Identifying types of seizures

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HealthWiki > Epilepsy and Seizures > Chapter 3: Types of seizures and how to identify them > Identifying types of seizures

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In this chapter:

 

In this chapter:

• Chapter 3: Types of seizures and how to identify them
• There are many types of seizures
• Identifying types of seizures
• Absence seizures
• When seizures are an emergency
• Seizures during sleep
• Seizures during childhood
• Health conditions that can cause seizures
• Seizures from alcohol and drug use
• Chemicals can cause seizures
• Seizures with psychological causes

When trying to identify the type of seizure a person has, first pay attention to what you see during their seizure, such as strong movements like the shaking or stiffening of body parts. Some seizures cause only small body movements, like the fluttering of eyelids, or happen with no movements, but only with staring or unusual feelings. These are harder to spot.

Seizure and epilepsy vocabulary

Medical words used to describe seizures are often unfamiliar and difficult to pronounce. But using them makes it easier to share information about what happens during different types of seizures and which medicines can manage them. Having a common vocabulary for seizures gives people living with epilepsy, their families, and caregivers a way to describe what is happening. This can help them get the support they need. That is why it is worth learning and using all the unfamiliar words.

I know all the new words sound strange and are hard to remember, but knowing them helps make sure everyone understands what type of seizures you have and what treatment will work best for you.

Identifying seizures by body movements

The body movements that happen during a seizure can point to where the seizure started in the brain, and whether it might be spreading to other areas in the brain.

The most commonly recognized body movement that happens during a seizure is a convulsion. Convulsions are uncontrolled, repeated, and often jerking movements. They can be alarming and are often the reason people decide to get medical help after a seizure. Describing convulsions is important because it gives useful clues to identifying seizure type and treatment that can control it.

The different convulsions and body movements a person may have during seizures have different names:

Tonic convulsions (stiffness): Muscles suddenly stiffen and become tensed and inflexible, especially the arms and legs. A person may fall.	Clonic convulsions (rhythmic jerks): Muscles, especially in arms and legs, rhythmically jerk or twitch, often on both sides of the body. Jerking movements can cause person to fall.
Myoclonic movements (rapid jerks): Sudden, rapid jerks of a muscle or a group of muscles, like a twitch of an arm, hand, or leg, or the face.	Atonic movements (loss of muscle tone): Muscles lose strength, so a person may suddenly go limp, drop their head, or fall. There is no jerking or shaking.

Not all seizures include convulsions. Some seizures may cause other body movements, or only affect a person’s alertness, awareness, and attention, causing changes in mood and behavior. It can be harder to know a seizure is happening if it does not cause convulsions.

Generalized and focal seizures

Generalized seizures affect both sides of the brain, and usually both sides of the body at the same time. Focal seizures occur in just one part of the brain and cause movements or sensations on only one side of the body. A focal seizure sometimes spreads to involve the whole brain, turning into a generalized seizure.

Both generalized and focal seizures can be caused by epilepsy or by other health conditions. Keeping track of seizure details—which parts of the body are affected and when, what kinds of movements happen, what the person feels or does before and after the seizure—can help determine what treatment will best control the seizures. Use the form in at the end of this chapter to gather seizure information and details.

Generalized seizure (Big: starts in, or spreads to, entire brain)

Types of convulsions or other movements: Tonic: sudden stiffening of muscles in the entire body Clonic: rhythmic jerking in the entire body Tonic-clonic: arm and leg muscles become stiff and jerk repeatedly Myoclonic: brief, muscle jerks in specific areas of both sides of the body Atonic: loss of muscle tone in the entire body No movement or very minor movement: see “Absence seizures” Some possible causes: Epilepsy Brain injury, tumor Recent brain surgery Stroke Tapeworm infection in brain (neurocysticercosis) Tick- or mosquito-borne brain diseases (encephalitis, malaria, others) High fever, especially in children Withdrawal from or heavy use of alcohol or other drugs Low blood sugar or low sodium

Focal seizure (Small: occurs in one part of the brain)

Types of convulsions or other movements, feelings, or sensations: Tonic: sudden stiffening in one part of the body, like an arm, leg, or face Clonic: rhythmic jerking in one area, like one arm or side of the face Myoclonic: brief, shock-like muscle jerks in one area, like a finger, hand, or part of the face Atonic: loss of muscle tone in just one part of the body Lip smacking, chewing, swallowing, or repetitive hand movements Intense feelings and emotions such as fear, anger, others Unusual sensations such as tingling, crawling, burning, “butterflies” in the stomach Unusual smells, tastes, or visuals (seeing things that aren’t there) Feeling too hot or too cold, or hot then cold Some possible causes: Epilepsy Brain injury, tumor Stroke High fever, especially in children Withdrawal from or heavy use of alcohol or other drugs Low blood sugar or low sodium Low or high blood pressure

Generalized tonic-clonic seizures

A generalized tonic-clonic seizure affects the entire brain and body. It causes loss of consciousness, falls, and noticeable convulsions. The generalized tonic-clonic seizure is often the most dramatic and most recognized type of seizure.

