There are a number of different types of seizures, including the following:

Partial Seizure (also called focal seizure) is a seizure which affects initially only one localised area of the brain and has a clinical pattern influenced by that location, for example:

  • Seizures of motor cortex present with unilateral motor features (jerking or twitching movements occurring on one side of the body) but no other features.
  • Temporal lobe seizures may present with complex sensory or emotional presentations such as fearfulness, deja-vu experience, abnormal taste or smell sensation or with stereotypical patterns such as staring, lip smacking, repeated chewing or episodic confusion.
  • Frontal lobe seizures typically present overnight or in mornings, with a variety of patterns, some influenced by proximity to motor cortex, or behavioural patterns (e.g. motor agitation or automatisms, strong emotional sensations; which may be accompanied by vocalisations or laughter/crying, features that may be misinterpreted as being psychogenic.

Simple Seizure:  a seizure without loss of consciousness.

Complex Seizure:  a seizure with loss of consciousness.

  • These terms may be combined e.g. a complex partial seizure is a partial seizure that includes loss of consciousness.

Generalised Seizure (also referred to as Diffuse or Tonic-Clonic seizures):  a seizure that affects both sides of the brain and has a clinical pattern that involves all limbs.

  • Partial seizures are said to become secondarily generalised if they initially present with a focal seizure pattern, but evolve during the course of a seizure into a generalised pattern
  • Patterns of generalised seizures may include:
    • Tonic seizures: predominant motor pattern is one of limb stiffness or rigidity
    • Atonic seizures: predominant motor pattern is one of loss of muscle tone, resulting in a pattern described as “drop attacks”.
    • Clonic and/or myoclonic seizures: present with rapidly alternating contraction and relaxation or “jerking”of a muscle
    • Myoclonic seizures often only last for a fraction of a second and you might have a single jerk or clusters of several jerks.
    • Absence seizures typically present as brief loss of consciousness which may appear to be daydreaming or ‘switching off’ possibly with blinking or slight jerking of body or limbs.

Seizure Phases:shutterstock_267014567

  • Prodrome (aura, the phase before a seizure):  the person may experience a sense of déjà vu, altered sensory perceptions or abdominal rising sensation.
  • Epileptic attack: tonic phase and/or rhythmic jerking or complex movements may occur during the seizure. The person may also be incontinent.
  • Post-ictal (phase after seizure):  The person may experience confusion, fear, exhaustion, self-injury and transient neurological deficits.

Status Epilepticus:  a seizure lasting greater than 30 minutes. It is a medical emergency with risks of arrhythmia, reduced cerebral oxygenation, cerebral oedema or muscle damage leading to renal failure

Triggers for Seizures include:

  • Missed anticonvulsant medication.
  • Alcohol excess/withdrawal.
  • Cocaine, ecstasy or other substance abuse/withdrawal.
  • Interacting medications (antidepressants, antipsychotics and oral antispasticity medications are the most commonly prescribed medications in TBI patients, but you should consult British National Formulary for complete list.
  • Lack of sleep.
  • Illness (febrile or afebrile).
  • Menstrual cycle.
  • Flickering lights.

For further information consult:

Epilepsy Scotland www.epilepsyscotland.org.uk

National Society for Epilepsy  www.epilepsysociety.org.uk