Epilepsy

The main symptom of epilepsy is recurrent seizures – these are often unpredictable and episodic, which means that they come and go. However, many people find it helpful to keep track of what happens before each seizure to help them build up a better understanding of any warning signs that are typical for them.

Most people with epilepsy have seizures that last for a short time (less than five minutes) and stop by themselves. But sometimes, a seizure can last longer than five minutes, or multiple seizures can happen with no recovery time in between. This is known as ‘status epilepticus’ and emergency assistance and/or medication may be required to end the seizure as quickly as possible. Make sure you call an ambulance if someone has a seizure that lasts longer than 5 minutes.

Seizures are categorised into focal, which start in one side of the brain, and generalised, which involve both sides of the brain from the start.

Focal seizures

Focal seizures are generally brief, lasting less than two minutes.

• Focal aware seizures– during these seizures, the person will not lose consciousness and will be aware that something is happening. Symptoms differ depending on the area of the brain that is affected. They can include a feeling of numbness or tingling, visual disturbances (such as flashing lights) and getting an unusual taste or smell.
• Focal impaired awareness seizures– these seizures affect a larger part of one side of the brain than focal aware seizures, so during these seizures your awareness or consciousness is affected. Your body tends to make involuntary movements, such as lip smacking, arm waving and making random noises.

Generalised seizures

• Tonic-clonic seizures– these are the seizures that are typically associated with epilepsy. They have two phases, typically lasting for just a few minutes in total. The first is the ‘tonic’ phase, when you lose consciousness, go stiff and fall to the floor. In the second (‘clonic’) stage, the limbs will jerk repeatedly, and breathing may be affected, which can cause a blue tinge around the mouth. Sometimes you may bite your tongue or lose control of your bladder and bowels.
• Absence seizures– this type of seizure usually lasts for up to 15 seconds and mainly affects children. It is where you lose awareness of your surroundings for a short time. Symptoms include fluttering eyelids, slight jerks in the body and staring into space as if in a daydream.
• Myoclonic seizures– these seizures are very short, lasting only for a fraction of a second, so consciousness is not generally affected. They cause sudden jerks or twitches that can affect some or all of your body. Myoclonic seizures can be mild or more forceful, like an electric shock.
• Tonic seizures– these usually occur while asleep and involve most of the brain. Depending on where in the brain the seizure starts, the muscles in one area of your body or in your entire body will tighten, making your body go stiff. If it happens when you are standing up, you might fall to the floor. These are short and generally last for less than 20 seconds.
• Atonic seizures– these only last for a few seconds, but they have a strong effect as they cause all the muscles to go limp. This can cause you to fall to the floor, or your head to drop forwards.
• Clonic seizures – these typically only last a few minutes and may cause a loss of consciousness. They cause repeated, jerking body movement.

Focal aware seizures are sometimes called ‘auras’ and are often seen as a warning that another type of seizure is going to happen. These can involve a feeling of déjà vu (feeling like you’ve been here before), suddenly feeling intense fear or joy, tingling in the arms and legs, stiffness or twitching in the body, unusual tastes or smells and a ‘rising’ sensation in the tummy.