Seizures: Types in Children and Adults

And Why They Can Happen in People With No History of Seizures

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A seizure is an episode of disrupted or erratic electrical activity among the nerves in the brain. It can involve altered awareness and uncontrolled movement of the body. There are several different types of seizures. Sometimes a seizure is called a convulsion.

If you have epilepsy, this means that you are prone to having seizures. Sometimes a seizure can occur due to certain changes in the body, even when a person doesn’t have epilepsy.

This article describes the causes, types, and treatments of seizures that occur as part of epilepsy or without an underlying epilepsy condition.

An illustration with information about what is a seizure

Illustration by Zoe Hansen for Verywell Health

Seizures in Those With Prior History

If you have had seizures in the past, you may have been diagnosed with epilepsy. Typically, epilepsy can be controlled with medication or interventional therapies. Epilepsy treatment can reduce the frequency and severity of seizures, but it is usually not curable.

Epilepsy can occur due to structural or microscopic changes in the cerebral cortex (a part of the brain) that cause an instability of nerve activity in the brain.

Epilepsy that begins during infancy or childhood is usually due to developmental variations of the brain, metabolic disorders (inability to break down certain chemicals in the body), or neurodevelopmental syndromes (such as autism or cerebral palsy). Epilepsy that begins during adulthood usually occurs due to head trauma, stroke, or an infection of the brain.

Epilepsy

Seizures in Those Without Prior History 

A seizure could be the first sign of epilepsy. However, some health conditions can cause a seizure, even in the absence of epilepsy. Generally, when a seizure is not associated with epilepsy, seizures will not occur again once the underlying cause is treated.

Causes of non-epileptic seizures include:

  • Meningitis: Infection of the tissue surrounding the brain
  • Encephalitis: Infection of the brain tissue
  • Electrolyte abnormalities in the blood: Especially sodium, potassium, or calcium
  • A brain hemorrhage: Bleeding in the brain
  • Vascular abnormalities: Brain aneurysm (outpouching of a blood vessel) or arteriovenous malformation (an abnormal connection between arteries and veins in the brain)
  • A stroke: Brain damage due to interrupted blood flow to a small region of the brain
  • Concussion: A consequence of head trauma
  • Head trauma: Can cause bleeding, concussion, or permanent brain damage
  • Alcohol or drugs: Intoxication or withdrawal
  • Diabetic crisis: Causes severe electrolyte imbalances

Some of these conditions, such as a stroke, might lead to epilepsy if they cause permanent damage to the brain. Other conditions, such as electrolyte abnormalities, might not cause recurrent seizures if the underlying cause is promptly treated.

It can be difficult to predict whether certain conditions that cause a first-time seizure will lead to epilepsy. For example, meningitis may lead to epilepsy, but it doesn’t always do so. 

Certain factors increase the risk of recurrent seizures. These include having additional seizures a short time after the first, structural changes seen on brain imaging, electroencephalogram (EEG) changes, or an altered neurological examination. Your neurologist will prescribe antiepileptic medication based on your likelihood of experiencing another seizure.

Seizures vs. Epilepsy

A seizure is an individual event, and epilepsy is a medical condition that causes a person to have a predisposition to recurrent seizures. There are many causes of seizures. Epilepsy is the most common cause of seizures, but not every seizure is associated with epilepsy.

Seizure Types and Location in Brain

One of the major distinctions between different seizure types is where they begin in the brain. This is because the treatment options for seizures that begin on both sides of the brain are a little different than the treatment options for seizures that begin on one side of the brain.

Seizures that begin in one area of the brain are described as focal onset, while seizures that begin on both sides of the brain are described as generalized onset. Sometimes focal onset seizures can spread and become generalized seizures. This is described as focal onset with secondary generalization. 

Focal Seizures 

Focal seizures begin in one area of the brain. This can be identified with an EEG study, and sometimes they may be identified with the help of brain imaging or with observation of the initial seizure symptoms. 

Common areas for a focal seizure to begin include:

  • Temporal lobe: May cause initial symptoms such as déjà vu, unusual smells, or a sense that a seizure is about to begin
  • Frontal lobe: May cause involuntary movements of one arm or one leg
  • Parietal lobe: May cause paresthesia (unusual sensations) on one side of the body

Generalized Seizures

Generalized onset seizures begin on both sides of the brain and are known for causing loss of awareness and loss of consciousness.

The common types of generalized onset seizures are:

  • Absence seizures: These are more common during childhood. They cause loss of consciousness, which looks like “spacing out” rather than an obvious loss of consciousness. Many times, children who have absence seizures appear to be daydreaming.
  • Generalized tonic-clonic seizures: This type of seizure causes involuntary rapid movement of the whole body, with loss of consciousness.

Four Effects of Generalized Seizures

Descriptions of generalized seizures include:

  • Tonic: Stiffened muscles
  • Atonic: Relaxed muscles
  • Myoclonic: Short jerks seen in parts of the body
  • Clonic: Shaking or jerking for a period of time in parts of the body

Secondarily Generalized Seizures 

Often, focal seizures may progress to involve both sides of the brain, and the symptoms can appear as a generalized tonic-clonic seizure rather than a focal seizure. This is because the generalization is often very quick and occurs before any symptoms of a focal seizure can be observed.

