NeuroCare Brain & Spine Center
Common types of epilepsy
If you have more than one event called a seizure without a separate treatable cause, then you have epilepsy. Many times seizures are solitary and either are treated briefly or not at all. Many illnesses or medicines can cause seizures and the treatment is to eliminate the cause. There are also non-epileptic events caused by emotional distress.
Seizures and possibly epilepsy are initially based on the description of what happened. Seizures come in many types and the things that happen during them can vary. The most commonly thought of seizure comes with many names that have been used in the past. Grand mal, convulsion or fit have all been used for what we currently call a tonic-clonic seizure. The words tonic (meaning stiffness) and clonic (meaning shaking) describe the way these seizures appear.
There is often an initial tightness that is seen with eyes that roll upward and a yell produced by the breathing muscle tightening and pushing air outward. Often, this yell is very disturbing to observers who assume it is pain-related, which it is not.
A tonic-clonic seizure begins as slight, rhythmic shaking; towards the end, the shaking is slower and harder. When the tonic-clonic seizure ends, there is a relaxation of the muscles. This can produce a funny breathing sound, loss of urine or bowel control and a general limpness for minutes (that seem like hours).
Fortunately, tonic-clonic seizures are uncommon and most respond to treatment. They can occur with other conditions besides epilepsy, such as high fever in children (febrile seizures), with alcohol (either when drinking a lot or immediately after stopping), in low and high blood sugar, with drugs like cocaine, or with low blood pressure (syncope).
The most common seizure type in children is "absence." This seizure was historically part of what was called petit mal. It generally lasts 2-15 seconds and consists of a motionless stare with immediate recovery of awareness. Absence is seen in the school setting with a sudden decline in schoolwork and can be occurring hundreds of times daily. Absence is generally easy to induce with over-breathing and occurs in intellectually normal children. Childhood absence was considered "petite mal" or "a little bad" to French neurologists, as it generally goes away in the teens and doesn't permanently compromise the child's health.
Partial seizures are common in children and the most common seizure in adults. Partial seizures are varied in their appearance because they represent the area of the brain they come from. The idea is that the seizure begins in a specific area and the function of that area is seen in the seizure. The simple partial seizure is the smallest version of this concept, beginning with a wide variety of symptoms. The seizure may start with jerking, tingling, indescribable feelings, stomach sensations, fear, unpleasant odors, visual images or sounds that begin and end quickly.
Sometimes these warn of the onset of a lapse of awareness called a complex partial seizure. Loss of memory and staring are common, but many automatic behaviors can occur that make it appear that the person is aware of what is going on when he or she is not. These seizures can be missed and sometimes are only apparent after a tonic-clonic has followed one. Partial seizures vary depending on the extent of brain included with the seizure but have a starting point that can often be located.
Many other seizure types, such as myoclonic, atonic and tonic also occur in combination with those types already mentioned.