Understanding, tracking, and identifying seizure types
Seizure types can be clues to uncovering a more specific diagnosis and can help guide treatment decisions, so it’s important to keep track of them so you can report back to your doctor.
As difficult as it can be in the moment, try to track seizures either in a notebook or by taking a video with your phone. This will help the doctor better identify the type of seizure and how to proceed with treatment.
A specific diagnosis starts with knowing and recognizing the seizure types
Absence/petit mal seizures
(ab-sans/pe-tē-mal)
- Previously known as petit mal seizures
- Causes a short period of “blanking out” or staring into space
- During the seizure, the person's eyelids may flutter
- Usually affect only a person’s awareness of what is going on at that time, with immediate recovery
Atonic seizures
(a-taa-nik)
- May be referred to as a “drop attack” or “drop seizure”
- Person has a sudden loss of muscle tone and goes limp
- Mild seizures look like a head nod or drop, while severe seizures can cause a person to fall to the ground
- People with these types of seizures may wear helmets to protect from injuries
Atypical absence seizures
(a-TIP-i-kul/ab-sans)
- Blank staring, with eye blinking, chewing movements, or lip smacking
- Could include finger or hand rubbing, or other small hand movements
- Electroencephalogram (EEG) shows a slow-spike wave pattern (SSW)
- May begin and end gradually, usually lasting for about 5 to 30 seconds
- May be difficult to distinguish between this seizure type and typical behavior in those with cognitive impairment
Clonic seizures
(klä-nik)
- Associated with repeated, rhythmic jerking movements lasting a few seconds to a minute that cannot be stopped by restraining or repositioning the arms or legs
- Hemi-clonic seizures (a type of focal seizure) occur when sustained rhythmic jerking rapidly involves one side of the body at seizure onset
- Most commonly occur in babies
- Often seen as part of a tonic-clonic seizure and may be difficult to distinguish from a myoclonic seizure; however, the jerking is more regular and sustained during a clonic seizure
- May also be associated with jerking or clonic movements that follow stiffening of muscles, as in a tonic-clonic seizure, and can last seconds to 1 to 2 minutes
Focal aware/simple partial seizures
(fō-kǝl ǝ-'wer/sim-pǝl pär-shǝl)
- Used to be called simple partial seizures
- Person is fully alert and usually able to interact
Experiences can include
- Involuntary motor movements on one side of the body
- Intense sensory or emotional episodes, such as déjà vu or feeling unexplained emotions
Focal impaired awareness/complex partial seizures
(fō-kǝl im-'perd ǝ-'wer-nǝs/käm-,pleks pär-shǝl)
- Used to be called complex partial seizures
- Person loses awareness, may not respond, and may have no memory of the seizure
Experiences vary, but can include
- Starting with a blank stare, followed by chewing/lip smacking
- Random activity like picking at the air or clothes, attempting to pick up objects, removing clothing, repeating words or phrases, etc
Generalized tonic-clonic/grand mal seizures
(jen-rǝ-,līzd tän-i(k)-'klä-nik/grän(d)-,mäl)
- Formerly known as “grand mal” seizures. This seizure type is what most people think of when they hear the word “seizure”
- Person loses consciousness or awareness, muscles extend and become rigid, and then jerk rhythmically on both sides of the body
Infantile spasms/epileptic spasms
(in-fǝn-,tī(-ǝ)l/e-pǝ-'lep-tik spa-zǝms)
- Typically occurs within first year of life, usually by 4 to 8 months
- Typically seen as a sudden stiffening of the body and brief bending forward or backward of the arms, legs, and head (can occur with limbs coming inwards towards chest, but not always)
- Face may grimace or look surprised
- Some infants arch their backs as they extend their arms and legs
- Some infants may experience head drops
- Frequently occur in clusters upon awakening or going to sleep
- May look like a startle reflex in infants
According to the Epilepsy Foundation, treating seizures early and appropriately is critical to maximizing developmental potential.
Contact your doctor right away if you think your child is having infantile spasms.
Myoclonic seizures
(MY-o-KLON-ik)
- Sudden, brief, shock-like muscle movements or jerks that usually don’t last more than a second or two
- Person is alert
- May occur in clusters and may be more pronounced upon wakening
Tonic seizures
(tän-i(k))
- Muscles in the body, arms, or legs suddenly become stiff or tense
- May happen during sleep or can cause a person to fall if standing
- Typically lasts for less than 20 seconds at a time
8 questions can help fill in the gaps
If you suspect the seizures may be a sign of something more, take a quick 8-question assessment to receive customized responses, including questions to ask your doctor or specialist.
