Epilepsy
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What are the symptoms of epilepsy?

The symptoms of epilepsy are seizures. A seizure happens when the normal electrical activity in your brain goes wrong.

There are lots of types of seizures. They can look and feel very different depending on where in the brain they start, and how far and how quickly they spread.
 
 
 
 
 
Source:
National Institute of Neurological Disorders and Stroke.
Seizures and epilepsy: hope through research.
October 2008. Available at http://www.ninds.nih.gov/disorders/epilepsy/detail_epilepsy.htm (accessed on 6 November 2008).
 
 
 
 
 
1
 
 
 
 
 
Source:
Commission on Classification and Terminology of the International League Against Epilepsy.
Proposal for revised clinical and electroencephalographic classification of epileptic seizures.
Epilepsia. 1981; 22: 489-501.
 
 
 
 
 
2 For example:

  • You may get a strange feeling, as though you're out of touch with your surroundings
  • Your muscles may feel stiff or limp
  • Your arms may jerk suddenly
  • You may twitch or tremble
  • You may black out and fall to the ground.
Some people get a warning sign, such as a strange smell or feeling, before their seizure starts. These are called auras. Other people get no warning and their seizure comes on suddenly.

Sometimes, seizures are set off by certain things, such as lack of sleep or flashing lights. Doctors call these things triggers.
 
 
 
 
 
Source:
Mosewich RK, So EL.
A clinical approach to the classification of seizures and epileptic syndromes.
Mayo Clinic Proceedings. 1996; 71: 405-414.
 
 
 
 
 
3
 
 
 
 
 
Source:
Browne TR, Holmes GL.
Epilepsy.
New England Journal of Medicine. 2001; 344: 1145-1151.
 
 
 
 
 
4 (To learn more, see Things that trigger seizures.)

Once a seizure ends, some people know what happened to them. But you may not. The length of seizures can vary. They can last for a few seconds or several minutes.

Most people don't get symptoms between seizures. But if their epilepsy is caused by a problem in the brain (such as a
 
 
 
 
 
brain tumor
A brain tumor is a lump of cells that is growing out of control in the brain. Tumors can be benign (which means they don't spread beyond a local area) or malignant (which means that they can spread to other parts of the body). A tumor in the brain can cause problems by pushing on other parts of the brain and affecting how they work.
 
 
 
 
 
tumor, infection or an injury), then this may lead to other problems besides the seizures. Medications for epilepsy may also cause headaches, rashes and other side effects.

Types of seizures
It's important to work out what type of seizure you or your child is having. This is because:

  • Some treatments work best for certain types of seizures
  • Your seizure pattern (the type of seizure you get and how often they happen) may suggest what's causing the epilepsy.
Seizures are usually divided into two main groups according to where they start in the brain and how you behave during a seizure.
 
 
 
 
 
Source:
Commission on Classification and Terminology of the International League Against Epilepsy.
Proposal for revised clinical and electroencephalographic classification of epileptic seizures.
Epilepsia. 1981; 22: 489-501.
 
 
 
 
 
2

  • Partial seizures (doctors sometimes call these focal seizures)
  • Generalized seizures.
But not all seizures can be grouped under these headings, especially those in babies. Doctors call these unclassified seizures.

Partial seizures: how they affect you
In a partial (focal) seizure, only part of the brain is affected. Symptoms depend on what that part of the brain does. (To learn more, see The parts of the brain and what they do.)

Partial seizures can be divided into simple partial seizures or complex partial seizures.
 
 
 
 
 
Source:
Commission on Classification and Terminology of the International League Against Epilepsy.
Proposal for revised clinical and electroencephalographic classification of epileptic seizures.
Epilepsia. 1981; 22: 489-501.
 
 
 
 
 
2 "Simple" means the person doesn't black out. "Complex" means the person blacks out or becomes less aware of his or her surroundings. Epilepsy that causes partial seizures is sometimes called focal epilepsy and partial seizures are sometimes called focal seizures. This is because they start from a particular focus (which means area) in the brain.

Here's a summary of the main symptoms. Click on the links below to read more about how each type of seizure looks and feels.

  • Simple partial (focal) seizures: During this type of seizure, you remain aware of what's going on. The muscles in your arms, legs and face may become stiff, and your limbs may twitch on one side of your body. You may have unusual sensations, such as strange smells, distorted vision, a rising feeling in your stomach, changes in emotion, or a feeling of fear or déjà vu.
     
