PulseGuard™ Handy Guide to Seizure Types and Terminology

Epilepsy is one of the most complex medical conditions in the world. This makes it difficult for even healthcare professionals to understand, let alone patients and families living with the condition daily.

Just when you think you are starting to understand your condition, you are often thrown a curveball and your seizure type or pattern changes. or a medication you have been successfully using for years stops working.

Epilepsy is difficult to predict, and you often find yourself second guessing when a seizure may strike.

Often when you are ill, overtired, stressed or have a sudden change to your everyday routine, seizures can become more frequent.

But you also have those seizures that can happen without warning and with no rhyme or reason behind them, leaving you pondering if anything has changed lately that may have triggered them.

The fact is that there are so many varying types of epilepsy from genetic conditions you are born with, to a brain illness or injury that causes a sudden onset of epilepsy at any point in your life. This can make it difficult for some people to understand their epilepsy and what types of seizures they may have.

What makes it even harder is the fact that over the years some terminology has changed that describes seizures, so you may hear different words to describe your specific seizure type and not understand the meanings, or if in fact they are describing the same type of seizure just with using different words.

As with everything, knowledge is the key and the more you understand about epilepsy, the better informed you can be to choose the right help and support for you and your family and tap into services and products available, to help you live your life to the full.

I have tried to break down the language barrier with this handy guide to seizure types and terminology so that you can understand epilepsy a little bit better.

Seizure Terminology  and Associated Symptoms                      

Fit/Fitting
Although no longer deemed as politically Correct
as the word “fit” can also be used to describe a
person having a tantrum.
This terminology is still widely used by healthcare
professionals as well as patients and family members
to describe any type of seizure occurring.
I.e. you may be asked –
“how long have they been fitting for”
rather than “how long have they been seizing”
if you were to call a GP or ambulance.

Generalised
Seizures

When you hear the term generalised it means that
the onset of the seizure has been produced by the
entire brain.
It can also be referred to as Global or Globalised
seizures.
These are broken down into seizure types –
Tonic Clonic/Tonic/Absence/Myoclonic
and are usually the most severe seizures
you can suffer from.

Partial seizures
(Focal)

This is where the seizure has started in one specific
part of the brain.
It may also be referred to as a localised seizure or
focal seizure.
These seizures are usually less severe than
generalised seizures but can sometimes start as a
partial seizure and then go into a generalised seizure.
These seizure types are –
simple motor/focal motor/simple sensory/
simple psychological/complex partial/
partial seizure with secondary generalization/
focal impaired awareness/focal partial

Generalised Seizures (produced by entire brain)

Tonic Clonic
(Formerly Grand Mal)

Causes the patient to become unconscious
(unresponsive) convulsions (body shaking)
muscle rigidity

Tonic
(Formerly Petit Mal)

Also commonly referred to as silent seizures.
Can make no movement or sound but just have
muscle stiffness and rigidity

Myoclonic
Sporadic isolated muscle jerking
of either full body or one limb

Atonic
(Drop Attack)

Also known as drop seizures.
Patient suffers a sudden loss of muscle tone
and collapses without warning –
most common for causing injuries during seizure

Clonic
Repetitive jerking movements of the whole body

Absence
Patient goes completely vacant.
Can last a few seconds or several minutes

Partial (Focal) Seizures – (Produced by a small area of the brain, awareness is retained)

Simple Motor
(Simple Focal Motor)

Jerking, muscle rigidity, spasms, head turning

Simple Sensory
(Aura)

Unusual sensations affecting either vision,
hearing, smell taste or touch.
This can also be known as an aura that can be
a tell-tale warning sign for many that you are
about to have a bigger seizure.

Simple Psychological
Memory or emotional disturbances

Complex Partial
(Focal impaired awareness)

Lip smacking, chewing, fidgeting, walking or
other involuntary but coordinated movements

(Focal) Partial Seizure
with Secondary Generalisation

Symptoms can present as any of the above seizures,
but then develop into unconsciousness and a
generalised seizure, which affects the whole of the brain.
This is called secondary generalisation

Other Seizures of Seizures and Terms Associated to Epilepsy

Cluster Seizures          
This is where a patient can have multiple seizures
over a short space of time.
Usually the patient will only stop one seizure for a
few seconds or minutes before the next seizure occurs.

Nocturnal Seizures
This is when a patient only has seizures when they are asleep.
Usually Tonic or Tonic Clonic Seizures.
These seizures are deemed as more dangerous as patients are
more likely to be alone at onset of seizure as family and carers
sleep, which can mean they miss seizures and are unable to
administer emergency medication which can lead to seizure complications placing them at a greater risk to SUDEP.

Status Epilepticus
This is when the seizure activity in the brain
becomes uncontrolled causing a patient to have
one prolonged seizure or a cluster of seizures
that have not been stopped with emergency
medication administered by family or paramedics.
The patient must be treated in hospital with stronger
anti-epileptic drugs and sometimes sedation and
life support to help prevent brain damage whilst
trying to stop the prolonged seizure activity in the brain.

Breakthrough Seizures
This is when a patient has experienced a period of time
with either a significant reduction or a complete break
from seizure activity then suddenly experiences a seizure
(or seizures).
These can be due to several factors, including – a growth spurt
or hormonal changes, medication changes or current medication
becoming less effective as the body becomes used to the
dosage or the medication itself.
Diet/lifestyle or environment changes.

Febrile Convulsions
Usually associated with illness or high temperature in children from birth usually up to the age of 5.
These seizures are non-epileptic seizures but present the same as a Tonic Clonic or Tonic Seizure. They can be stopped with anti-epileptic emergency medication.

NEAD Seizures
(Non Epileptic Activity Disorder)

These seizures can present the same as any type of epileptic seizure but are not caused by electrical activity in the brain.
They are commonly linked to mental health disorders and although they cannot be controlled with anti-epileptic medication, they can sometimes be controlled with anti-depressants or mood stabilisers alongside therapy.
They are known by various different names such as – dissociative seizures/psychogenic non-epileptic seizures (PNES) and unfortunately are sometimes referred to as pseudo seizures.

Psuedo Seizures
Refers to when someone pretends to have any type of seizure.
Sometimes this is done to obtain seizure medication for addicts or if a patient is suffering from mental health issues or wants attention.

Controlled Epilepsy
This is where a patient has been able to find the right medications or treatments such as a VNS (vagal nerve stimulator) or brain surgery to stop having frequent seizures.
Patients can sometimes go years without a seizure which can then enable them to drive and carry out normal everyday jobs and activities.

Uncontrolled Epilepsy
This is where unfortunately no combination of medication or treatments have been able to stop frequent seizures. Patients can have seizures daily sometimes multiple seizures which can affect their everyday activities.

SUDEP
(Sudden Unexpected Death in Epilepsy)

This is a fatal complication of epilepsy.
SUDEP is still a big unknown in the epilepsy world as no one knows what truly causes it or if it can be prevented.
It usually occurs during a seizure when the body shuts down its internal organs one by one and the patient is unable to be stabilised or resuscitated

Author – Kate Farmer Senior Clinical Advisor for PulseGuard™ International Ltd

Author Info

Kate Farmer

Senior Clinical Advisor for PulseGuard International Ltd. I have 15 years experience working frontline A&E in the UK NHS Ambulance Service. I have gone on to train and research extensively around epilepsy, to provide the most up to date information, clinical advice and support to PulseGuard customers and followers as well as living first hand with the personal effects of Dravet Syndrome within my family

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