Seizure symptoms can vary widely. Some people with epilepsy simply stare blankly for a few seconds during a focal or generalized seizure, while others repeatedly twitch their arms or legs. Having a single seizure doesn’t mean you have epilepsy. At least two seizures without a known trigger (unprovoked seizures) that happen at least 24 hours apart are generally required for an epilepsy diagnosis.
Treatment with medications or sometimes surgery can control seizures for the majority of people with epilepsy. Some people require lifelong treatment to control seizures, but for others, the seizures eventually go away. Some children with epilepsy may outgrow the condition with age.
Symptoms of Seizures
Because epilepsy is caused by abnormal activity in the brain, seizures can affect any process your brain coordinates. Seizure signs and symptoms may include:
Temporary confusion
A staring spell
Stiff muscles
Uncontrollable jerking movements of the arms and legs
Loss of consciousness or awareness
Psychological symptoms such as fear, anxiety or deja vu
Symptoms vary depending on the type of seizure. In most cases, a person with epilepsy will tend to have the same type of seizure each time, so the symptoms will be similar from episode to episode.
Doctors generally classify seizures as either focal or generalized, based on how and where the abnormal brain activity begins.
Focal seizures
When seizures appear to result from abnormal activity in just one area of your brain, they’re called focal seizures. These seizures fall into two categories:
Focal seizures without loss of consciousness.
Once called simple partial seizures, these seizures don’t cause a loss of consciousness. They may alter emotions or change the way things look, smell, feel, taste or sound. Some people experience deja vu. This type of seizure may also result in involuntary jerking of one body part, such as an arm or leg, and spontaneous sensory symptoms such as tingling, dizziness and flashing lights.
Focal seizures with impaired awareness.
Once called complex partial seizures, these seizures involve a change or loss of consciousness or awareness. This type of seizure may seem like being in a dream. During a focal seizure with impaired awareness, you may stare into space and not respond normally to your environment or perform repetitive movements, such as hand rubbing, chewing, swallowing or walking in circles.
Symptoms of focal seizures may be confused with other neurological disorders, such as migraine, narcolepsy or mental illness. A thorough examination and testing are needed to distinguish epilepsy from other disorders.
Generalized seizures
Seizures that appear to involve all areas of the brain are called generalized seizures. Six types of generalized seizures exist.
Absence seizures:
Absence seizures, previously known as petit mal seizures, typically occur in children. They’re characterized by staring into space with or without subtle body movements such as eye blinking or lip smacking and only last between 5-10 seconds. These seizures may occur in clusters, happening as often as 100 times per day, and cause a brief loss of awareness.
Tonic seizures.
Tonic seizures cause stiff muscles and may affect consciousness. These seizures usually affect muscles in your back, arms and legs and may cause you to fall to the ground.
Atonic seizures.
Atonic seizures, also known as drop seizures, cause a loss of muscle control. Since this most often affects the legs, it often causes you to suddenly collapse or fall down.
Clonic seizures.
Clonic seizures are associated with repeated or rhythmic, jerking muscle movements. These seizures usually affect the neck, face and arms.
Myoclonic seizures.
Myoclonic seizures usually appear as sudden brief jerks or twitches and usually affect the upper body, arms and legs.
Tonic-clonic seizures.
Tonic-clonic seizures, previously known as grand mal seizures, are the most dramatic type of epileptic seizure. They can cause an abrupt loss of consciousness and body stiffening, twitching and shaking. They sometimes cause loss of bladder control or biting your tongue.
When to see a doctor
Seek immediate medical help if any of the following occurs:
The seizure lasts more than five minutes.
Breathing or consciousness doesn’t return after the seizure stops.
A second seizure follows immediately.
You have a high fever.
You’re pregnant.
You have diabetes.
You’ve injured yourself during the seizure.
You continue to have seizures even though you’ve been taking anti-seizure medication.
If you experience a seizure for the first time, seek medical advice.