Epilepsy is a common neurological disorder that affects millions of people worldwide. Characterized primarily by seizures, epilepsy can present in a variety of ways depending on the individual and the region of the brain affected.
“It’s all about the brain,” said Jennifer DeWolfe, D.O., professor in the University of Alabama at Birmingham Department of Neurology. “Seizure manifestations are stereotyped, so the same symptoms occur with each seizure that involves that region of the brain in that person.”
Types of seizures: focal vs generalized
Understanding the types of seizures is key to recognizing and managing epilepsy. Seizures are typically classified into two main categories: focal seizures and generalized seizures.
Focal seizures involve one area of the brain. These seizures can include preserved and impaired consciousness depending on the brain region involved. A focal seizure can begin with preserved awareness and progress to impaired awareness if the seizure spreads to a brain region that affects consciousness. These seizures can be mistaken for other conditions such as migraines, narcolepsy or mental health disorders due to their subtle presentation.
Generalized seizures, unlike focal seizures, involve all areas of the brain. Generalized seizures typically involve a loss of awareness or consciousness and abnormal movements on both sides of the body.
Common epilepsy symptoms
When most people think of epilepsy, they think of intense seizures with stiff jerking movements and a noticeable loss of consciousness. These symptoms describe a type of seizure, specifically tonic-clonic seizures; but symptoms of epilepsy can present in several even more subtle ways. Seizures can affect different regions of the body depending on the area of the brain involved. There are six common seizure symptoms that can be associated with epilepsy.
- Short-Term Confusion: Seizures can disrupt the brain’s ability to process information, leading to temporary confusion during and after the event.
- Staring Spells: A person may appear to “zone out” or stare blankly, often without responding to stimuli. These episodes may or may not involve physical movement.
- Muscle Stiffness: Sudden stiffness in the arms, legs or torso can occur, sometimes causing falls. The severity and location depend on the brain region involved.
- Jerking Movements: Repetitive, uncontrolled jerking of limbs may happen on one or both sides of the body. These movements can occur whether the person is conscious or unconscious.
- Loss of Consciousness: Some seizures begin with or lead to a complete loss of awareness. The extent of consciousness loss varies based on the brain area affected.
- Psychological Symptoms: Seizures may trigger intense emotions such as fear, anxiety or a sense of déjà vu. These symptoms often occur at the onset of a seizure.
Recognizing seizure warning signs: What is an aura?
A seizure aura is often the first sign of a focal seizure. It represents seizure activity in one part of the brain before it spreads.
“People often have the misperception that the aura is not a seizure,” DeWolfe said.
An aura may be considered a warning because it can indicate that seizure activity may spread to another region of the brain.
Warning signs can include a feeling in the stomach, feelings of anxiety and fear, specific tastes or smells, visual signs such as flashing lights or colors, hallucinations, and dizziness or loss of balance. These auras are seizures in that region of the brain. The “seizure” that begins after the “aura” represents the seizure activity’s spreading to another brain region.
Seizure first aid: How to help someone having a seizure
Seizure first aid is crucial and can be performed by anyone. The primary goal is to keep the person safe. Key steps include:
- Stay calm and ensure the person is in a safe position.
- Do not restrain movements or place anything in their mouth.
- Time the seizure and call for medical help if it lasts longer than five minutes.
- After the seizure, offer reassurance and stay with the person until they are fully alert.