The most common sort of generalized
seizure - used to be known as ‘Grand mal’.
Tonic phase - The muscles contract,
the body stiffens and then - Clonic phase - jerks uncontrollably. You may let
out a cry as air is forced out of the lungs and the lips may go blue due to lack
You lose consciousness - when you
come round you cannot remember anything. You will need time to recover - from
minutes to, in some, hours.
What To Do
Do not try to restrain the person.
Clear away possible risks - sharp edged furniture etc.
Cushion the person’s head when they
fall and, when the limbs stop jerking, put the person in the recovery position.
Do not put anything in the person’s
Do not try to give the person
anything to drink until they have recovered consciousness.
Be quietly reassuring and stay with
them until they have recovered.
Do not call for medical help unless
the seizure lasts more than 5 minutes.
This generalized seizure is
literally an absence - a momentary lapse in awareness - used to be called "Petit
More common in children and
You stop what you are doing, stare,
blink or look vague for a few seconds before carrying on with what you were
doing. Onlookers may think you were just daydreaming or may not notice.
These seizures used to be called
petit mal, which roughly translated means small illness. This name makes them
sound fairly harmless and, for many, they are little more than an occasional
nuisance. However, then they occur frequently they can make life very confusing.
During an absence seizure it can
appear to onlookers that the person is daydreaming or switching off, something
we all do when we are bored or distracted. However, in an absence seizure the
person cannot be alerted or woken up; they are momentarily unconscious and
therefore totally unaware of what is happening around them.
Absence seizures are rare in
adults, most commonly beginning in childhood, particularly between the ages of
six and twelve. Girls are more prone to absences than boys. Most children will
respond to anti-epileptic drug treatment, often being able to stop the treatment
after a few years. Some children may go on to experience tonic-clonic seizures
later in life; other 'grow out' of their epilepsy. Like many generalized
seizures, doctors can rarely say why a child develops absences, although between
25 and 40 per cent of children with absences have relatives who have experienced
Because most children tend to
daydream or wander off into a world of their own, absences can be very hard to
spot. Parents and teachers tend to lose patience with children unless it becomes
obvious that something more serious is happening. In the worst cases, children
can be having hundreds of very brief absence seizures a day, effectively
preventing them learning and participating in school or family activities. These
children are missing out on tiny pieces of information; they might hear the
first part of a sentence but not the end; hear the instruction to go out play
but not be back in ten minutes. This can be easily misinterpreted as
What To Do
Do not try to ‘wake up’ the person.
Tell them what has happened while
their seizure was happening - particularly important for children during
Tell the child’s parents if they do
not know the child has this type of seizure.
Occurs in just part of the brain -
type of symptoms depend on the area of the brain involved.
Symptoms include one or more of the
following: twitching, numbness, sweating, dizziness, nausea, disturbances to
hearing, vision, smell or taste, strong déja vu etc.
These symptoms last for several
seconds and then go away. You remain fully aware.
These seizures often progress to
other types of seizure and can therefore act as a warning or ‘aura’.
WHAT TO DO
Do not try to restrain the person.
Stay with the person and be
reassuring until the symptoms go away.
Be aware that the person may go on
to have another type of seizure - be ready to move any sharp objects, furniture
This common form of seizure
includes temporal lobe epilepsy and psychomotor seizures.
You may behave strangely - plucking
at your clothes, smacking lips, swallowing repeatedly or wandering around as if
drunk - these actions are called automatisms. Other symptoms are similar to
simple partial seizures but you may not remember them afterwards.
You are not aware of your
surroundings or of what you are doing.
WHAT TO DO
Do not try to restrain the person
but try to steer them away from any unsafe situations.
Do not try to ‘wake’ them.
Stay with the person, being gently
reassuring, until the person has recovered.
The person may need to rest for a
Some people only experience
seizures during their sleep. They can often be missed if nobody witnesses them.
