Epilepsy - Symptoms 

Symptoms of epilepsy 

The main symptoms of epilepsy are repeated seizures (fits). There are many different types of seizure, depending on the area of the brain affected.

People with epilepsy can experience any type of seizure, although most people have a consistent pattern of symptoms.

Seizures can occur when you are awake or asleep.

Doctors classify seizures by how much of the brain is affected. There are:

  • partial (or focal) seizures – where only a small part of the brain is affected
  • generalised seizures – where most or all of the brain is affected

Some seizures do not fit into these categories and are known as unclassified seizures.

Partial seizures

There are two main types of partial seizure.

Simple partial seizures

Simple partial seizures are where you remain fully conscious throughout.

Symptoms of a simple partial seizure can include:

  • a general strange feeling that is hard to describe
  • a "rising" feeling in your tummy – sometimes likened to the sensation in your stomach when on a fairground ride
  • an intense feeling that events have happened before (déjà vu)
  • experiencing an unusual smell or taste
  • a tingling sensation, or "pins and needles", in your arms and legs
  • a sudden intense feeling of fear or joy
  • stiffness or twitching in part of the body, such as an arm or hand

These seizures are sometimes known as "warnings" or "auras", because they can be a sign that another type of seizure is on its way. This can give you time to warn people around you and make sure you are in a safe place.

Complex partial seizures

Complex partial seizures are when you lose your sense of awareness and can’t remember what happened after the seizure has passed.

The symptoms of a complex partial seizure normally involve apparently strange and random bodily behaviour, such as:

  • smacking your lips
  • rubbing your hands
  • making random noises
  • moving your arms around
  • picking at clothes
  • fiddling with objects
  • adopting an unusual posture
  • chewing or swallowing

During a complex partial seizure, you will not be able to respond to anyone else, and you will have no memory of the event.

Generalised seizures

There are six main types of generalised seizure.

Absences

Absence seizures, which used to be called petit mal, mainly affect children, but they also occur in adults. They cause the person to lose awareness of their surroundings, usually for up to 15 seconds. The person will seem to stare vacantly into space, although some people will flutter their eyes or smack their lips. The person will have no memory of the seizure.

Absences can occur several times a day. They may affect a child's performance at school, and can be dangerous if they occur at a critical time, such as crossing a busy road.

Myoclonic seizures

These types of seizures cause your arms, legs or upper body to jerk or twitch, as if you have received an electric shock. They often only last for a fraction of a second, and you will normally remain conscious during this time.

Myoclonic jerks often happen in the first few hours after waking up and can occur in combination with other types of generalised seizures.

Clonic seizures

These cause the same sort of twitching as myoclonic jerks, except the symptoms will last longer, normally up to two minutes. Loss of consciousness may also occur.

Atonic seizures

Atonic seizures cause all your muscles to suddenly relax, so there is a chance you may fall to the ground and there is a risk you could injure yourself.

Tonic seizures

Tonic seizures cause all your muscles to suddenly become stiff, which can mean you lose balance and fall over. Like atonic seizures, there is a risk of injury.

Tonic-clonic seizures

Tonic-clonic seizures or convulsions, which used to be known as grand mal, have two stages. Your body will initially become stiff and then your arms and legs will begin twitching. You will lose consciousness and some people will wet themselves. The seizure normally lasts a few minutes, but can last longer.

This type of seizure is what most people think of as an epileptic fit.

What to do if someone has a seizure

If you see someone having a seizure, there are simple things you can do to help.

Tonic-clonic seizures

If you are with someone who has a tonic-clonic seizure:

  • protect them from injury by removing any dangerous or potentially harmful objects nearby, and cushioning their head with your hands or soft material
  • do not restrain them or attempt to move them (unless they are in immediate danger) and don't put anything in their mouth
  • stay calm, and stay with them until they regain consciousness

When the convulsions have stopped, put them into the recovery position until they have recovered.

Other types of seizure

If someone is having one of the other types of seizure:

  • protect them from injury by removing any dangerous or potentially harmful objects nearby, and cushioning their head with your hands or soft material
  • only attempt to move them if they are in immediate danger
  • stay with them and comfort them until they have fully recovered

When to call an ambulance

It will not usually be necessary to call an ambulance after a seizure. However, you should call 999 if:

  • the seizure has not stopped after five minutes
  • the person has more than one seizure without recovering in between
  • you know it is the person's first seizure
  • the person is injured, has breathing problems, or needs emergency medical attention for any other reason
  • the person’s behaviour after a seizure is unsafe

Status epilepticus

Status epilepticus is the name for any seizure that lasts longer than 30 minutes, or a series of seizures where the person does not regain consciousness in between. This is a medical emergency and requires treatment as soon as possible.