Status Epilepticus 

A seizure that continues for several minutes at a time without stopping is described as status epilepticus. This is a dangerous type of seizure that can cause brain damage, in addition to the brain damage that has caused the seizure. 

Certain situations may increase the risk of status epilepticus. These include medication-resistant epilepsy, metabolic problems, severe infections, illness, and organ failure. Status epilepticus is a medical emergency that requires prompt treatment with intravenous (IV) antiepileptic drugs to stop the seizure as it is happening.

Common Types of Seizures in Children

Childhood seizures include:

  • Infantile spasms cause sudden and brief jerking of the body.
  • Febrile seizures occur with high fevers.
  • Absence seizures cause staring spells.
  • Epilepsy syndromes begin during childhood and are associated with developmental delay, multiple seizure types, and medication-resistant epilepsy.

Recognizing Symptoms of Seizures in Others 

Recognizing seizures can be difficult if you have not seen them before, or if you don’t know that someone has epilepsy.

Common symptoms include:

  • A lack of responsiveness when someone appears to be awake
  • Rapid shaking or jerking of the arms or legs
  • Twitching of the face
  • Unusual noises that seem to be involuntary (not on purpose)
  • Falling to the ground

Any of the symptoms above can indicate a seizure. However, there are other medical issues that may cause similar symptoms.

If you witnessed someone having episodes that could be a seizure, it’s important to call for medical help. The healthcare team will work quickly to rule out other possible health problems, such as a stroke, heart attack, vertigo, tics, or a psychiatric disorder. This can involve a physical examination, checking vital signs, and diagnostic testing.

Signs of a Stroke

A seizure and a stroke can cause sudden, distressing symptoms. These medical conditions are not the same, and the treatment for a seizure differs from the treatment for a stroke.

Signs of a stroke include:

  • Weakness or sensory changes on one side of the face or body
  • Difficulty communicating or understanding speech
  • Confusion
  • Vision changes

Keep in mind that you do not need to know the difference between a seizure and a stroke. If you or someone else is having any symptoms that could be a stroke or a seizure, seek emergency medical attention. The healthcare team will be able to identify the difference and initiate proper treatment.

Treatment for Seizures

Seizures can be treated with medication. They may also be treated with epilepsy surgery or a special diet. Additionally, lifestyle adjustments may help reduce the frequency of seizures for people who have epilepsy. Most of the time, medical intervention can reduce the frequency and severity of seizures.

The medications that are used to treat seizures are short-acting. Additionally, long-acting, antiepileptic drugs (AEDs) can prevent seizures from occurring when people have epilepsy.

Seizure treatments include:

  • Rescue medications to stop ongoing seizures: Ativan (lorazepam) and Valium (diazepam) are among the fast-acting AEDs that can help stop a seizure as it’s happening. These treatments are often used for managing status epilepticus.
  • Seizure prevention: Medications such as Keppra (levetiracetam), Trileptal (oxcarbazepine), and Zarontin (ethosuximide) have indications for certain seizure types. Generally, monotherapy (one AED) is effective, but some people need to take more than one AED to achieve seizure control.
  • Epilepsy surgery: There are several different procedures. These techniques are most often used to treat focal onset seizures that secondarily generalize.
  • Ketogenic diet: This high-fat, very low-carbohydrate diet is sometimes recommended for treating medication-resistant epilepsy, especially for children who have epilepsy syndromes.

Managing Repeat, Future Seizures

If you or your child is diagnosed with epilepsy, this is a predisposition to recurrent seizures. While living with epilepsy can be challenging, the condition can be managed with medication and lifestyle adjustments. Sometimes other interventions, such as epilepsy surgery, may be necessary.

In addition to managing seizures with treatment, you also need to understand how to stay safe in case you have a seizure.

After a seizure, it’s important that you get some rest and stay in a safe place. You may need to talk to your family or roommates so they will know what to do in case you have a seizure.

Issues to consider:

  • Driving: Have an honest discussion with your neurologist so that you can determine whether it is safe for you to drive. If you are not permitted to drive, work with a social worker to determine what types of services you can obtain so that you can get around.
  • School: If you or your child is a student, you may need special accommodations due to your epilepsy. This can include things like taking summer school if coursework is not completed during the school year or getting extensions after the school year is over to finish the learning process after experiencing a setback due to seizures.
  • Work: Many jobs are not suited for people with epilepsy. This may include jobs that involve driving, operating heavy machinery, climbing ladders, or using dangerous or sharp objects. Additionally, you may need to discuss how to avoid seizure triggers and how to handle potential absences from work if you experience a seizure.

Summary 

Seizures are events that may involve involuntary movement or loss of consciousness, or both. The most common reason for seizures is epilepsy. However, sometimes a seizure can occur due to other circumstances, such as head trauma, drug overdose or withdrawal, or as a side effect of certain medications.

There are several different types of epilepsy-associated seizures that correspond to seizure activity beginning in different parts of the brain. If you or someone else has a seizure, it’s important to get medical attention.

People who are diagnosed with epilepsy might not need to get medical attention every time they have a seizure. But it’s important for anyone with epilepsy to be under the care of a neurologist, who will prescribe medication, as well as instructions for how to prevent a seizure and what to do in case a seizure occurs.

11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Heidi Moawad, MD
Heidi Moawad is a neurologist and expert in the field of brain health and neurological disorders. Dr. Moawad regularly writes and edits health and career content for medical books and publications.