Epilepsy - Symptoms 

Symptoms of epilepsy 

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

People with epilepsy can experience any variety of seizure, although most people follow a consistent pattern of symptoms known as an epilepsy syndrome.

Seizures can occur when you are awake or asleep (nocturnal seizures).

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

  • partial 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 types of partial seizure:

  • simple partial seizure – where you remain fully conscious throughout
  • complex partial seizure – where you lose your sense of awareness and can’t remember what happened after the seizure has passed

Symptoms of a simple partial seizure include:

  • changes in the way things look, smell, feel, taste or sound
  • an intense feeling that events have happened before (déjà vu)
  • a tingling sensation, or ‘pins and needles’, in your arms and legs
  • a sudden intense emotion, such as fear or joy
  • the muscles in your arms, legs and face may become stiff
  • you may experience twitching on one side of your body

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.

Complex partial seizures are quite common and account for 2 in 10 of all seizures experienced by people with epilepsy.

Generalised seizures

In most cases, a person having a generalised seizure will be completely unconscious.

There are six main types of generalised seizure:

Absences

Absence seizures, sometimes called petit mal, mainly affect children. They cause the child to lose awareness of their surroundings for up to 20 seconds. The child will seem to stare vacantly into space, although some children will flutter their eyes or smack their lips. The child will have no memory of the seizure.

Absences can occur several times a day. Although they are not dangerous, they may affect the child's performance at school.

Myoclonic jerks

These types of seizures cause your arms, legs or upper body to jerk or twitch, much like if you have received an electric shock. They often only last for a fraction of a second, and you should 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 seizure

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

Atonic seizure

Atonic seizures cause all your muscles to suddenly relax, so there is a chance you will fall to the ground. Facial injuries are common with this type of seizure.

Tonic seizure

Unlike an atonic seizure, tonic seizures cause all the muscles to suddenly become stiff. You can lose balance and fall over, so injuries to the back of the head are common.

Tonic-clonic seizure

A tonic-clonic seizure, sometimes known as grand mal, has two stages. Your body will 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 between one and three minutes, but they can last longer.

This is the most common type of seizure, and about 60% of all seizures experienced by people with epilepsy are tonic-clonic seizures.

Tonic-clonic seizures are what most people think of as an epileptic fit.

Auras

People who have epilepsy often get a distinctive feeling or warning sign that a seizure is on its way. These warning signs are known as auras, but they are actually simple partial seizures.

Auras differ from person to person, but some common auras include:

  • noticing a strange smell or taste
  • having a feeling of déjà vu
  • feeling that the outside world has suddenly become unreal or dreamlike
  • experiencing a sense of fear or anxiety
  • your body suddenly feeling strange

Although this warning cannot prevent the seizure, it can give you time to warn people around you and make sure you are in a safe place.

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Status epilepticus

Status epilepticus is a seizure that lasts longer than 30 minutes or a series of seizures where the person does not regain consciousness in between. If a seizure lasts longer than five minutes, call 999 for an ambulance.

Prolonged seizures can be treated with diazepam given as an injection or through someone's rectum. However, if seizures continue because they are not quickly brought under control in this way, it is very important that the patient be transferred to hospital. In hospital, the airways will need to be closely monitored and a high level of sedation may be required to control the seizures.

An alternative treatment is a medication called buccal midazolam. This comes in liquid form and is administered by trickling the liquid onto the inside of your cheek. It is then absorbed into your bloodstream.

You do not have to be a healthcare professional to do this, but you do need the correct training as well as permission from the person who has epilepsy. If you care for someone with epilepsy, you can be trained to administer rectal diazepam or buccal midazolam in case status epilepticus occurs.

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Page last reviewed: 06/09/2012

Next review due: 06/09/2014

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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.

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