Epilepsy is a common neurological condition which affects the brain. Sudden bursts of electrical activity in the brain cause temporary disruption, triggering a seizure. Epilepsy is a common, often life-long condition, that can develop at any time in your life. However, it is most commonly diagnosed in children and people over the age of 65. In the UK, epilepsy affects an estimated 600,000 people.

This article will look in more detail at the different types of seizures you may experience as a result of epilepsy. For more information on the condition as a whole, take a look at our in-depth guide. You can also read about the other common medical conditions affecting older people.

What is a Seizure?

A seizure is the body’s response to sudden changes within the electrical activity in your brain causing a temporary disruption to normal activity. It is important to note that anyone can have a one-off seizure; this does not always mean they have epilepsy. Generally speaking, you will need to have more than one seizure to receive an epilepsy diagnosis. There are many different types of epileptic seizure. In some instances, you may remain alert and aware. However, you will often lose awareness when you are having a seizure.

According to the Epilepsy Society seizures are divided into groups depending on the following factors:

• Onset – Whereabouts in the brain they start including focal, generalised, or unknown onset.
• Awareness – Whether or not your awareness is affected.
• Other symptoms – Whether or not you have other symptoms with the seizure such as body movement.

Facial Seizures

Also referred to as a focal onset seizure, this is where the epileptic seizure starts in one part of the brain. This could be a large part of one hemisphere (side) of the brain or a small area in one of the brains lobes. This area is sometimes referred to as the ‘focus’ of the seizure. These seizures can have both motor and non-motor symptoms and the affect the seizure has on you will vary depending on which part of the brain has been affected.

There are two main types of focal seizure which are differentiated depending on the awareness you have during the seizure.

Focal Aware Seizures (FAS)

With this type of seizure, you will remain conscious, meaning you are aware and alert to your surroundings. You may find it hard to explain how you are feeling when this happens to you, which can be upsetting and frustrating. You may have some ‘strange’ sensations which, according to the NHS, can present as:

• A rising sensation in your stomach.
• A feeling of déjà vu.
• Unusual smells or tastes.
• Tingling in your arms or legs.
• An intense feeling of fear or joy.

This type of seizure may also be known as a warning or ‘aura’, as it can serve as a sign that you are about to have another type of seizure.

Focal Impaired Awareness Seizure (FIAS)

This type of seizure affects a bigger part of one hemisphere of your brain. In this case, your awareness will be affected at some point during the seizure, this often means you are unable to respond to the people around you, your reactions may be different to normal, and you can be very confused.

The effect that these seizures have on somebody with epilepsy will vary from person to person, and will also depend on which part of the brain is affected by the seizure. After the seizure the person may be very confused and want to rest. They may also have no memory of the seizure.

For more information on focal seizures, visit Epilepsy Action (EA).



Tonic-clonic Seizures

This type of seizure is the one that most people will recognise when they think of epilepsy. They have generalised onset meaning they affect both sides of the brain from the start. These seizures happen in two phases:

1. Tonic phase – This is the part where you will lose consciousness, your body will stiffen, and if standing you will fall to the floor. Sometimes you will cry out due to air pushing past your voice box. It is also at this phase that you may bite down on your tongue or the inside of your mouth.
2. Clonic phase – This phase shortly follows the tonic phase and it is during this part that your limbs begin to jerk quickly. You may lose control of your bladder and/or bowels and your breathing may be affected. Your breathing may sound noisy as it becomes difficult to breathe. Due to this, your skin may start to change colour to a blueish tinge.

The seizure usually lasts between one and three minutes. If the tonic-clonic seizure is lasting for longer than five minutes you may need emergency medical treatment. After the seizure is over you will often feel tired, sore, very unwell, and you may have a headache. The recovery time after a seizure of this type will vary from person-to-person but can take from a couple of hours to several days.

