Epilepsy Talk

Updated — 40+ Different Kinds of Seizures | September 13, 2017

When I was first diagnosed with epilepsy, there were two kinds of seizures. Grand Mal and Petit Mal. (Can you guess how old I am?)

Now, things are much more different and difficult. No more cut and dried.

So, please, if you have any additions, subtractions or corrections, feel free to chime in.

Because I don’t pretend to be an expert. In fact, this has certainly been a learning experience, from start to finish.

Here, to the best of my knowledge, are the 40+ different types of seizures.

1. Absence Seizure (“Petit Mal”)

Absence seizures account for 2-4 percent of epilepsy. They are characterized by brief episodes of staring, usually lasting only 2-10 seconds and may happen repeatedly during the day. There is no warning before a seizure and the person is completely alert afterwards, with no memory of it. Because they are so mild, you might not even realize you had one and it’s easily not noticed by those around you.

2. Aicardi Syndrome

A rare inherited (genetic) disorder in which the structure that connects the two sides of the brain (corpus callosum) is partly or completely missing.

3. Alice in Wonderland Syndrome (Micropsia)

Children with Alice in Wonderland Syndrome (or AIWS) feel that their body is changing, because of migraines and headaches. They don’t just see themselves changing in size, though, but they also see other people, animals and objects look larger or smaller than they actually are. They can also feel that their hearing and sense of touch have changed. Like what happens to Alice in the beginning of the book, some people with epilepsy who also have AIWS can feel like they are falling down a hole…

Children are the most affected by Alice in Wonderland Syndrome. Most of the effects occur in the dark, where they feel the most scared. Oddly enough, some cough syrup ingredients might cause AIWS. Other causes for AIWS in children are Epstein-Barr Virus and Mononucleosis (or Mono for short). Most times, the symptom will last for only one month. And although it’s unlikely, adults are able to get Alice in Wonderland Syndrome as well.

4. Atonic Seizures (Drop Attacks)

Without warning, a person will abruptly loses consciousness, collapse and fall to the floor. Your head may drop suddenly, your eyelids may droop, your head may nod, and you may drop things. This is caused by sudden loss of muscle tone. Although it’s not usually associated with loss of consciousness and There is no convulsion, it’s possible to bang your head as you fall. Recovery occurs after a few seconds. You regain consciousness, and can again stand and walk.

5. Atypical Absence Seizures

The person will stare (as they would in any absence seizure) but often is somewhat responsive. You may experience eye blinking or slight jerking movements of the lips.

6. Autonomic Seizures

These seizures are accompanied by autonomic symptoms or signs, such as abdominal discomfort or nausea which may rise into the throat (epigastric rising), stomach pain, the rumbling sounds of gas moving in the intestines belching, flatulence and vomiting. This has sometimes been referred to as abdominal epilepsy. Other symptoms may include pallor, flushing, sweating, hair standing on end, dilation of the pupils, alterations in heart rate and respiration, and urination. A few people may experience sexual arousal, penile erection, and orgasm.

7. Benign Rolandic Epilepsy (Sylvan Seizures or Benign Partial Epilepsy of Children)

Accounts for more than one-third of epilepsy beginning in middle childhood between ages 3 and 13. Seizures usually occur infrequently in children, as generalized nocturnal seizures characterized by a variety of minor tonic-clonic movements and often affect only one side of the face. A typical attack involves twitching, numbness, or tingling of the child’s face or tongue (a partial seizure), which often interferes with speech and may cause drooling There’s a jerking of the corner of the mouth that may spread to the rest of that side of the face, causing a twisting motion. The child usually does not lose consciousness, except in cases of secondarily generalized seizures of this type. In rare cases, the seizure may progress to encompass the entire side of the body, becoming a generalized tonic-clonic condition. Seizures typically occur at night and these children are otherwise normal and healthy. The prognosis is favorable with 95% of children outgrowing their seizures by age 15.

8. Catamenial Seizures

This is seizure activity associated with a woman’s menstrual cycle. Studies have shown that fluctuations in female hormones prior to and during menstruation may elevate seizure frequency in some women. In a small percentage of women, catamenial seizures may occur only during the days just before their periods; for others, during the period itself. Higher ratios of estrogen to progesterone may increase seizure frequency. Water retention, electrolyte imbalance, and even poor sleep are also contributing causes.

The connection between menstruation and seizures has been demonstrated in women with simple partial, complex partial, and generalized tonic-clonic seizures. However, different types of seizures may be associated with different phases of a woman’s menstrual cycle. For example, a women with absence seizures may have more seizures during days 16 to 28 of her average cycle and may have the least during her period. A women with partial seizures, on the other hand, tends to have fewer seizures during days 16 to 28 and more just prior to ovulation and during menstruation.

