Understanding Epileptic Seizures

Learn about different types of epileptic seizures and how to help someone who is having one.

Neurologists have divided seizures into three major categories: focal onset seizures, generalized onset seizures and unknown onset seizures.

Medically reviewed in January 2022

According to the Centers for Disease Control and Prevention, almost 3.5 million people in the United States are diagnosed with epilepsy. A neurological disorder in which the normal pattern of neuron activity becomes disturbed, epilepsy is the term given to recurring seizures that happen less than 24 hours apart.

Symptoms can range from unusual sensations and emotions to severe convulsions or loss of consciousness. Some people with epilepsy may experience several seizures a day, while others may go months, or even years, without one. And epilepsy is not always a lifelong diagnosis—some forms are confined to certain stages of childhood. 

Types of epileptic seizures 
Neurologists have divided seizures into three major categories: focal onset seizures, generalized onset seizures and unknown onset seizures. 

Focal onset seizures are a type of seizure that occurs in just one part of the brain. Focal seizures can range from simple—in which the person remains conscious but experiences unusual feelings, sensations or emotions—to complex seizures that result in repetitious behaviors such as blinks or twitches, or even loss of consciousness. 

Generalized onset seizures are the result of abnormal neuronal activity on both sides of the brain, and can take many forms. In absence seizures, for example, the person may have twitching muscles and may appear to be staring into space. Tonic seizures cause stiffening of the muscles, generally in the back, legs and arms. Other types of generalized seizures include: 

  • Clonic seizures, characterized by repeated jerking movements on both sides of the body. 
  • Atonic seizures, a temporary loss of normal muscle tone and strength. 
  • Tonic-clonic seizures, which are a mix of symptoms including stiffening of the body and repeated jerks of limbs as well as loss of consciousness. 

A third category is unknown onset seizure. With this type, the location where the seizure begins is not known, but could be focal or general, and may be diagnosed as one or the other at a later time. 

How to help someone having an epileptic seizure 
As with any medical event, watching someone have a seizure can be a frightening experience. Fortunately, there are steps you can take to help ensure the person’s safety during a seizure. Here are some tips to follow: 

  • Note the time the seizure begins. If the seizure lasts longer than 5 minutes, you will need to call for help, but someone will need to remain with the person who is having a seizure. 
  • Do your best to keep the person from falling, by guiding them gently to the floor and making them as comfortable as possible. 
  • Place something soft and flat, like a folded blanket or shirt, underneath the person’s head, and support the head so it doesn’t hit the floor. 
  • Remove glasses (if the person is wearing glasses). 
  • If there are any obstructions in the way, such as furniture or other objects, remove them immediately. 
  • Try to position the person on their side so that any fluid or saliva can safely leave the mouth, and the tongue can fall away to the side of the mouth for a clearer airway. According to the Epilepsy Foundation, it's physically impossible for someone to swallow their tongue. 
  • Do not force anything into the person's mouth, as this could result in injuries such as broken teeth. 
  • Do not try to restrain the person, as this could result in injuries such as a dislocated shoulder. 
  • When the seizure is over, stay with the person, but make sure they have some space; being surrounded by a crowd can be embarrassing and confusing. Reassure the person that they are safe and explain to them what happened.

Treating epilepsy 
According to the National Institute of Neurological Disorders and Stroke (NINDS), with treatment, seizures can be controlled in 70 percent of patients. Treatment can include medications and surgical procedures.

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