Epilepsy Center

Types of seizures

There are many types of epilepsy. All types cause seizures. It can be hard to determine what type of epilepsy you have because of the numerous possible causes. Different types of seizures can occur in the same person, and the types may affect each person differently. Some specific types of seizures are:

• Generalized seizure: These seizures appear to start in the whole brain at once on EEG (electroencephalograpy—brain wave recording). They are manifested by immediate loss of consciousness and usually jerking convulsions of the arms and legs.
• Partial complex seizure: People with this seizure type may or may not experience a warning, then lose contact, stare, and may have automatic movements of hands with swallowing and lip-smacking. People will not usually remember what they did during the seizure.
• Simple partial seizure: Seizures of this type may start with jerking of a limb or the face, but it may end with a generalized convulsive seizure with loss of consciousness.
• Drop attacks: A very disabling seizure type in which people with no warning fall to the ground, often violently and frequently injuring themselves. This seizure is usually a generalized seizure type.

Types of epilepsy

Just as there are many different kinds of seizures, there are many different kinds of epilepsy. Doctors have identified hundreds of different epilepsy syndromes — disorders characterized by a specific set of symptoms that include epilepsy. Some of these syndromes appear to be hereditary. For other syndromes, the cause is unknown. Epilepsy syndromes are frequently described by their symptoms or by where in the brain they originate. The professionals within the UofL Physicians – Epilepsy Center discuss the implications of the type of epilepsy with their patients to assist them in understanding the full range of symptoms, the possible treatments and the prognosis.

Absence epilepsy

People with absence epilepsy have repeated seizures that cause momentary lapses of consciousness. These seizures almost always begin in childhood or adolescence, and they tend to run in families, suggesting that they may be at least partially due to a defective gene or genes. Some people with absence seizures have purposeless movements during their seizures, such as a jerking arm or rapidly blinking eyes. Others have no noticeable symptoms except for brief times when they are “out of it.” Immediately after a seizure, the person can resume whatever he or she was doing. However, these seizures may occur so frequently that the person cannot concentrate in school or other situations. Childhood absence epilepsy usually stops when the child reaches puberty. Absence seizures usually have no lasting effect on intelligence or other brain functions.

Benign focal childhood epilepsy

Benign focal childhood epilepsy causes muscles all over the body to stiffen and jerk. These seizures usually occur at night. Typically this epilepsy syndrome is well controlled with medicine and most children will grow out of this epilepsy.

Childhood and juvenile absence epilepsy

Childhood and juvenile absence epilepsy causes staring into space, eye fluttering and slight muscle jerks.

Infantile spasms (West syndrome)

Infantile spasms (West syndrome) causes muscle spasms that affect a child’s head, torso and limbs. Infantile spasms usually begin before the age of six months.

Juvenile myoclonic epilepsy

Juvenile myoclonic epilepsy causes jerking in the shoulders or arms.

Lennox-Gastaut syndrome

Lennox-Gastaut syndrome causes frequent and several different types of seizures to occur. This syndrome can lead to falls due to drop attacks during a seizure, which can cause an injury.

Temporal lobe epilepsy

Temporal lobe epilepsy, or TLE, is the most common epilepsy syndrome with focal, also known as partial, seizures. These seizures are often associated with auras, a feeling or other type of warning when a seizure is coming. TLE often begins in childhood. Research has shown that repeated temporal lobe seizures can cause a brain structure called the hippocampus to shrink over time. The hippocampus is important for memory and learning. While it may take years of temporal lobe seizures for measurable hippocampal damage to occur, this finding underlines the need to treat TLE early and as effectively as possible.

Neocortical epilepsy

Neocortical epilepsy is characterized by seizures that originate from the brain’s cortex, or outer layer. The seizures can be either focal or generalized. They may include strange sensations, visual hallucinations, emotional changes, muscle spasms, convulsions and a variety of other symptoms, depending on where in the brain the seizures originate.

Other types of epilepsy

There are many other types of epilepsy, each with its own characteristic set of symptoms. Many of these begin in childhood, including Lennox-Gastaut syndrome and Rasmussen’s encephalitis. Children with Lennox-Gastaut syndrome have severe epilepsy with several different types of seizures, including atonic seizures, which cause sudden falls and are also called drop attacks. This severe form of epilepsy can be very difficult to treat effectively. UofL Physicians – Epilepsy Center physicians will consult with each patient and their family to outline a treatment plan based on their individualized goals.

Some epilepsy syndromes are easily treated, do not seem to impair cognitive functions or development and usually stop spontaneously. Some epilepsies like this include benign infantile encephalopathy and benign neonatal convulsions. Other syndromes, such as early myoclonic encephalopathy, have neurological and developmental problems. However, these problems may be caused by underlying neurodegenerative processes rather than by seizures. Epilepsy syndromes in which the seizures and/or the person’s cognitive abilities get worse over time are called progressive epilepsy.

UofL Physicians - Epilepsy Center offers both consultations and ongoing care management to patients with seizure disorders. Our physicians are professors and researchers with the University of Louisville School of Medicine and are at the forefront of new technology and treatment options.