Although all seizures are caused by abnormal electrical and chemical changes in the brain, there are different types of seizures. Children and youth with epilepsy may have one type of seizure or a combination. The specific type of seizure a person has depends on where in the brain the seizure starts, how the seizure spreads and how much/what part of the brain is involved.

Physicians categorize seizures into two main categories based on how much of the brain is affected at the start of the seizure:

1. Generalized seizures – Involve the whole brain.
2. Focal seizures – Start in one area of the brain.

Families/caregivers should consult with their child’s physician to identify the seizure type(s) as their behavior, risk of injury and treatment depend upon what kind(s) of seizures they have.

A seizure that lasts more than five minutes, or multiple seizures in a row without the person regaining consciousness between seizures is a condition referred to as status epilepticus. While most seizures are short, stop on their own, and do not cause injury to the brain, if status epilepticus is suspected, emergency treatment is needed to stop the seizure.

Generalized Seizures

Absence Seizures

Absence seizures are a type of generalized seizure that can be mistaken for daydreaming. They can also cause the child or adolescent to be unconscious and/or less responsive. These seizures usually last only a few seconds (no longer than 30 seconds). The child might stare blankly ahead, blink rapidly or their mouth/face may twitch. When the seizures are over, the child will often seem normal and may not recall what just happened. These types of seizures may occur several times a day. Note: These seizures were previously called “petit mal” seizures, but that term is no longer used.

Additional information about absence seizures can be found here.

Atonic and Tonic Seizures (also referred to as “drop” seizures)

During these seizures, the child or adolescent collapses and falls due to a loss of muscle tone (atonic) or from stiffening of the body (tonic). The child may be limp and unresponsive. Because children often fall with this type of seizure, they are risk for injuries, including head injuries. Providers may recommend that a child with this type of seizure wear a helmet during certain activities such as playing outdoors. The seizure usually lasts less than a minute, and the child will regain consciousness and awareness after the seizure ends, though they may be sleepy afterwards.

Additional information about atonic and tonic seizures can be found here.

Generalized Tonic Clonic Seizures (also referred to as convulsive seizures)

These are the most common and recognized type of generalized seizure. The child or adolescent may cry or groan and then often lose consciousness, become stiff, and begin to move arms and legs in a jerking/rhythmic movement. Their eyes may roll back, and they may have drooling or foaming at the mouth. Their skin may appear bluish if they have trouble breathing. The child may wet or soil themselves due to a loss of bladder or bowel control and may bite their tongue or inside cheek. The seizures usually last 1 to 3 minutes but can often take longer for a child to recover after the seizure has ended. Afterward, the child may be confused, irritable and will typically fall into a deep sleep. If a generalized tonic clonic seizure lasts longer than 5 minutes, immediate medical attention is needed. Note: These seizures were previously called “grand mal” seizures, but that term is no longer used.

Convulsive seizures occur in about 5 out of every 100 people at some time during childhood. It is important to note that not everyone who has a single convulsive seizure will go on to develop epilepsy.

Additional information about tonic clonic seizures can be found here.

Myoclonic Seizures

These seizures cause sudden jerking or quick movement of muscles, usually affecting the child or adolescent’s neck, shoulders and upper arms. The child is usually conscious and able to think clearly, but the seizure can occasionally be strong enough to make a child fall. These seizures are common in the morning and often occur in clusters (several times a day or several days in a row). The seizures usually last a second or two.

Additional information about myoclonic seizures can be found here.

Focal Seizures

Focal Aware Seizures (also referred to as focal onset aware seizures)

These seizures begin in one part of the brain and symptoms will vary depending on the area of the brain involved. For example, these seizures can cause uncontrolled movement of parts of the body or sensory changes such as things smelling or tasting strange to the child or adolescent. During these seizures, the child is aware and alert but unable to respond to others or have control of their body movements. These seizures usually last between a few seconds to 2 minutes. Note: These seizures were previously called “simple partial” seizures, but that term is no longer used.

Additional information about focal aware seizures can be found here.

Focal Impaired Awareness Seizures

These seizures begin in one part of the brain, and symptoms will vary depending on the area of the brain involved. During these seizures the child or adolescent may be confused, consciousness is impaired and they likely are unaware of their surroundings. The child may have unusual behaviors like making repetitive movements, mumbling, running or screaming. These seizures can occur when the child is sleeping. This type of seizure can last one or two minutes, after which the child may be frightened or confused. Note: These seizures were previously called “complex partial” seizures, but that term is no longer used.

Additional information about focal impaired awareness seizures can be found here.

Additional Resources

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Last Updated

04/12/2022

Source

American Academy of Pediatrics