9. Clonic Seizures

During a clonic seizure, you may lose control of bodily functions and begin jerking rhythmically in various parts of your body. Consciousness may be temporarily lost and followed by confusion. Clonic seizures begin in early childhood. With time, clonic seizures may eventually progress to generalized tonic-clonic seizures.

10. Complex Partial Seizures (Psychomotor or Temporal Lobe Seizures)

Begins with a blank look or empty stare. You may be unaware of your surroundings and seem dazed and confused. The seizure may progress to include chewing movements, mumbling, uncoordinated activity, or sometimes performing meaningless bits of behavior which appear random and clumsy. These may include picking at your clothes, trying to remove them, walking about aimlessly, picking up things, or mumbling. Someone experiencing a complex partial seizure may become frightened and try to run and struggle. Following the seizure, there will be no memory of it. A complex partial seizure usually lasts about 2 to 4 minutes. It may be followed by a longer lasting confusion. Once the pattern of seizures is established, it will usually be repeated with each subsequent seizure.

11. Dravet Syndrome — Severe Myoclonic Epilepsy of Infancy

(SMEI), is a severe form of epilepsy. It appears during the first year of life with frequent febrile seizures – fever-related seizures that, by definition, are rare beyond age 5.

Later, other types of seizures typically arise, including myoclonus (involuntary muscle spasms). Status epilepticus – a state of continuous seizure requiring emergency medical care – also may occur.

Children with Dravet syndrome typically experience poor development of language and motor skills, hyperactivity, and difficulty relating to others.
In 30 to 80 percent of cases, Dravet syndrome is caused by defects in a gene required for the proper function of brain cells.

12. Eclampsia

Convulsions are the other most common feature of this syndrome. Convulsions are usually generalized tonic-clonic in nature. Usually a brief single seizure occurs. Multiple seizures can also occur and status epilepticus is rare. Partial seizures or complex partial seizures can also occur. The seizures can occur prepartum, intrapartum, or postpartum. If the seizure occurs postpartum, it usually occurs within the first 24 hours after delivery, however, late postpartum eclamptic convulsions are by no means rare and have been reported as late as 23 days postpartum.

13. Ecstatic Seizures

Also called Dostoyevsky’s Epilepsy, are a type of seizure activity that is characterized by feelings of ecstasy or transcendent joy. Mystical, spiritual, and hallucinatory experiences often occur as well. The temporal lobe is effected by the seizure activity and provides a neural basis for these experiences. These seizures can involve more than one seizure symptom, such as tonic-clonic, tonic & more.

14. Febrile Seizures

Children aged 3 months to 5 years may have febrile seizures when they have a high fever. This occurs in only 2% to 5% of all children. A febrile seizure is usually mild and brief, often resulting in a slight slumping and loss of consciousness, or a rolling of the eyes back in the head. Sometimes there may be convulsive stiffening and jerking, but there is no need to panic. Protect the child from sharp, hot, or otherwise dangerous objects. Loosen tight clothing. Do not put anything in the child’s mouth. Do not restrict his/her movements. Roll the child on his/her side and try to keep everyone relaxed.

There are 2 types of febrile seizures: simple and complex. Simple febrile seizures are more common and relatively harmless. They usually last less than 15 minutes and have no after-effects. A neurological examination following a simple seizure will yield no abnormalities.

15. Complex Febrile Seizures

May be more threatening. They can last longer than 15 minutes and although only one side of the body is affected during a complex febrile seizure, neurological reports may indicate abnormalities.

In both cases, febrile seizures pose no threat of mental retardation, cerebral palsy, learning disabilities, or death. Only 25-30% of children who experience one will ever have another. And the incidence of febrile seizures does not indicate a possibility of developing long-term epilepsy. Less than 2% of children who experience febrile seizures will develop epilepsy later in life. Febrile seizures are classed as incidents rather than as a condition.

16. Focal Cortical Dysplasia

This is the most common cause of intractable epilepsy in children and is a frequent cause of epilepsy in adults. All forms of focal cortical dysplasia lead to disorganization of the normal structure of the cerebral cortex.

17. Frontal Lobe Epilepsy

May produce weakness or inability to use certain muscles, including those that govern speech. Frontal lobe seizures may involve thrashing movements during sleep, also stiffening with the head turned to one side and the arm rising into a brief frozen state. Some seizures may be dramatic and upsetting to others, with screaming, bicycling movements of the legs, running. Treatment is with medication, and, in some cases, surgery.

18. Gelastic Seizures

These seizures are both unpredictable and unprovoked by the person’s surroundings. They are abrupt in onset and quickly over. They may occur nocturnally, waking you from sleep and leaving you exhausted. Basically, they are characterized by brief outbursts of emotion, usually in the form of a laugh or a cry. They may be accompanied by forced eye movements, chewing or grinding the teeth, tonic posturing, and clonic jerking. You may appear confused and/or dazed during and after an episode. Gelastic seizures usually last 5 to 60 seconds and you may remember them clearly or may be completely unaware of what occurred.

