Seizures come in two major categories. Focal seizures start in a part of the brain (and were once known as “partial seizures”) and can cause either a strange experience (unusual smell, numbness/tingling, visual hallucinations, butterflies in the stomach or a sense of déjà-vu) that is called an aura. They can also cause loss of awareness and unconscious chewing or picking movements known as automatisms. These types of seizures will sometimes progress to a generalized tonic-clonic (GTC) seizure (also called grand mal seizure) with stiffening of the arms and legs followed by rhythmic jerking, usually lasting about 1-2 minutes and often followed by sleepiness, confusion, and sometimes tongue biting or bladder incontinence. GTC seizures can also occur without an earlier focal seizure.
The second category of seizures is generalized, as these appear to start all over the brain rather than in a single location. A GTC without focal onset is considered a type of generalized seizure. Other types of generalized seizures include absence seizures which have bland staring without the automatisms seen in focal seizures, as well as myoclonic seizures (brief jerks of the arms or head), tonic seizures (whole body stiffening with arms thrown upward) and atonic seizures (whole body loss of tone causing a fall). Some of these seizures types occur with specific syndromes and have other symptoms as well. Since the seizure type frequently determines which medication is most helpful, your doctor will need a very good description of each type of spell you have as well as any precipitating factors. We will also want to know about any family history of seizures, whether you have had a severe head injury, convulsions with a high fever during early childhood, or a brain infection like meningitis or encephalitis.