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Seizure Types

GENERALIZED – seizure activity involves whole brain.

PARTIAL – seizure activity located in portion of brain – behavior reflects area of brain that is damaged.

Generalized

TONIC-CLONIC – ( grand mal) convulsive (Most often recognized, but only 10% of those with epilepsy have this type of seizure)

Stiffens, may utter cry, loss of consciousness, falls, body jerking
1 – 3 minutes
loss of bladder or bowel control or vomiting possible
breathing – during tonic phase, breathing may decrease or cease – causing cyanosis (bluing) of lips, face, nail beds – returns during clonic phase though may be irregular
after seizure = confusion, exhaustion, possible agitated or depressed. Won’t remember seizure. 15 min to several hours
most likely of seizure types to go into status

MYOCLONIC

Brief, shock-like jerks of muscles – usually on both sides of body at same time
Neck, shoulder, upper arms, body, upper legs
If something in hand, may get thrown
Occurs in variety of epilepsy syndromes
Usually no loss of consciousness

TONIC

Stiffening of body, arms or legs
Less than 20 sec., often during sleep
May lose balance & fall
May be loss of consciousness

CLONIC

Jerking, convulsive movements with no stiffening
Loss of consciousness
Usually not followed by confusion or tiredness

ATONIC

Sudden loss of muscle tone – head, arm or body falls
Brief loss of consciousness
Less than 15 seconds
Injury common (helmets recommended)

ABSENCE (petit mal)

Brief episodes of staring
Impaired awareness & lack of responsiveness
May be eye blinks, chewing movements
10-20 seconds or less – up to 100s a day
most common in children
promptly resumes activity – no after effect
will have missed ensuing activity, no awareness of seizure

Partial

Simple Partial – Aware, can remember what occurs

“Auras”
Generally last only a few minutes
Motor seizures – change in muscle activity
- Involuntary contractions – body jerking, ie. finger or arm, face twitching
- Weakness of body part – hand (drop object), vocal (difficulty speaking)
Sensory – changes in sensation – hallucinations & illusions
- Touch (numbness, “pins & needles”)
- Smell (detect odor)
- Taste
- Vision (seeing something not there; occasionally momentary loss of vision)
- Hearing (music, ringing, person’s voice)
Autonomic – change in area controlling automatic bodily functions
- Strange sensations in abdomen (nausea), chest (pressure), head (dizziness)
- Sweating, heart rate or breathing changes for no reason
Psychic – changes that affect how we think, feel & experience things
- Problems with language function (garbled speech, difficulty understanding spoken or written language, word repetition)
- Emotions – sudden fear, anxiety, depression, crying, hysterical laughter (spontaneous – not result of something triggering emotion)
- “Déjà vu” (feeling of having lived through this moment before); “jamais vu” (familiar things seems strange); feeling of being on “outside looking in on self” “in a dream” “world isn’t real”

Complex Partial – impaired consciousness or awareness; unable to respond

Can include any of behaviors listed under Simple Partial
Activity is purposeless, undirected, inappropriate
Dazed appearance
May wander
Can’t understand directions or communicate
Automatisms (staring, lip chewing, picking at clothes)
Inappropriate, possible socially embarrassing behaviors (screaming, running, disrobing, “sexual”-appearing movements, unfocused aggression or anger)
Lasts 30 sec to 5 minutes or more
After seizure: May be confusion, tiredness for 15 min. to ½ hour

Secondarily Generalized

Starts as a simple (“aura”) or complex partial seizure, then
Moves to whole brain seizure – usually tonic-clonic
Example: May start with increased heart rate, chest pressure, sweating, nausea (may be conscious at this time), then moves to dazed behavior, then loss of consciousness with any repetitive movement from tonic-clonic to as subtle as eye fluttering.

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Seizure Types

Generalized

TONIC-CLONIC – ( grand mal) convulsive (Most often recognized, but only 10% of those with epilepsy have this type of seizure)

MYOCLONIC

TONIC

CLONIC

ATONIC

ABSENCE (petit mal)

Partial

Simple Partial – Aware, can remember what occurs

Complex Partial – impaired consciousness or awareness; unable to respond

Secondarily Generalized

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