19. Infantile Spasms (West Syndrome)

These consist of a cluster of sudden jerks followed by stiffening. Often the arms are flung out as the knees are pulled up and the body bends forward.
Infantile spasms consist of clusters of sudden, quick movements. Typically, if the child is sitting up, the head may fall forward, the arms will flex forward, and the body may flex at the waist. If lying down, the knees will be drawn up, with arms and head flexed forward as if the body is reaching for support. Individual spasms last only 1 or 2 seconds. They often repeat in a series of 5 to 50 or more. A child may have many series per day. Spasms are most likely to occur when the child is drowsy, just waking from a nap or falling asleep. They’re sometimes called “jackknife seizures” and are very rare. They occur only during the first year of life, usually starting around 3-7 months of age. Many children with infantile spasms have associated developmental delay and may go on to develop other forms of epilepsy, such as Lennox-Gastaut syndrome.

20. Jacksonian Seizure (Also called Jacksonian March)

A kind of simple partial seizure. “Simple” in this context means patients do not lose awareness. Partial means that abnormal neuron firing only occurs in part of the brain, and, accordingly, abnormal movement or sensation is limited to only part of the body. The characteristic features of Jacksonian march are that it only occurs on one side of the body and it progresses in a predictable pattern from twitching or a tingling sensation or weakness in a finger, a big toe or the corner of the mouth, then marches over a few seconds to the entire hand, foot or facial muscles.

Jacksonian march seizures are generally brief and relatively mild. They are episodic, come and go. There is no confusion afterwards. Sometimes patients may not even notice them. Some patients may also have a phenomenon called “automatism,” such as compulsively licking the lips, fumbling with clothing, or other rhythmic finger movements. Others may experience head turning, eye movement, muscle cramping, numbness, tingling, and a crawling sensation over the skin. Hallucinations can occur too, which can be visual or auditory, meaning patients may see or hear things that are not there.

21. Juvenile Myoclonic Epilepsy

(Also called Janz’s syndrome, impulsive petit mal, myoclonic epilepsy of adolescence, and jerk epilepsy.) Typically begins at puberty in otherwise healthy children. The first symptom is usually a generalized convulsion. These children may also have myoclonic seizures (jerking of the muscles) on awakening. A hand may suddenly fling out, a shoulder may shrug, a foot may kick, or the entire body may jerk. A child may spill or drop whatever he or she is holding or fall from their chair. Absence seizures may also occur. Juvenile myoclonic seizures can occur as a single event or in a series.

22. Lafora Disease

Is a severe form of epilepsy, characterized by seizures and progressive neurological degeneration. It occurs during late childhood or early adolescence. Death usually occurs within 10 years of the first symptoms.

23. Landau-Kleffner Syndrome

Also a rare disorder beginning between ages of 3 and 7. Produces seizures and affects speech. Children develop normal speech, and then slowly lose it. Simple partial and tonic clonic seizures. Treated with antiepileptic drugs to control seizures, and, possibly, steroids.

24. Lennox-Gastaut Syndrome

Affects between 3-10% of children with epilepsy, more commonly males. The peak age for onset is between 1 and 8 years of age with extreme incidence occurring in the first and tenth years of life The most characteristic manifestation of the Lennox-Gastaut syndrome is in a large variety of seizures.

Tonic seizures, the most inherent kind associated with the syndrome, may occur at any time, both day and night. They are usually brief and consciousness is often impaired. Those cases which do appear nocturnally usually occur during the periods of slow-wave sleep in the latter part of the night.

Atypical absence seizures are also present in many cases. Such seizures can begin and end gradually with consciousness only partially affected. The child may continue to be active, however distant or abstracted thoughts. Often, there is a loss of facial and the neck muscles, accompanied by imbalance and abnormal posture. They might lean forward with an open mouth and signs of myoclonic epileptiform activity may become evident in a twitching of your eyelids and mouth. In such cases, massive myoclonic jerks, myoclonic-atonic attacks, as well as atonic seizures may occur, though much less frequent and severe than the other traits.

Tonic-clonic, clonic, or partial seizures are also characteristic of the syndrome and usually are evidence of an underlying cerebral disorder. Even worse, severe cases of status epilepticus may develop, leaving the child unconscious with a continuous array of atonic and myoclonic-atonic seizures. Such seizures may persist through days, weeks, or even months, causing possible mental developmental delay and physical repercussions.

25. Limbic Epilepsy

Limbic areas are regions in the temporal and frontal lobes, which are involved with memory and emotion and this is a seizure happening in this area.