You may find this type of seizure
less troublesome than those occurring during the day.
WHAT TO DO
Do not try to restrain the person,
but put them in the recovery position after the seizure to ensure that they can
Do not put anything in their mouth.
Be sure to tell the person that
they have had a seizure during the night.
Other Generalized Seizures
These include atonic seizures (drop
attacks) and myoclonic seizures which cause brief forceful jerks.
WHAT TO DO
Atonic seizures can cause injury -
an increased awareness of safety is vital if this type of seizure occurs
Gelastic seizures are brief outbursts of emotion, usually in the
form of a laugh or a cry. They may be accompanied by forced eye movements,
chewing or grinding the teeth, tonic posturing, and
clonic jerking. The person may appear confused
and/or dazed during and after an episode. Gelastic seizures usually last 5 to 60
seconds. The person may remember them clearly or may be completely unaware of
Gelastic seizures are both unpredictable and unprovoked by the
person's surroundings. They are abrupt in onset and quickly over. Gelastic
seizures may occur nocturnally, waking the person from sleep and leaving them
Research shows that gelastic seizures often occur in people who
have an (often maternal) family history of migraines.
phenobarbital, sometimes in combination, may be
prescribed to control gelastic seizures
(Information obtained from
Myoclonic Seizures or Jerks
Most people have experienced a
sudden jerk as they are falling asleep or have jumped when someone leaps out
as them unexpectedly and this is similar to the jerks experienced by someone who
has myoclonic seizures. Caused by a sudden contraction of the muscles, it can
affect the whole body but it is usually restricted to one or both arms and
sometimes the head. As in absence seizure, the person is not conscious, but the
seizure is so brief that the person appears to remain fully conscious.
Myoclonic jerks occur most
frequently in the morning. Although the seizures are brief, they can be
extremely frustrating, resulting as they often do in spilt drinks or similar
Tonic and Atonic Seizures
Tonic seizures result in all the
muscles contracting. The body stiffens and the person will fall over if
Atonic seizures (also called 'akinetic'
seizures) are, in a way, the opposite of tonic seizures. Instead of the body
going stiff, all muscle tone is lost and the person simply drops to the ground,
hence their other name 'drop attacks'. Although the person falls heavily, they
are usually able to get up again straight away. When the body goes limp it
inevitably falls forward and the person's head can get a serious knock if the
seizures occur frequently.
For those who have frequent tonic
or atonic seizures, extra safety precautions - such as protective headgear -
Sometimes, the activity that starts
as a simple partial or complex seizure can spread to the whole brain resulting
in a tonic-clonic seizure. This is known as a secondary generalized seizure.
Often the person will experience the simple partial seizure as an 'aura' or
warning but sometimes the spread of epileptic activity can be so quick that the
person appears to go straight into a tonic-clonic seizure. This can cause
problems with diagnosis of the seizure type until the necessary tests are done
and the specialist can see where the activity first occurs.
Not all seizures are epileptic in
origin. This is why, when making an initial diagnosis doctors will conduct
various tests to rule out other causes. People with epilepsy can experience
non-epileptic seizures as well. This section looks at cases where the
non-epileptic seizures appear regularly and similarly to those in a person with
Non-epileptic seizures are also
sometimes referred to as pseudo-epileptic seizures, pseudoseizures, psychogenic
seizures or Non-Epileptic Attack Disorder. These seizures are identical to
epileptic seizures, but the difference is that they are not epileptic in nature.
Non-epileptic seizures can be
symptoms of various psychological factors, specific to the person concerned. The
management of non-epileptic seizures will therefore need to be considered on an
individual basis and the options discussed with the epilepsy specialist.
It is important to take notes of
all the circumstances surrounding undiagnosed seizures, together with careful
descriptions of what happens, how long the seizure lasts, how the person feels
etc. Every piece of information can help the doctor make an accurate and
informed diagnosis and this, in turn, ensures that the patient receives the
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