening of the muscles of the whole body which cause it to go rigid. If a person is standing, they will fall rapidly to the ground. Recovery is swift, but injuries can be sustained. These seizures can also occur in sleep.
Atonic seizures are a sudden, brief loss of muscle tone of the whole body. Once again, the person will abruptly collapse to the ground, usually head first, so facial and head injuries are common. There is no noticeable loss of consciousness and the person usually recovers swiftly unless injured.
Epileptic spasm (which include infantile spasms) consist of a sudden forward flexion of the upper body followed by stiffening. Often the arms are flung out as the knees are pulled up and the body bends forward. Less often, the head can be thrown back as the body and legs stiffen in a straight-out position, or movements can be more subtle and limited to the neck or other body parts. Each seizure lasts only a second or two but they usually occur in clusters.
*Note: Tonic and Atonic seizures are also known as drop attacks and are more likely to occur in people with severe epilepsy and multiple seizure types.
The majority of people with epilepsy achieve good control through the use of antiepileptic medication and many become seizure free. With regular medication and a sensible lifestyle a full and active life is possible.
For more information or advice about epilepsy, contact Epilepsy Action Australia on 1300 37 45 37 or email firstname.lastname@example.org