26. Motor Seizures

They are a form of simple partial seizures which include clonic, jerking, convulsive movements. Jerking typically begins in one area of the body – your face, arm, leg, or trunk — and may spread to other parts of the body. These seizures are sometimes called Jacksonian motor seizures, their spread is called a Jacksonian march and they cannot be stopped.

27. Multifocal Seizures

While most seizures can be neatly split into partial and generalized, there exists some that don’t fit. For example: the seizure may be generalized only within one hemisphere. Alternatively there may be many focal points (multifocal seizures) that are distributed in a symmetrical or asymmetrical pattern.

28. Musicogenic Seizures

This reflex epilepsy is triggered by certain types of music or even specific frequencies of pitch for which your brain has a low threshold or tolerance. They usually involve a degree of cognitive or emotional appreciation of the stimulus. This usually results in a complex partial seizure, but may also induce others, such as tonic-clonic seizures. Sensitivity to music varies from person to person. Some people are sensitive to a particular tone from a voice or instrument. Others are sensitive to a particular musical style or rhythm. Still others are sensitive to a range of noises.

29. Neonatal Seizures

Neonatal seizures occur in babies soon after birth. As many as 1.5 to 2.5% of newborns have seizures in the first month of life. A further 20% of all seizures in children under 3 years of age have neonatal seizures. They’re generally classified as subtle, clonic, tonic, and myoclonic.

Subtle attacks are characterized by apneas with episodes of pallor, fixed staring, deviation of one or both eyes, eye blink, motor changes, episodic chewing movements, or stereotypic limb movements such as swimming or bicycling motions. Drooling and unusual alertness may accompany neonatal seizures. Usually, most neonatal seizures occur over only a few days and fewer than half of affected infants develop seizures later in life.

30. Nocturnal Seizures

These are usually tonic-clonic. They might occur just after a person has fallen asleep, just before waking, during daytime sleep, or while in a state of drowsiness. People who experience nocturnal seizures may find it difficult to wake up or to stay awake. Although unaware of having had a seizure while asleep, they may arise with a headache, have temper tantrums, or other destructive behavior throughout the day.

Nocturnal seizures are very uncommon and their mechanisms poorly understood. There is evidence that sleep enhances epileptic discharges in the EEG, though their daytime recordings may appear to be normal. However, if a pattern of limiting seizures to the hours of slumber is maintained, the chance of them occurring during the daytime is greatly reduced.

31. Partial (Focal) Seizure

They may occur at any age, as a single episode or as a repeated, chronic seizure disorder. They are seen less frequently in children than in adults, but still account for about 45% of pediatric seizure disorders. Patients with focal seizures can have any of the symptoms below. Those with simple focal seizures do not lose consciousness and will be aware and remember the events that occur at the time. If you have complex partial seizures, you will have abnormal consciousness and may or may not remember any or all of the symptoms or events surrounding the seizure.

Symptoms include: abnormal muscle contractions affecting one side of the body, abnormal head movements, staring spells, abnormal mouth movements like lip smacking, chewing or swallowing without cause, numbness, tingling, abdominal pain, nausea, or discomfort, sweating, a flushed face, rapid heart rate or pulse, sensation of déjà vu and changes in mood or emotion. (That about covers everything, doesn’t it?)

32. Pattern — Sensitive Epilepsies

In this reflex condition, seizures are produced by particular visual patterns. These triggers may consist of circles, stripes, or other patterns, usually of high contrast. Moving patterns are most likely to incite a seizure.

33. Photosensitive Epilepsy

If you have photosensitive epilepsy, certain types of flickering or flashing light may incite a seizure. The trigger could be exposure to television screens due to the flicker or rolling images, computer monitors, certain video games or TV broadcasts containing rapid flashes, even alternating patterns of different colors, in addition to intense strobe lights. And surprisingly, seizures may be triggered by natural light, such as sunlight, especially when shimmering off water, even sun flickering through trees or through the slats of Venetian blinds.

34. Post Traumatic Seizures

Seizures may develop immediately after an injury to the brain or may develop in delayed fashion, showing up months or years after the initial trauma. Generally speaking, the risk of post traumatic seizures is related to the severity of the injury. The greater the injury, the higher the risk of developing seizures. Even mild to moderate injuries can result in seizures.

It is thought that a head injury disrupts the pathways of the brain and that an epileptic seizure can be viewed as a sort of short circuit of the brain’s electrical functioning. During the seizure the electrical fields in the brain are overloaded, resulting in seizures. The most commonly seen seizures related to traumatic brain injury are “generalized” seizures, which are also called tonic-clonic or “grand mal” seizures.

