Symptoms of Epilepsy

Reviewed by: HU Medical Review Board | Last reviewed: November 2021

Epilepsy is a neurological, or brain, disease that causes seizures. With epilepsy, clusters of nerve cells in the brain called neurons do not work correctly. Neurons normally create tiny electrical signals in a regular rhythm. With epilepsy, neurons create too many electrical signals, too quickly. You may hear this called an electrical storm in the brain.

Seizures can impact any process your brain coordinates. This means seizures may cause many physical and mental symptoms, including:1

  • Full or partial loss of awareness
  • Muscle jerks or muscle stiffness
  • Loss of muscle tone
  • Changes in senses and emotions
  • Confusion or fear
  • Sudden stillness
  • Staring
  • Repeating movements like hand-clapping or lip-smacking

Some people have the same symptoms with every seizure. Another person may have different symptoms from one episode to the next. Symptoms may vary according to the type of seizure and what part of the brain is affected.1,2

Symptoms of generalized seizures in epilepsy

Generalized seizures are caused by abnormal electrical activity on both sides of the brain. These seizures tend to happen with no warning.2

Tonic-clonic seizure: The person having the seizure loses consciousness and often collapses. During the tonic phase, they become stiff. During the clonic phase, the muscles jerk, and the jaws may clench. These seizures can last seconds to a few minutes. The person who had the seizure may feel tired or confused afterwards. "Grand mal" is the old name for these seizures.

Absence seizure: This type of seizure involves short periods of absence. Someone having this type of seizure may lose awareness and stare for a few seconds. There are usually no other symptoms. These seizures begin and end quickly and may occur several times a day. "Petit mal" is the old name for these seizures.

Myoclonic seizure: This very quick seizure causes the body to jerk for a few seconds. The jerks may involve 1 muscle, multiple muscles, or the whole body.

Clonic seizure: This type of seizure causes rhythmic jerking of the arms and legs. The jerking may be on both sides of the body.

Tonic seizure: This type of seizure causes your muscles to suddenly get stiff. If the person is standing, they will often fall.

Akinetic or atonic seizure: This seizure causes muscles to relax or get weak, often in the arms and legs. The person usually is conscious. It may be called a drop attack because the seizure can cause you to fall, which may lead to injury.

Symptoms of focal seizures

Focal seizures are caused by abnormal activity in a specific, smaller part of the brain. The part of the brain causing the seizure is called the seizure focus.2Focal seizures with awareness: The person remains conscious but may not be able to talk or move until after the seizure. There may also be uncontrolled jerking or stiffening of muscles and strong emotions like fear, rage, or joy. Some people hear ringing, smell strange things, or feel a sense of déjà vu. This may also be called a simple partial seizure.

Focal seizure with impaired awareness: Someone having this type of seizure loses consciousness and may appear to be daydreaming, confused, or disorganized. They may also stare. Other symptoms can be similar to focal seizures with awareness. This may also be called a complex partial seizure.

Focal to bilateral seizures: This type of seizure begins on 1 side of the brain and spreads to both sides. This means the seizure can include symptoms of both generalized and focal seizures. The person may be conscious at first and then lose consciousness and have convulsions. This may be called a secondary generalization seizure.

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