Absence Seizures

This type of seizure most commonly affects children but it can happen at any age, so it is still important to be aware of. There are two common types of absence seizures:

• Typical absences – You will be unconscious for a few seconds, meaning you do not know what is happening around you. This can often look like daydreaming so people around you may not notice that you are actually having a seizure. You may also have some physical symptoms with this, including fluttering eyelids and slight jerking movements of your limbs. Typical absences often happen in clusters, but some people can have hundreds of absences per day.
• Atypical absences – These are very similar to typical absences however they tend to last longer. You will sometimes be able to move and respond to your surroundings when having an atypical absence seizure.

Myoclonic Seizures

Myoclonic seizures are also referred to as myoclonic jerks. They can be either generalised onset or focal onset. In these seizures you will be conscious and have muscle jerks. In myoclonic seizures you will experience sudden, short-lasting jerks in parts of your body, or all of your body. Some people refer to this feeling as an ‘electric shock’ sensation.

The jerks can vary from mild to severe in force. They are very short-lived as the seizures will only last a fraction of a second. However, many people will experience these seizures in clusters so they can seem to last a longer period of time.

Clonic Seizures

According to the NHS, these seizures are similar in presentation to a tonic-clonic seizure as they cause your body to rhythmically shake and jerk. However, your body will not go stiff at the start.

Tonic Seizures

These seizures can be generalised or focal onset, meaning they can affect both sides or just one side of the brain from the start. According to EA, if a tonic seizure starts in one side of your brain your muscles tighten in just one area of your body. However, if a tonic seizure starts in both sides of your brain your whole body will be affected.

The symptoms you will experience may include:

• All your muscles will tighten, and your body will stiffen – if standing you may fall.
• Your neck may extend, your eyes open wide and roll upwards.
• Your arms may raise up and your legs might either stretch or contract.
• You might cry out.
• You may have breathing difficulties.

These seizures usually last less than 60 seconds.

Atonic Seizures

Atonic seizures are sometimes referred to as ‘drop attacks’. These seizures carry different symptoms to tonic seizures. Instead of the muscles tightening and stiffening, with an atonic seizure usually all of your muscles will relax and go limp which can cause you to drop to the floor.

This is dangerous as you will suddenly fall, and you may gain injuries to your head or other areas of your body. Like tonic seizures, these are usually very brief and happen with no warning. There is usually little recovery time needed after an atonic seizure and you are likely to be able to get straight back up unless you have injured yourself.



Other Types of Epilepsy Seizures

There are some other types of seizures, however the above are the most common. Sometimes, if a seizure has not been witnessed or doctors can’t ascertain whereabouts it started in the brain, it will be referred to as an unknown onset seizure.

Status Epilepticus

A person diagnosed with epilepsy will usually become familiar with the types of seizures they experience and their usual recovery time, and this includes any medications they may need to take. In most cases, their seizures will last a similar length of time and stop by themselves.

Status epilepticus is the name given to a seizure that lasts a very long time, usually five minutes or more, or when a person has a series of seizures without time to recover or regain consciousness in between. This is not common, however it can happen with any type of seizure and it means that the person must seek medical attention. If status epilepticus occurs with a convulsive seizure this would warrant a medical emergency and urgent medical help must be sourced.

All epileptic seizure symptoms will be different, and it is very important to regularly discuss and review your epilepsy and the medications you are given with your medical professional.

Personal Alarms Can Help

If you have epilepsy, it may be wise to consider a personal alarm. This way, if you suffer from any of the seizures mentioned above and you’re alone, you’ll be able to press your pendant button and send an alert call to our 24/7 Response Team. For added security, our fall detector will automatically detect when you’ve fallen to the ground and sends an alert without you needing to do anything.

If you want to find out more about our service, please give our customer service team a call on 0800 999 0400. Alternatively, complete our contact us form and we will get back to you as soon as possible.

Editor’s Note: This article was updated on 18th April 2022 to reflect current information.

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