Epileptic seizures can vary greatly from person to person. Some only last a few seconds and even go unnoticed, some only affect one arm or one leg, whereas others affect the whole body. Sometimes people become unconscious, sometimes they are just mentally absent for a short while, and sometimes they remain fully conscious.
Epileptic seizures don't usually last very long. If a seizure lasts longer than five minutes, it is referred to as "status epilepticus." This is a medical emergency requiring immediate treatment with medication. People may also have several seizures within a short space of time.
There are two main categories of epileptic seizures:
- Generalized seizures
- Partial (focal) seizures
Generalized seizures affect the whole brain. They aren't necessarily worse than seizures that affect individual parts of the brain (partial seizures). But generalized seizures are more likely to lead to loss of consciousness and make your whole body convulse.
There are different types of generalized seizures:
- Tonic seizures: Your arms and legs become rigid and stiff. This kind of seizure usually passes quite quickly and doesn't always affect your state of consciousness.
- Atonic seizures ("drop attacks"): Here the muscles in one part of your body suddenly become limp. As a result, your chin might drop down towards your chest, or your legs might give way, for instance. You may also briefly become unconscious and fall.
- Clonic seizures: Large muscle groups – for instance in the arms or legs – jerk in a slow rhythm. This is usually accompanied by loss of consciousness.
- Myoclonic seizures: Individual muscle groups twitch rapidly. Your state of consciousness is usually not affected.
- Tonic-clonic seizures (sometimes called "grand mal seizures"): Your whole body convulses and twitches, and you become unconscious.
- Absence seizures (sometimes called "petit mal seizures"): In this mild type of seizure, people suddenly lose awareness (appear to "zone out") for a brief moment.
Partial (focal) seizures
Partial seizures arise in just one part of the brain. The symptoms will depend on what that part of the brain does, and may include things like twitching of the arm (motor disturbances), abnormal sensations (sensory disturbances) or changes in vision (visual disturbances).
When people have partial seizures they may experience abnormal sensations, lose awareness, or hear, see or smell things differently. They may also feel dizzy, feel anxious or hallucinate. This is known as an aura. Some people smack their lips, grimace, stammer, walk around aimlessly or fiddle with things. Partial seizures may be accompanied by twitching or convulsions. Sometimes partial seizures affect your awareness or ability to concentrate.
Partial seizures may spread across the whole brain, resulting in a generalized seizure.
People with epilepsy usually don't have any physical symptoms in between seizures.