Types of seizures (fits)

This information is for prison staff dealing with prisoners with epilepsy. Further information on seizure types is on our website.

There are many different types of seizures, some that affect the whole brain (generalised) and some that affect part of the brain (partial).

Common generalised seizures

Tonic-clonic seizures (sometimes called grand mal)

The person loses consciousness, goes stiff and falls to the ground. Sometimes they appear to cry out. The skin (particularly around the mouth and under the finger nails) may appear blue in colour. There can be loss of bladder or bowel control. The limbs jerk as the muscles contract and relax in quick succession. The person may bite their tongue and the inside of their cheeks. Slowly they will regain consciousness, but may well be groggy or confused. Very often, the person remains sleepy and may have a headache and aching limbs.

Absence seizures (sometimes called petit mal)

During an absence seizure the person is momentarily unconscious. It may appear that they are daydreaming or switching off. However, they are totally unaware of what is happening around them and they cannot be woken up. Absence seizures are most common in childhood.

Myoclonic seizures

These are sudden jerks. They can affect the whole body, but are usually restricted to one or both arms and sometimes the head. The person is not conscious, but the seizure is so brief that the person appears to remain fully conscious.

Common partial seizures

Simple partial seizures

The person remains fully conscious, but they are unable to stop or control the seizure. Examples of symptoms are the movement of a limb; tingling; experiencing a non-existent smell or taste; going pale; sweating; or experiencing a churning feeling in the stomach. Other symptoms can be feelings of fear, panic, sadness or happiness, or experiencing deja vu.

When seizures occur in the part of the brain responsible for vision, people can see flashing or balls of light, or experience temporary absence of vision.

Complex partial

The person is only partly conscious and although it may appear that they are fully aware of what they are doing, this isn’t the case. Examples of symptoms are chewing and swallowing, fumbling with buttons, repeatedly scratching the head or searching for an object. Some people may remove items of clothing. Sometimes the seizures can involve complex body movements, apparently strange behaviour or actions of a sexual nature.

Secondary generalisation

Sometimes, a simple partial or complex partial seizure can spread to the whole brain resulting in a tonic-clonic seizure.

Epilepsy and non-epileptic attack disorder (NEAD)

Epilepsy is defined as a tendency to have seizures. Seizures can happen for many reasons. An epileptic seizure occurs when there is a surge of electrical activity in the brain.

Some people can have seizures that are like epileptic seizures, but that have not been caused by any change of brain activity. The person experiences it because they are psychologically or emotionally troubled in some way. This is known as non-epileptic attack disorder, or NEAD.

It’s very important not to confuse NEAD with seizures that are ‘put on’. In NEAD the person really has no more control over their seizures than someone with epileptic seizures.

Some people can have epileptic seizures and NEAD, so it’s important not to jump to conclusions about what’s happening.