Generalised seizures

Tonic clonic seizures are what most people think of when they hear the word epilepsy. They used to be referred to as 'grand mal' seizures.

The seizure starts with the tonic phase, where the person cries out or groans as air is forced out of the lungs. The person then becomes stiff and falls to the ground unconscious.

The clonic phase follows where the person's limbs begin to jerk. After a few minutes, the jerking slows and stops.

After the seizure (usually around 1 - 3 minutes), the person may be drowsy, confused, agitated and need to sleep.

Emergency medication

Most seizures stop by themselves, but however sometimes a medical emergency does occur.

Previously called 'petit mal' seizures, a person may 'shut off', staring blankly into space usually for about 5-10 seconds and be unaware of what's happening around them.

Then they’ll snap back, so these episodes may not even be noticed.

These seizures may happen many times a day and put the person in a brief unresponsive, daydream-like state, but they are in fact not conscious.

One of the main problems with absence seizures in children is that because the person appears to be daydreaming, it may seem that they not paying attention. They may also find it hard to learn because they miss information.

Symptoms are not always clear, however some of the signs can include:

• Stare into space and not respond to anything.
• Stop talking in the middle of a sentence
• Flutter their eyelids, fidget with their hands, or walk around aimlessly.

During myoclonic seizures, a burst of electrical activity in the muscle control area of the brain cause a sudden jerk of the muscles in the arms, legs, neck or body.

Seizures often happen just after waking, or when the person is tired before going to bed. There is a very short period of loss of consciousness, but it’s not noticeable because it is so short.

Myoclonic seizures usually involve both sides of the body at the same time, and the person may fall over.

Myoclonic seizures occur in a variety of epileptic syndromes, such as juvenile myoclonic epilepsy syndrome.

Tonic seizures are more common childhood, but are considered relatively uncommon.

Patients with Lennox-Gastaut syndrome can be more susceptible to this type of seizure.

In a tonic seizure the muscles stiffen and, if standing up, the person will fall heavily to the floor, usually backwards. The muscles (including those in the chest, arms and legs) contract and the back arches, but there is no jerking.

The person is unconscious during the seizure. Once the seizure has stopped the person regains consciousness and the muscles regain their normal tone.

In atonic seizures all muscle tone is lost and the person will drop to the ground. However, they quickly becomes conscious and alert again after the seizure

Loss of consciousness is often brief and recovery is usual quick, although the person is a risk of injury, especially head and facial injuries.

Children who also have other seizure types, such as tonic or myoclonic seizures may also have atonic seizures.

Often referred to as ‘drop attacks’, or astatic seizures, this type of seizure may be hard to recognise if the child is sitting or lying down, because he will not fall. In babies, atonic seizures most often appear as a head drop.