     
     
     
     
    Source:
    Commission on Classification and Terminology of the International League Against Epilepsy.
    Proposal for revised clinical and electroencephalographic classification of epileptic seizures.
    Epilepsia. 1981; 22: 489-501.
     
     
     
     
     
    2
  • Complex partial (focal) seizures: With this type of seizure, you often have a warning sign (an aura) before the seizure starts, and you may become less aware of your surroundings. You may not answer when called or you may black out. Some people start fidgeting, walking around or doing something over and over again, like chewing or smacking their lips (doctors call these automatisms).
     
     
     
     
     
    Source:
    Commission on Classification and Terminology of the International League Against Epilepsy.
    Proposal for revised clinical and electroencephalographic classification of epileptic seizures.
    Epilepsia. 1981; 22: 489-501.
     
     
     
     
     
    2
Sometimes partial seizures spread throughout the brain. If this happens, you may have a generalized seizure (often a tonic-clonic seizure).

Generalized seizures: how they affect you
These affect the whole brain. During most of these seizures, the person blacks out (loses consciousness). There are several types of generalized seizures.
 
 
 
 
 
Source:
National Institute of Neurological Disorders and Stroke.
Seizures and epilepsy: hope through research.
October 2008. Available at http://www.ninds.nih.gov/disorders/epilepsy/detail_epilepsy.htm (accessed on 6 November 2008).
 
 
 
 
 
1
 
 
 
 
 
Source:
Commission on Classification and Terminology of the International League Against Epilepsy.
Proposal for revised clinical and electroencephalographic classification of epileptic seizures.
Epilepsia. 1981; 22: 489-501.
 
 
 
 
 
2 Click on the links below to read more about how each type looks and feels.

  • Tonic-clonic seizures: A tonic-clonic seizure causes a mixture of symptoms, including stiffening of the body and jerking of the arms and legs. The person blacks out, and may bite their tongue or wet themselves.
  • Absence seizures: The person appears to be staring blankly into space, unaware of his or her surrounding. Muscles may jerk or twitch, and the eyes may flutter. These seizures pass very quickly. They usually last only three seconds to 10 seconds.
  • Myoclonic seizures: The upper body, arms or legs jerk or twitch as if they are being shocked. This may happen once or more than once. People tend not to black out during these seizures.
  • Atonic seizures: The muscles suddenly relax, which makes the person fall down without warning or drop.
Sometimes doctors say a person has an epilepsy syndrome. This is a set of symptoms that fit a particular pattern. An epilepsy syndrome may include more than one type of seizure. Children are more likely than adults to have an epilepsy syndrome.
 
 
 
 
 
Source:
National Institute for Health and Clinical Excellence.
Newer drugs for epilepsy in children.
April 2004. Technology appraisal 79. Available at http://www.nice.org.uk/ta79 (accessed on 6 November 2008).
 
 
 
 
 
5 To learn more, see Epilepsy syndromes.

Knowing which type of epilepsy syndrome you or your child has can help your doctor decide on the best treatment. It can also indicate if the epilepsy will change in the future and whether it can be passed on from parent to child.

Sources for the information on this page:
  1. National Institute of Neurological Disorders and Stroke.Seizures and epilepsy: hope through research.October 2008. Available at http://www.ninds.nih.gov/disorders/epilepsy/detail_epilepsy.htm (accessed on 6 November 2008).
  2. Commission on Classification and Terminology of the International League Against Epilepsy.Proposal for revised clinical and electroencephalographic classification of epileptic seizures.Epilepsia. 1981; 22: 489-501.
  3. Mosewich RK, So EL.A clinical approach to the classification of seizures and epileptic syndromes.Mayo Clinic Proceedings. 1996; 71: 405-414.
  4. Browne TR, Holmes GL.Epilepsy.New England Journal of Medicine. 2001; 344: 1145-1151.
  5. National Institute for Health and Clinical Excellence.Newer drugs for epilepsy in children.April 2004. Technology appraisal 79. Available at http://www.nice.org.uk/ta79 (accessed on 6 November 2008).
This information was last updated on Dec 04, 2008
BMJ Group
This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment.
© BMJ Publishing Group Limited 2009. All rights reserved.
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