35. Primary Reading Epilepsy

This is a reflex epilepsy where seizures are triggered by reading. Seizures usually begin in adolescence, and onset is unusual in younger children or adults over 30 years old. Patients report jaw jerking or clicking while reading, often with jerks of the arms, and if reading continues, a generalized convulsion may occur. Transient cognitive impairment has also been noted with the jerks.

36. Progressive Myoclonic Epilepsy

A rare, form of epilepsy with myoclonic (jerking) and tonic-clonic (grand mal) seizures. Children with this condition may have trouble with maintaining balance and experience rigid muscles. There is also a loss of mental ability. A gene for this disorder has recently been discovered

37. Psychogenic Seizures (PNES or “Pseudo Seizures”)

Psychogenic seizures are not classified as a form of epilepsy. They may be brought on by stress, trauma, anxiety or a history of sexual abuse.

It’s difficult to differentiate between psychogenic and epileptic seizures. However, one reliable indicator of a psychogenic seizure is eye closure during the seizure. If you have a seizure, your eyes tend to stay open. Still, statistics indicate that, in 20-30% of cases, epileptologists are incorrect in attempting to distinguish one from the other. Although psychogenic seizures are not caused by electrical discharges in the brain and thus do not register any EEG abnormalities, they are often mistaken for epileptic disorders. It’s also possible to have both psychogenic seizures and epilepsy. Most patients with psychogenic seizures are misdiagnosed and consequently treated with epilepsy drugs or other epilepsy therapies, sometimes with severe and fatal side effects.

38. Rasmussen’s Encephalitis — also Chronic Focal Encephalitis (CFE)

This is a rare, progressive neurological disorder which affects one half of the brain, producing severe seizures, loss of motor control and speech along with paralysis on one side of the body. Various treatments have been tried, including surgery to remove the affected half of the brain.

39. Reflex Epilepsy

A seizure is considered a reflex seizure when it occurs as a direct response to a particular stimulus or event in the environment. These seizures are experienced by approximately 6% of people with epilepsy. They can be triggered by visual stimulation, a sudden “startle”, or a variety of other factors alone or in combination. If a patient only has seizures as a result of a certain stimulus then it is possible to control them by avoidance. Begins in childhood, is associated with absence epilepsy, and may disappear in adulthood.

40. Secondarily Generalized Seizures

Generally, they’re partial seizures evolving into generalized seizures, most often with tonic-clonic convulsions. The partial seizures which were once limited to one hemisphere of the brain progress to encompass the entire brain bilaterally, causing a generalized seizure. The clinical nature of a secondarily generalized seizure usually does not differ from that of the initial, originating seizure.

Secondarily generalized seizures are predominant in 16% of all children and 9% of all adults with seizure disorders. Most people with complex partial seizures and many with simple partial seizures will experience such a seizure at some point. When they occur frequently, the chances for future partial seizures may be increased.

41. Simple Partial Seizures (Focal Seizures)

Although your ability to respond may be preserved, motor manifestations or anxiety relating to the seizure symptoms may prevent you from responding appropriately You may see or hear things that are not there. Feel emotions, often fear, but sometimes sadness, anger, or joy. There may be a bad smell or a bad taste, a funny feeling in the pit of your stomach or a choking sensation. Sudden or restless movement or vision distortion are also characteristics. These seizures are sometimes called simple partial seizures of temporal lobe origin or temporal lobe auras.

42. Sensory Seizures

Some simple partial seizures consist of a sensory experience. People with sensor seizures may smell or taste things that aren’t there, hear clicking, ringing, or a person’s voice when there is no actual sound. You may also see lights, hear a buzzing sound, or feel tingling or numbness in a part of the body. Simple partial seizures usually last just a few seconds, although they may be longer. If there are no convulsions, they may not be obvious to those around you.

43. Startle Epilepsy

This is a type of reflex epilepsy in which seizures are provoked by loud noises or sudden surprises. Most patients with startle epilepsy are only sensitive to one sensory modality (i.e. temperature, taste, sound, pressure); however, it is the unexpected nature of the stimulus, rather than the sensory modality, that characterizes startle epilepsy. These seizures usually last less than 30 seconds. The seizure begins with a startle response, followed by a brief tonic phase. Patients sometimes fall to the ground and experience clonic jerks. Responsiveness to the stimulus decreases as a result of repeated exposure to the stimulus. Spontaneous seizures also occur in patients with startle epilepsy, but are infrequent in most cases.

People with startle epilepsy usually have static cerebral lesions and developmental delay. For many people, half of the body is partially paralyzed and it is the weak side of the body that is primarily involved in the startle seizures. Startle epilepsy is often associated with disorders such as Down syndrome and cortical dysplastic lesions.