You can be trained to treat status epilepticus if you care for someone with epilepsy, but if you haven't had any training, it is important to call 999 for an ambulance immediately if you suspect status epilepticus.

If you have been trained to treat the condition, you will usually have been advised to use either:

  • a medication called diazepam that is placed in the person's rectum
  • a medication called buccal midazolam that  comes in liquid form and is given by trickling the liquid onto the inside of the person's cheek

If you have tried one of these treatments and the seizures are continuing, call 999 for an ambulance.


Page last reviewed: 25/11/2014

Next review due: 25/11/2016

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Comments

The 6 comments posted are personal views. Any information they give has not been checked and may not be accurate.

connor91 said on 24 February 2014

im not sure why the driving ban is 12 months. i generally have only 1 fit a year which means every year i am legal to drive for about a month and then i have another fit. it wasnt a massive problem before as i was at university and couldnt afford a car but now its becoming a pain. ive had epilepsy since i was 5 and im now 22 as ive grown up with the condition i wasnt aware of half the symptoms everyone else has said they have was due to my epilepsy.

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victoria88 said on 01 November 2013

Im 25 + for some yrs iv sufferd anxiety wich i have learned to controle but iv been waking feeling realy strange though the night + i dont think its to do with anxiety as the doctor keep saying. Reading frew the types of epilepsy i can say i do twitch often, mainly in my legs/feet, wen this is bad at night wile im drifing of i tend to find this is when i wake up feeling confused, extremely dizzy + shakey + then my hearts starts to pound as i panick wandering what is happening to me as i feel asif im going to fit or pass out, it takes me a good 10mins to feel 'normal' again + not confused but i cant sleep aftrr as it scares me so much. Iv noticed i day dream alot, get ringing in my ears that stats outa no wer, the feling asif my face/forhead feels numb or tight, tingles in my face + body, slight headaches + pains in/around my head, i get the deja vu feeling alot aswel + the sence of being in a strange place wile im outside but is that just anxiety or something more? I dont know if this is something i should be more concerned about but my doctor doesnt seem intrested...please can any1 help anser my questions to what this could be + if it may or may not be a link in anyway to epilepsy? Thank you

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eddtt said on 01 July 2013

"Although this warning cannot prevent the seizure"

I can actually prevent most, but not all, seizures when I get this warning. when I feel a seizure coming I kneel down on my knees, hang my head down and stretch my arms out horizontally. when the warning is in the right or left side of the brain, I hang that part of my head further down than the non-affected part.
most of the time the warning just disappears, with no seizure occurring. must have something to do with blood circulation. I discovered that position by accident..

I seriously doubt that will help everyone, but if it helps just one..

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4L3X said on 06 June 2013

As per the previous comment. I took seizures myself between the ages of 3 and 12. They disappeared and then came back when i was 34. I think this is pretty rare though.

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Poppy shop said on 22 April 2013

My husband had been seizure free for 10 years and began having them again so I would take care

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Bobdaspider said on 01 September 2012

I have been diagnosed with complex partial seizures with my last seizure occurring in May this year. However, I have been told by my doctor that I have to be seizure-free for a full 12 month period before being able to drive a car again.
However, is this 12 month period purely an arbitrary figure - in other words, is there any scientific/medical evidence that people are more prone to suffer a seizure after being seizure-free for 9 months compared to say 12 months, or 15 or 18 months?
If I reach 9 months without a seizure, I am tempted to request a special dispensation from the medical authorities to allow me to drive a car again (and get my life back) unless it can be proven that the 12 month period requirement is not arbitrary but is based on some scientific/medical evidence.
I suspect it is arbitrary since in the US, I am led to believe that individual States have individual 'seizure-free' requirements that range from 6 to 12 months etc.
I suspect the medical authorities are concerned with covering themselves in respect of potential accidents should the seizure-free period be reduced etc. - which is understandable but surely such a period needs to be based on evidence, on proof, not human instinct?
Thoughts?

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I have seizures, but I've been told it's not epilepsy. Why is this?

These are called non-epileptic seizures. Other conditions – such as diabetes, heart conditions and psychological conditions – can cause seizures.

The word seizure means any sudden, short event that changes a person’s awareness, behaviour, or feelings. Not all seizures are epileptic.

What to do if you see a seizure

Make sure you know what to do if you see someone having a seizure (fit), whether caused by epilepsy or not