In generalised seizures the epileptic activity is in both halves of your brain. The main types of generalised seizure are tonic-clonic, absence, myoclonic, tonic and atonic.
In tonic-clonic seizures, you will fall to the floor. In some other types of generalised seizure the epileptic activity misses a small part of your brain and makes your symptoms more limited. For example, in absence seizures, you don’t fall to the floor. In a myoclonic seizure, the symptoms are jerking in just a part of your body, and you rarely fall to the floor.
Tonic-clonic seizures
This is the most common and widely recognised generalised seizure. There are two phases to this type of seizure: the ‘tonic’ phase, followed by the ‘clonic’ phase.
The tonic phase
You lose consciousness and, if standing, will fall to the floor. Your body goes stiff because all your muscles contract. You may cry out because your muscles contract, forcing air out of your lungs. Your breathing patterns change, so there is less oxygen than normal in your lungs. Because of this, the blood circulating in your body is less red than usual. This causes your skin (particularly around your mouth and under your finger nails) to appear blue in colour. This is called ‘cyanosis’. You may bite your tongue and the inside of your cheeks.
The clonic phase
After the tonic phase has passed, the clonic phase of the seizure begins. Your limbs jerk now because your muscles tighten and relax in turn. You may occasionally lose control of your bladder and/or bowels. It is not possible to stop the seizure, and no attempts should be made to control your movements, as this could cause injury to your limbs.
After a tonic-clonic seizure
After a short time, your muscles relax and your body goes limp. Slowly you will regain consciousness, but may well be groggy or confused. You will gradually return to normal but may not be able to remember anything for a while. It’s usual to feel sleepy and have a headache and aching limbs. Recovery times can be different for different people. Some people will quickly want to get back to what they were doing. Some people will need a short sleep and others will need plenty of rest.
Post-ictal state
‘Post’ means after and ‘ictal’ refers to a seizure. After a tonic-clonic seizure, some people may be very confused, tired or have memory loss. This is known as a post-ictal state. A post-ictal state can last from minutes to days.
Absence seizures
During an absence seizure, you are unconscious for a few seconds. You appear to be daydreaming or switching off. You don’t know what is happening around you, and you can’t be brought out of it.
Because anybody can daydream at any time, absences can be very hard to spot. It’s possible to have hundreds of absence seizures a day, preventing you from fully taking part in daily activities. You could also miss out on tiny pieces of information or events. This may be mistaken for lack of attention or concentration.
Myoclonic seizures
The word myoclonic comes from ‘myo’ meaning muscle, and ‘clonus’ meaning jerk. So in a myoclonic seizure your muscles jerk.
Myoclonic seizures can sometimes cause your whole body to jerk. More usually, they only cause jerking in one or both arms and sometimes your head. Although it may not be obvious, during the seizure, you are unconscious for a very brief time.
Even though the seizures are brief, they can be extremely frustrating. For example, they often result in spilt drinks or similar accidents.
The most common time for myoclonic seizures to happen is first thing in the morning.
Myoclonic seizures are similar to the jerks that some people have when falling asleep. These jerks when falling asleep are not epilepsy.
Tonic seizures
In a tonic seizure all your muscles tighten. Your body stiffens and you fall over unless you are supported. Tonic seizures usually last less than 20 seconds and most often happen during sleep.
Atonic seizures (drop attacks or akinetic seizures)
In an atonic seizure you lose all muscle tone and drop heavily to the floor. The seizure is very brief and you are usually able to get up again straight away. You are not confused afterwards.
Because your body usually falls forward in an atonic seizure, you are at risk of banging your head on furniture or other hard objects. If you have frequent atonic seizures, extra safety precautions – like protective headgear – make sense. Epilepsy Action can provide further information on this.
This information has been produced under the terms of The Information Standard.
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Updated July 2011To be reviewed July 2013
Comments: read the 5 comments or add yours
Comments
I have had Tonic Clonic seizures since I was 19, but they were incredibly infrequent. I would have a seizure once every 3-4 years. I was on Lamotrogine. Since December 2010 my seizures have got worse, my seizure type is now general and not focal and the neurology department are trying to find a balance in medication to stabilise me again, with difficulty. I had to be signed off sick from work as the meds had an adverse effect. It can get you feeling very low, I'm on anti-depressants now too. It is hard to keep a smile on your face when it is such a worry for everyone, but you have to keep plodding on. One day they'll sort me out I'm sure.
I had my 1st seizure in january 2011. I was 37yrs old. I wos out shopping alone. All i remember is walking in the door, my vision blurred for a few seconds, i must have. when i came round i was at the front door being held by a security gaurd. I didnt believe them. So i left the shop and jumped into my car and drove away. I live only a few mins away. A few mins later the door went. I wasnt expecting the police to be standign there. they wanted to make sure i was ok. I still didnt believe that id had a seizure. Then a poloice van turned up to give me a breathalizer. My behaviour and dialated pupils suggested otherwise. I dont drink so i wasnt worried. It was clear.
I didnt think any more about it. Five months passed, thats when i had my next 1. I couldnt just get up and walk away. As there is no warning, i hit the concrete with such force, blunt force trauma they called it. I was rushed away by ambulance. I thought just stitch the gap together. there was nothing to stich it to, it was a gaping hole the size of a golf ball. It felt very strange as the nurse had a feel around for any fractures. Suprisingly i hadnt. So 5hrs and 15 stitches later, i was allowed home. I started taking Lamotrigine 50mg / 100mg.
Amongst those you don't seem to describe my fits that I have most of the time I completely lose consciousness but generally do not fall over though will drop things in my hand s d have beeknown to put my hand into a fire and on to a hot saucepan I pull at the front of my clothes and bite the I side of my mouth this can last upto 3 mins I wondered what this type of fit would be called I Do have others as well this is just my main one I get most regularly.
I was removed from an18 year employment due to abscences relating to epilepsy and fatigue, and depression. I have spent over 12 months job hunting, yet I cannot get any jobs. I have tried to live a normal over the past 17 years that I have been diagnosed with grand mal epilepsy. My husband and daughter are good to me, I am still scared and very confused when it happens and my memory issue is also getting worse but the job seekers department will not except the reasons for non employment. Yet employers see it as a safety issue, so employment doesn't happen. Now I am annoyed and despite meds still having fits, due to fustration, and depression.
I seem to have lots of different seizure types. I had my first fit when I was 8 years old, focal temporal lobe as I found out when I was 19 when I was finally diagnosed after having 3 tonic-clonics. I also have absences, atonic head drops, and very rarely myoclonic jerks. I have focal temporals almost daily, sometimes more than once a day, and yet my EEG came back normal. Docs are totally baffled by my condition because all my scans are normal except a tiny pineal cyst, deemed harmless.