44. Status Epilepticus

Status epilepticus (SE) is a common, life-threatening neurologic disorder. It is essentially an acute, prolonged epileptic crisis. Aggressive treatment is necessary. Maintenance of vital signs, including respiratory function, is of major importance. It may occur as a first seizure or if you are known to have seizures. Duration may last for a long time, or repeat without recovery. This prolonged or repeated seizure activity can result in death if it’s not treated immediately. Status epilepticus can be convulsive (tonic-clonic or myoclonic seizures) or non-convulsive (absence or complex partial seizures). A person in non-convulsive status epilepticus may appear confused or dazed.

45. Temporal Lobe Epilepsy

The seizures associated with temporal lobe epilepsy consist of simple partial seizures without loss of awareness and complex partial seizures, with loss of awareness. You lose awareness during a complex partial seizure because the seizure spreads to involve both temporal lobes, which causes impairment of memory. The result is complex partial seizures coupled with simple partial seizures. Generalized tonic clonic seizures may be part of this syndrome as well.

46. Tonic Seizures

Tonic seizures are characterized by facial and muscle spasms of your trunk, flexing or reaching of your upper and lower extremities, and impaired consciousness. Several types of tonic seizures exist. Those grouped with absence, myoclonic, and atonic seizures are non-convulsive and tend to be brief. The more prolonged seizures usually are convulsive and may manifest dilation of your pupils, tachycardia, apnea, a bluish tinge to your skin, salivation, and the loss of bladder or bowel control. Tonic seizures are often followed by postictal confusion.

47. Tonic-Clonic Seizures (“Grand Mal”)

In a generalized tonic-clonic (grand mal) seizure, you will probably give out a short cry and fall to the floor. Your muscles will stiffen during the tonic phase and then, during the clonic phase your extremities will jerk and twitch. Often you will lose consciousness, stop breathing or have difficulty breathing, turn blue and lose bladder control which in not uncommon, but extremely embarrassing.

Afterwards, you may feel tired, confused and disorientated. This may last from 5 minutes to several hours or even days. Rarely, this disorientation may last up to 2 weeks. You may asleep, or gradually become less confused until full consciousness is regained.

48. Vertigo Epilepsy

While epilepsy is commonly accompanied by dizziness or vertigo, vertigo is only rarely caused by epilepsy. This arises primarily because vertigo is much more commonly caused by ear conditions. Epileptic vertigo is due to brain injury, typically the part of the temporal lobe that processes vestibular signals. Loss of consciousness usually occurs at the time of injury. The typical symptom is “quick spins.”

49. Withdrawal Seizures

This type of seizure is seen when certain medications, such as barbiturates and benzodiazepines, are stopped abruptly. In this case, continued treatment with antiepileptic medications is usually not advisable. Withdrawal seizures are common when a person with alcoholism is trying to quit drinking. If a person with epilepsy drinks alcohol heavily and experiences withdrawal seizures, it is difficult for the physician or specialist to determine the exact cause of the seizure and to determine the next appropriate step. Therefore, it is important to avoid alcoholic beverages once you begin taking antiepileptic medications.

FUTURE CLASSIFICATIONS

In 1997, the International League Against Epilepsy began work on reclassifying seizures, epilepsies and epileptic syndromes. This revision remains in the works. But here’s what you have to look forward to…

Replace partial with the older term focal to describe seizures that originate in one part of the brain (though not necessarily a small or well defined area).

The word partial was regarded as ambiguous.

Drop the terms simple partial and complex partial – grouping based on the effect to consciousness is no longer regarded as useful.

Replace cryptogenic with probably symptomatic.

The hierarchy goes like this:

Self limiting seizure types
Generalized seizures
Tonic-clonic seizures (includes variations beginning with a clonic or myoclonic phase)
Clonic seizures (with and without tonic features)
Typical absence seizures
Atypical absence seizures
Myoclonic absence seizures
Tonic seizures
Spasms
Myoclonic seizures
Massive bilateral myoclonus
Eyelid myoclonia (with and without absences)
Myoclonic atonic seizures
Negative myoclonus
Atonic seizures
Reflex seizures in generalized epilepsy syndromes
Seizures of the posterior neocortex
Neocortical temporal lobe seizures
Focal seizures
Focal sensory seizures
Focal motor seizures
Gelastic seizures
Hemiclonic seizures
Secondarily generalized seizures
Reflex seizures in focal epilepsy syndromes
Continuous seizure types
Generalized status epilepticus
Generalized tonic-clonic status epilepticus
Clonic status epilepticus
Absence status epilepticus
Tonic status epilepticus
Myoclonic status epilepticus
Focal status epilepticus
Epilepsia partialis
Aura continua
Limbic status epilepticus (psychomotor status)
Hemiconvulsive status

The 1981 classification was marked by a distinction between simple and complex partial seizures. In the 1970 classification, the distinction was whether the symptoms involved elementary sensory or motor functions (simple) or whether “higher functions” were involved (complex).