Generalized tonic-clonic seizures are sometimes called “grand mal” seizures, which means “big illness” in French. It’s better to call it a generalized tonic-clonic seizure because it clearly describes what happens—both sides of the brain are involved (generalized) and the seizure has both stiffening (tonic) and jerking (clonic) movements.

A seizure can be scary to see if you do not understand what is happening.

When I had my first tonic-clonic seizure, everyone around me just screamed and ran away.

This is why seizure first aid training is so important for the community!

If you are not used to seeing people lose control of their body movements, it can be disturbing to see someone have a generalized tonic-clonic seizure. Do not let that stop you from helping them to prevent injury during the seizure. For information about how to give seizure first aid, see Chapter 2.

Generalized tonic-clonic seizure (grand mal seizure)
Description: Tonic-clonic convulsions (arm and leg muscles become stiff and jerk repeatedly) Loss of consciousness, often causing a fall Tongue-biting	Saliva or bubbles coming from the mouth Passing urine or stool during the seizure Movements usually last around 2 minutes
Some possible causes: Epilepsy Traumatic head injury Stroke High fever, especially in children Tapeworm infection in brain (neurocysticercosis) Tick- or mosquito-borne brain diseases (encephalitis, malaria, others) Withdrawal from or heavy use ofalcohol or other drugs Low blood sugar or low sodium	Antiseizure medicines that may help (see Chapter 4): Carbamazepine Lacosamide * Lamotrigine Levetiracetam Phenobarbital Phenytoin Topiramate Valproic acid (not safe during pregnancy) *(This medicine is not included in Chapter 4: Medicines for epilepsy and seizures, because it is not available in many communities Where it is available, this information is useful to know)

Stages of a generalized tonic-clonic seizure

Aura (in some people)

An aura is a warning sign at the beginning of a seizure, such as a strange smell, taste, feeling, or change in vision or hearing

Loss of consciousness

Muscles contract, body stiffens

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Breathing stops briefly, skin, lips, or nail color may appear pale or bluish

10 to 30 seconds

Eyes may roll upward or to the side

Jerking physcial movements (arms, legs, sometimes jaw, torso)

Tongue biting, sometimes causing bleeding (may happen in tonic or clonic stage)

1 to 2 minutes

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Saliva dripping or foaming from the mouth

Breathing may be irregular but usually returns to normal in 1 to 2 minutes

Slow return of consciousness, some confusion or disorientation

How long this takes will be different for each person

R
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Tiredness, headache, thirst, nausea, and sore muscles

Tonic seizure
Description: Tonic convulsions (arm and leg muscles become stiff, tensed) Person may fall Movements usually last a few seconds to 1 minute Can be generalized or focal
Some possible causes: Epilepsy Traumatic head injury Stroke High fever, especially in children Tick- or mosquito-borne brain diseases (encephalitis, malaria, others) Withdrawal from or heavy use of alcohol or other drugs Electrolyte imbalances Low blood sugar or low sodium Psychological causes	Antiseizure medicines that may help (see Chapter 4): Lamotrigine Levetiracetam Phenobarbital Topiramate Valproic acid (not safe during pregnancy)
After the seizure: Confusion, tiredness, headache, and muscle soreness usually lasts for a few minutes or hours but sometimes takes longer to recover fully.

Clonic seizure
Description: Clonic convulsions (legs and arms jerk repeatedly) Movements can be on one or both sides of the body Person may fall Movements usually last 1 to 2 minutes Can be generalized or focal
Some possible causes: Epilepsy Head injury Tick- or mosquito-borne brain diseases (encephalitis, malaria, others) Withdrawal from or heavy use of alcohol or other drugs Electrolyte imbalances Low blood sugar or low sodium Psychological causes	Antiseizure medicines that may help (see Chapter 4): Lamotrigine Levetiracetam Phenobarbital Topiramate Valproic acid (not safe during pregnancy)
After the seizure: Confusion, tiredness, headache, and muscle soreness can last for a few minutes or hours but sometimes takes longer to recover fully

Myoclonic seizure
Description: Usually begin between 3 to 13 years of age, may continue into adulthood Myoclonic body movements (one or both arms suddenly and rapidly jerk), often causing the person to drop things Sometimes affects only the fingers or shoulders Each jerk typically lasts 1 to 2 seconds, episodes often happen while falling asleep or just after waking up Can be generalized or focal
Possible causes: Epilepsy, especially childhood epilepsy syndromes	Antiseizure medicines that may help (see Chapter 4): Levetiracetam Valproic acid (not safe during pregnancy)
After the seizure: Very rapid recovery

Atonic seizure
Description: Usually begins between 2 and 5 years of age, but can happen at other ages Atonic body movements (sudden loss of muscle strength), causing person to go limp, drop their head, or collapse Often called “drop attacks” because the person falls suddenly Usually lasts between 1 and 5 seconds Can be generalized or focal
Possible causes: Epilepsy, especially childhood epilepsy syndromes	Antiseizure medicines that may help (see Chapter 4): Lamotrigine Valproic acid (not safe during pregnancy)
After the seizure: Very rapid recovery, but risk of injury from sudden fall

This page was updated:19 May 2026