Types of Seizures and Their Symptoms in Epilepsy | MyEpilepsyTeam

Connect with others who understand.

sign up Log in
Resources
About MyEpilepsyTeam
Powered By

Types of Seizures and Their Symptoms in Epilepsy

Medically reviewed by Evelyn O. Berman, M.D.
Updated on November 8, 2021

Epilepsy is a spectrum of neurological disorders and seizures that can affect any region of the brain. As a result, symptoms vary widely depending on the type of seizure. Most people will experience the same type of seizure each time, so symptoms should be similar from one seizure to the next. However, a person can have multiple seizure types.

There are many different kinds of seizures, but they can be classified into three main types:

  • Generalized onset seizure
  • Focal onset seizure
  • Unknown onset seizure

These seizure types describe where in the brain the seizure starts, a person’s level of awareness during the seizure, and whether or not the seizure involves movement. The terminology used in this article is based on a new classification system developed in 2017 by the International League Against Epilepsy. You may also encounter older classification systems when reading about or discussing seizures.

Generalized Onset Seizures

Generalized onset seizures affect both sides of the brain — or the same groups of cells on both sides of the brain — at the same time, leading to a loss of consciousness and postictal (after the seizure) fatigue.

Generalized Tonic-Clonic Seizures

Generalized tonic-clonic seizures were previously known as grand mal seizures. There are five distinct phases to this type of seizure, although not everyone will experience all five. During the tonic phase, the body, arms, and legs will flex, then straighten, then shake. In the clonic period, contraction and relaxation of the muscles follow. The seizure ends with the postictal period, during which fatigue, vision and speech problems, and head and body aches are common. Generalized tonic-clonic seizures may be preceded by an aura, which is sometimes actually a focal onset aware seizure. Tonic-clonic seizures may also cause vomiting and loss of bladder control.

Absence Seizures

Absence seizures, formerly referred to as petit mal seizures, typically last less than 30 seconds. Absence seizures cause a short period of staring and altered consciousness. Most likely, the person will remain standing or sitting upright. Their eyes may blink rapidly, or their face or mouth may twitch. After the seizure, they may not remember what just happened. Absence seizures may happen multiple times a day.

Atonic Seizures

Atonic seizures or akinetic seizures (also called drop attacks) cause a sudden loss of muscle tone. A person may suddenly drop their head or fall from a standing position. During the seizure, the body will be limp and unresponsive.

Myoclonic Seizures

Myoclonic seizures often occur in clusters. This type of seizure may cause quick movements or the sudden jerking of muscles. Myoclonic seizures may happen multiple times a day or many days in a row.

Clonic Seizures

Clonic seizures cause jerking, rhythmic motions of the arms and legs, sometimes affecting the face and neck. Clonic seizures can occur on both sides of the body.

Tonic Seizures

Tonic seizures cause the muscles to stiffen suddenly. Tonic seizures can last as long as 20 seconds. If a person is standing when a tonic seizure begins, they usually fall.

Focal Onset Seizures

Focal seizures affect only one part of the brain. In the past, focal onset seizures were referred to as partial seizures.

Focal Aware Seizures

Focal aware seizures, previously called simple partial seizures, begin in one part or one group of cells of the brain. If a person is awake and aware during the seizure, it is called a focal aware seizure. Symptoms of a focal seizure vary depending on which part of the brain it affects but may include visual disturbances, isolated muscle twitching, sweating, nausea, intense emotions, or unusual sensations. Focal aware seizures can sometimes precede a tonic-clonic seizure, leading some people to regard them as auras, warning signs, or premonitions of an oncoming generalized seizure.

Focal Impaired Awareness Seizures

During focal impaired awareness seizures, formerly referred to as complex partial seizures, a person may be confused, appear awake but be unresponsive, or become unconscious. Other behaviors during focal impaired awareness seizures may include chewing, gagging, laughing, crying, screaming, or running. These seizures last between 30 seconds and one minute. After the seizure, extreme fatigue is common.

Secondary Generalized Seizures

Secondary generalized seizures begin in one part of the brain but then spread to both sides. A secondary generalized seizure is two seizures: a focal seizure followed by a generalized seizure.

Learn more about managing focal seizures.