This was changed to consider whether consciousness was fully retained or not.

As a result, studies that group patients according to these classifications are not directly comparable from one generation to another.

Speaking in its favor, the 1970 classification helped standardize the modern terms for many seizure types.

Before this, when life was intelligible and easy (but not quite as exact), terms such as petit mal, grand mal, Jacksonian, psychomotor and temporal-lobe seizures were used.

(And we actually understood what they meant.)

Now the terms and types of seizures have been reclassified:

There are now 3 major groups of seizures. 

  1. GENERALIZED ONSET SEIZURES: These seizures affect both sides of the brain or groups of cells on both sides of the brain at the same time. This term was used before and still includes seizures types like tonic clonic, absence or atonic to name a few.
  2. FOCAL ONSET SEIZURES: The term focal is used instead of partial to be more accurate when talking about where seizures begin. Focal seizures can start in one area or group of cells in one side of the brain. Focal Onset Awareness Seizures: When a person is awake and aware during a seizure, it’s called a focal aware seizure. This used to be called a simple partial seizure. Focal Onset Impaired Awareness: When a person is confused or their awareness is affected in some way during a focal seizure, it’s called a focal impaired awareness seizure. This used to be called a complex partial seizure.
  3. UNKNOWN ONSET SEIZURES: When the beginning of a seizure is not known, it’s now called an unknown onset seizure. A seizure could also be called an unknown onset if it’s not witnessed or seen by anyone, for example when seizures happen at night or in a person who lives alone.  And as more information is learned, an unknown onset seizure may later be diagnosed as a focal or generalized seizure.

Resources:

http://www.epilepsywarriors.org/resources/epilepsy-seizures/different-types-of-seizures-known/

https://www.efepa.org/living-with-epilepsy/types-of-seizures/

http://www.webmd.com/epilepsy/types-of-seizures-their-symptoms#2

http://www.epilepsy.org.uk/info/seizures/possible-seizure-triggers

http://www.nlm.nih.gov/medlineplus/ency/article/000697.htm#visualFile

http://emedicine.medscape.com/article/1177069-overview

http://emedicine.medscape.com/article/1184384-overview

http://emedicine.medscape.com/article/1164462-overview

http://emedicine.medscape.com/article/1184509-overview

http://www.epilepsy.com/learn/types-seizures

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25 Comments »

  1. This is very informative. Thank you so much!!

    Like

    Comment by Georgette Johnson — September 13, 2017 @ 7:34 PM

    • Glad that you liked the article.

      If you ever have a query, try putting it into the search box to get to the appropriate subject.

      Like

      Comment by Phylis Feiner Johnson — September 14, 2017 @ 8:43 AM

  2. You may have omitted Rolandic epilepsy which is associated with Sylvian (spelling?) seizures….. And….non epileptic seizures, of which there are several types…..unless I overlooked them in your list due to my aging eyesight!

    The U.K. Updated classification of seizures is helpful, see

    https://www.epilepsy.org.uk/info/seizure-classification?dm_i=72O,55DDO,P4CLSS,JRSAU,1

    Like

    Comment by Michael H — September 13, 2017 @ 9:47 PM

    • Nope, it there under “Benign Rolandic Epilepsy (Sylvan Seizures or Benign Partial Epilepsy of Children)”. And non epileptic seizures are lumped under “Psychogenic Seizures (PNES or Pseudo Seizures)”

      Thanks for the link. Very helpful!

      Like

      Comment by Phylis Feiner Johnson — September 14, 2017 @ 8:28 AM

  3. Thanks for including PNES, I have them as a result of complex PTSD, but for 40yrs I was treated for uncontrolled epilepsy and poisoned with unecessary drugs. Doctors must be made aware of them

    Like

    Comment by Gail — September 14, 2017 @ 5:24 AM

  4. Hi~
    I didn’t find, and maybe it’s not even associated with any kind of seizure, but sleep paralysis. My son who is 12,and has been experiencing(what we think are… AIWS, Temporal lobe auras, Sensory seizures,headaches, that come and go quickly and the most recent, sleep paralysis, and also insomnia. We have been dealing with this for about 4-5 years. He has had 4 EEG, all normal. His Dr. (neurologist at Children’s Hospital), doesn’t think that any of these symptoms, has anything to do with possible seizure activity. In fact, when we first went to see neurology dept, they thought he was making it all up and we needed to seek mental help. He has now advised us to go to the sleep center. My husband was diagnosed with Simple partial Seizure disorder, about 14 years ago. Still, with all of this information, my son’s Dr. doesn’t see any connection. It’s now very frustration, we can’t seem to get any answers. And don’t really know where to turn or what to do. When I read these different disorders, they seem to fit his situation. Any kind of help would be greatly appreciated!
    Thank you for this post and all the others as well!
    Blessings to all

    Like

    Comment by Tammie Bullock — September 14, 2017 @ 10:52 AM

    • I think a sleep study would be helpful.

