Epilepsy: The Different Kinds of Seizures - from Conscious to Unconscious and In Between

After doing a lot of research on my own seizure types, I have come across many others that I was unaware of. I have two types of seizures, but there are over 30! All seizures originate in the brain. When the words "epilepsy" and "seizures" come up, most people automatically assume it means tonic clonic seizures (a "newer" term for grand mal seizures). I have had these since two days after I was born, as well as simple partial seizures which I diagnosed myself with a few years ago. There are two very broad categories of seizures: generalized and partial. There are different main categories within each and I will briefly share with you the descriptions as well as share my own experience.

Generalized Seizures

Generalized seizures affect the whole brain and many cause unconsciousness.

Absence seizures (sometimes called petit mal seizures) are oftentimes mistaken for ADHD or daydreaming. They are characterized by staring spells, eye fluttering, and/or unresponsiveness, though there are such things as atypical absence seizures in which the individual may be semi-responsive by physical movements such as head nodding. Spells can last for any amount of time; typically, they last for less than 10 seconds, though many last longer, especially the atypical kind. They occur with no warning, and individuals are usually unaware that they had one.

Myoclonic seizures are brief, usually lasting one to three seconds. During a myoclonic seizure, a muscle or group of muscles jerk. An individual can have multiple in a row without warning, and they can affect one or both sides of the body. The outlook of these varies on a person-to-person basis, and there are also syndromes classified within them, including Juvenile Myoclonic Epilepsy (JME), Lennox-Gastaut Syndrome (LGS), and Progressive Myoclonic Epilepsy.

Atonic seizures, also known as "drop attacks", are characterized by sudden loss of muscle tone in the body. They usually last less than 15 seconds. Most atonic seizures result in the individual falling and getting injured, though some atonic seizures may only affect certain parts of the body, typically the head.

Tonic seizures, on the other hand, are characterized by the stiffening of the muscles. The individual may be conscious or conscious, and these seizures usually last less than 20 seconds. It is not rare for someone standing to fall when having tonic seizures, and they are commonly witnessed in individuals who have LGS.

Clonic seizures are the opposite of tonic seizures in that the muscles jerk rapidly and in immediate succession. There is no average time span, as it can vary greatly.

Tonic-clonic seizures (also known as grand mal seizures) are very easy to recognize. They are basically the alternation between tonic seizures and clonic seizures. The individual is unconscious until the seizure ends and may seem confused and dazed afterwards. Tonic-clonic seizures may result in injury and can be life threatening, a condition called status epilepticus which may be discussed in a later post. I have this type of seizure, and I usually fall and tear up the insides of my cheeks, which takes many days to heal. A headache usually occurs after these seizures, and sleep is typically needed afterwards to help the individual recover from the intense abnormal neuron firing.

Partial Seizures

There are two types of partial seizures: simple and complex.

Simple partial seizures (sometimes referred to as simple focal seizures) affect a small portion of one hemisphere of the brain and the individual maintains consciousness. Since they can begin anywhere in the brain, the symptoms usually vary. There are four classifications of simple partial seizures: motor, sensory, autonomic, and psychic. I personally have sensory and psychic simple partial seizures. During my sensory seizures, I either smell something burning (the classic "burnt toast" reference) and/or I get a terrible metallic taste in my mouth. The type I have most often is psychic, where I get a "scared feeling". My doctor always said it seemed like an anxiety attack, but after doing some research on my own, I discovered they are really seizures. Since these do not affect my consciousness, I am able to carry on with whatever I am doing.

Complex partial seizures only affect one hemisphere of the brain but affect multiple areas, normally resulting in impaired consciousness and strange behaviors, such as lip smacking or picking at the person's clothes. Numerous behaviors can be associated with complex partial seizures, and they last approximately 2 minutes - confusion afterwards can remain for hours.

Secondary Generalized Seizures

Secondary generalized seizures combine both generalized seizures and partial seizures. They begin with a partial seizure and result in the seizure spreading throughout the whole brain, causing a generalized seizure. My seizures sometimes resemble these, as I get a partial seizure before a tonic clonic; however, sometimes I have no warning before a tonic clonic.

Conclusion

I have outlined the categories of seizures though there are many more types. There is no cure for epilepsy, but there are multiple routes of treatment that can be tried which I may discuss in a future post.