Unknown Onset Seizures

Sometimes, it is not known how or where the seizure begins. A doctor may be able to diagnose an unknown onset seizure later as a focal or generalized seizure if more information is learned.

Triggers

In some people with epilepsy, certain circumstances can trigger a seizure. Triggers vary from person to person, but the most common are:

  • Stress
  • Missing a dose of medication
  • Lack of sleep
  • Flashing lights
  • Alcohol
  • Hormonal changes related to menstruation in women
  • Fever or infection
  • Hypoglycemia (low blood sugar)
  • Caffeine and other stimulants
  • Pain
  • Certain medications

Identifying seizure triggers allows a person with epilepsy to avoid their triggers and hopefully to have fewer seizures. Keeping a seizure diary is a good way to identify triggers. When a seizure occurs, note the date and time, any special situations surrounding the seizure, and how it felt. There are many apps and websites that can help you track seizures and triggers.

Condition Guide

Updated on November 8, 2021
All updates must be accompanied by text or a picture.

Become a Subscriber

Get the latest articles about epilepsy sent to your inbox.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Evelyn O. Berman, M.D. is a neurology and pediatric specialist and treats disorders of the brain in children. Review provided by VeriMed Healthcare Network. Learn more about her here
Brooke Dulka, Ph.D. is a freelance science writer and editor. She received her doctoral training in biological psychology at the University of Tennessee. Learn more about her here
Kelly Crumrin is a senior editor at MyHealthTeam and leads the creation of content that educates and empowers people with chronic illnesses. Learn more about her here

Related Articles

A child living with severe epilepsy may experience one or more types of seizures, some of which a...

What Do Severe Childhood Seizures Look Like?

A child living with severe epilepsy may experience one or more types of seizures, some of which a...
Seizures happen when there is a burst of abnormal electrical activity among neurons, which are t...

What Happens to Your Body During a Seizure

Seizures happen when there is a burst of abnormal electrical activity among neurons, which are t...
Epilepsy refers to a spectrum of disorders that alter normal brain activity, causing seizures.

Fatigue and Epilepsy

Epilepsy refers to a spectrum of disorders that alter normal brain activity, causing seizures.
People with epilepsy, a condition characterized by seizures (also known as convulsions), commonl...

How Does Epilepsy Affect Memory?

People with epilepsy, a condition characterized by seizures (also known as convulsions), commonl...
An aura can be the first sign that an epileptic seizure is about to happen. An epilepsy aura is ...

Auras and Epilepsy

An aura can be the first sign that an epileptic seizure is about to happen. An epilepsy aura is ...
When someone experiences more than one seizure that can’t be attributed to another cause (such a...

Take the Poll: How Often Do You Have Seizures?

When someone experiences more than one seizure that can’t be attributed to another cause (such a...

Recent Articles

For millions of people with epilepsy, navigating daily life means balancing seizure control with ...

Alcohol Consumption and Keppra: What Are the Effects?

For millions of people with epilepsy, navigating daily life means balancing seizure control with ...
“In a couple of days, I’ll feel the adrenaline rush of roller coasters!” a MyEpilepsyTeam member ...

Riding Roller Coasters With Epilepsy: Is It Safe?

“In a couple of days, I’ll feel the adrenaline rush of roller coasters!” a MyEpilepsyTeam member ...
Several antiepileptic drugs (AEDs) commonly cause weight gain or weight loss, but levetiracetam (...

Keppra and Weight Change: Is It a Side Effect?

Several antiepileptic drugs (AEDs) commonly cause weight gain or weight loss, but levetiracetam (...
Several members of MyEpilepsyTeam have mentioned skydiving is among their “bucket list” items. Bu...

Can You Go Skydiving With Epilepsy?

Several members of MyEpilepsyTeam have mentioned skydiving is among their “bucket list” items. Bu...
How many hours per day do you and your loved ones spend looking at computer monitors, tablets, an...

Can Too Much Screen Time Cause Seizures?

How many hours per day do you and your loved ones spend looking at computer monitors, tablets, an...
Sticking to your medication schedule is an essential step in controlling your epilepsy. But in so...

What Should You Do if You Vomit Your Seizure Medication?

Sticking to your medication schedule is an essential step in controlling your epilepsy. But in so...