15.1.1  Types of seizure

Grand-mal seizures

Grand-mal seizures (also called ‘tonic-clonic’ seizures) are the most common type of generalised seizure. Generalised seizures affect all or most of the brain. The person will lose consciousness and won’t remember what happened. During the tonic phase of an epileptic attack, the person may lose consciousness, have stiff muscles, which can make them lose their balance and fall to the ground, cry out, or bite their tongue or cheek. During the clonic phase they may have jerking muscles, lose bladder or bowel control, or become very pale. Tonic seizures are often followed by clonic seizures; however, people may also have either the topic or the clonic phase alone. The epileptic attack (also called the ictal phase) is usually preceded by a phase in which the person feels unhappy and fearful, and may experience unusual sensory events, such as the perception of a strange light, or an unpleasant smell. This period just before the attack is also called the pre-ictal phase. After the attacke (the post-ictal phase) the person often feels drowsy and confused and may have a headache.

Petit-mal seizures

Petit-mal seizures (also called ‘absence’ seizures) happen mainly in childhood. This kind of seizure doesn't involve falling down or having involuntary jerking movements. Instead, the person may lose awareness, look blank and their eyelids might flutter. They may look as if they’re daydreaming. Common between the ages of five and nine years, petit-mal seizures may disappear in adolescence, giving way to grand-mal seizures.

Partial seizures

Partial seizures are seizures that only affect a part of the brain. People with a partial seizure may not lose their consciousness. But these partial seizures may be a precursor to a larger seizure, resulting in a generalised seizure, such as the grand-mal seizure described above.

15.1.2  Features of seizures