      Sleep studies (Polysomnography) with expanded EEG aids can indicate the difference between seizures and parasomnias (sleep disorders).

      If being observed in a sleep lab, there is a decrease in rapid eye movement (REM) and an increase in the lighter stages of sleep, according to the article “Nocturnal Seizures,” by Carl W. Bazil, MD, PhD.

      As for EEGs, I know of people who have had 5 EEGs, only to be properly diagnosed when they finally had Video EEG Monitoring.

      An abnormal EEG does not diagnose epilepsy nor does a normal EEG reading exclude it.

      Like

      Comment by Phylis Feiner Johnson — September 14, 2017 @ 10:59 AM

      • Thank you for your reply~
        I really appriciate it!

        Like

        Comment by Tammie Bullock — September 14, 2017 @ 3:45 PM

      • Any thing I can do to help…

        Like

        Comment by Phylis Feiner Johnson — September 14, 2017 @ 3:51 PM

  5. Thank you so much for this article ( and all your posts )
    Very helpful and appreciated !

    Like

    Comment by Susan S. — September 14, 2017 @ 11:01 AM

  6. I appreciate all the posts also but when are we going to start talking about the real cure medical marijuana..sick of side effects of the drugs…why do we let the government control our medical care fed up with all of it!!!

    Like

    Comment by Jody Zimmer — September 18, 2017 @ 8:33 AM

  7. Thank you for your link.

    And yes, medical marijuana is used by many and the famous neurorlogist, Orrin Devinsky is running trials to assert its effectiveness.

    But technically, the evidence is still anecdotal and the jury is still out.

    Like

    Comment by Phylis Feiner Johnson — September 18, 2017 @ 9:19 AM

  8. I have been seizure free for 4 years thanks to Keppra, but recently I have had a few weird experiences. Buzzing in my ears as though I had a radio inside my head, forgetfulness as well as putting things in the wrong place, I can dismiss those as general things that most people do.
    But the other day I was speaking to my Mother, when I suddenly zoned out. She then asked me why I had raised my arm in the air (I didn’t realise I had done so)
    I really hope this doesn’t mean I’m going to have a Tonic Clonic anytime soon. I thought that was all behind me.
    A really interesting article, thanks so much for keeping us informed.
    Knowledge is power !

    Like

    Comment by Michelle Sawyer — September 19, 2017 @ 8:05 AM

    • My guess is that it could have been a breakthrough seizure.

      I would have my blood levels checked to make sure the meds are at their therapeutic level.

      Your metabolism could have sped up and perhaps your dose is off.

      Like

      Comment by Phylis Feiner Johnson — September 19, 2017 @ 9:03 AM

      • Thanks that’s what I was thinking..!

        Like

        Comment by Michelle Sawyer — September 19, 2017 @ 9:20 AM

  9. NEA asked me to assist them at a fair on Wednesday at NIH.

    She told me since I have worked with them before and this is a “health fair ” it should be easy!

    Your information is up to date!

    Stay Cool this week 😊

    Thank you,

    Toni Robison

    Liked by 1 person

    Comment by red2robi — September 24, 2017 @ 11:20 PM

  10. The more we learn about epilepsy, the better we handle and confront it! I have a pretty good handle on it (perhaps one petit mal every 6 to 9 days on the average an a hospital visit once every 2 yrs or so). But I STRONGLY encourage keeping yourself physically as well as mentally strong. One thing very irritating is my short term memory loss and reiterating data and conversation to people, and that bothers me because it makes me feel stupid. But that is a side effect of keppra. And I also take lamictal and vimpat. Let me give you (if you do not mind the story…) a backup of my situation: 1979 car accident, 5 day coma, UCLA ICU 3 wks, temp paralyzed, subdural hematoma, 2 and a half weeks rehab. List goes on…Then suffered 4 and a half hour seizure that could not be stopped about 25 yrs ago. Induced coma lasting 5 days. Last year overcame stage 3b breast cancer with emergency lumpectomy. But I will not give up!!! Let us keep positive attitudes as that gives us all power!!! If this long story helps any one of you to realize how important your self confidence is, that makes my day!!

    Like

    Comment by Alicia — November 12, 2017 @ 11:30 PM


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    About the author

    Phylis Feiner Johnson

    Phylis Feiner Johnson

    I've been a professional copywriter for over 35 years. I also had epilepsy for decades. My mission is advocacy; to increase education, awareness and funding for epilepsy research. Together, we can make a huge difference. If not changing the world, at least helping each other, with wisdom, compassion and sharing.

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