Seizures can take on many different forms, and seizures affect different people in different ways. Anything that the brain does normally can also occur during a seizure when the brain is activated by seizure discharges. Some people call this activity “electrical storms” in the brain.

Seizures have a beginning, middle, and end. Not all parts of a seizure may be visible or easy to separate from each other. Every person with seizures will not have every stage or symptom described below. The symptoms during a seizure usually are stereotypic (occur the same way or similar each time), episodic (come and go) and may be unpredictable.

Beginning:

Some people are aware of the beginning of a seizure, possibly as much as hours or days before it happens. On the other hand, some people may not be aware of the beginning and therefore have no warning.

Prodrome:

Some people may experience feelings, sensations or changes in behavior hours or days before a seizure. These feelings are generally not part of the seizure, but may warn a person that a seizure may come. Not everyone has these signs, but if they do, the signs can help a person change their activity, make sure to take their medication, use a rescue treatment and take steps to prevent injury.

Aura:

An aura or warning is the first symptom of a seizure and is considered part of the seizure. Often the aura is an indescribable feeling. Other times it’s easy to recognize and may be a change in feeling, sensation, thought, or behavior that is similar each time a seizure occurs.

  • The aura can also occur alone and may be called a simple partial seizure or partial seizure without change in awareness.
  • An aura can occur before a change in awareness or consciousness.
  • Yet, many people have no aura or warning; the seizure starts with a loss of consciousness or awareness.

Common symptoms before a seizure:

Awareness, Sensory, Emotional or Thought Changes:

  • Déjà vu (a feeling of being there before but never have)
  • Jamais vu (a feeling that something is very familiar but it isn’t)
  • Smells
  • Sounds
  • Tastes
  • Visual loss or blurring
  • “Strange” feelings
  • Fear/panic (often negative or scary feelings)
  • Pleasant feelings
  • Racing thoughts

Physical Changes:

  • Dizzy or lightheaded
  • Headache
  • Nausea or other stomach feelings (often a rising feeling from the stomach to the throat)
  • Numbness or tingling in part of the body

Middle:

The middle of a seizure is often called the ictal phase. It’s the period of time from the first symptoms (including an aura) to the end of the seizure activity, This correlates with the electrical seizure activity in the brain. Sometimes the visible symptoms last longer than the seizure activity on an EEG. This is because some of the visible symptoms may be aftereffects of a seizure or not related to seizure activity at all.

Common symptoms during a seizure.

Awareness, Sensory, Emotional or Thought Changes:

  • Loss of awareness (often called “black out”)
  • Confused, feeling spacey
  • Periods of forgetfulness or memory lapses
  • Distracted, daydreaming
  • Loss of consciousness, unconscious, or “pass out”
  • Unable to hear
  • Sounds may be strange or different
  • Unusual smells (often bad smells like burning rubber)
  • Unusual tastes
  • Loss of vision or unable to see
  • Blurry vision
  • Flashing lights
  • Formed visual hallucinations (objects or things are seen that aren’t really there)
  • Numbness, tingling, or electric shock like feeling in body, arm or leg
  • Out of body sensations
  • Feeling detached
  • Déjà vu (feeling of being there before but never have)
  • Jamais vu (feeling that something is very familiar but it isn’t)
  • Body parts feels or looks different
  • Feeling of panic, fear, impending doom (intense feeling that something bad is going to happen)
  • Pleasant feelings

Physical Changes:

  • Difficulty talking (may stop talking, make nonsense or garbled sounds, keep talking or speech may not make sense)
  • Unable to swallow, drooling
  • Repeated blinking of eyes, eyes may move to one side or look upward, or staring
  • Lack of movement or muscle tone (unable to move, loss of tone in neck and head may drop forward, loss of muscle tone in body and person may slump or fall forward)
  • Tremors, twitching or jerking movements (may occur on one or both sides of face, arms, legs or whole body; may start in one area then spread to other areas or stay in one place)
  • Rigid or tense muscles (part of the body or whole body may feel very tight or tense and if standing, may fall “like a tree trunk”)
  • Repeated non-purposeful movements, called automatisms, involve the face, arms or legs, such as
    • lipsmacking or chewing movements
    • repeated movements of hands, like wringing, playing with buttons or objects in hands, waving
    • dressing or undressing
    • walking or running
  • Repeated purposeful movements (person may continue activity that was going on before the seizure)
  • Convulsion (person loses consciousness, body becomes rigid or tense, then fast jerking movements occur)
  • Losing control of urine or stool unexpectedly
  • Sweating
  • Change in skin color (looks pale or flushed)
  • Pupils may dilate or appear larger than normal
  • Biting of tongue (from teeth clenching when muscles tighten)
  • Difficulty breathing
  • Heart racing

Ending:

As the seizure ends, the postictal phase occurs - this is the recovery period after the seizure. Some people recover immediately while others may take minutes to hours to feel like their usual self. The type of seizure, as well as what part of the brain the seizure impacts, affects the recovery period – how long it may last and what may occur during it.

Common symptoms after a seizure. 

Awareness, Sensory, Emotional or Thought Changes:

  • Slow to respond or not able to respond right away
  • Sleepy
  • Confused
  • Memory loss
  • Difficulty talking or writing
  • Feeling fuzzy, lightlheaded or dizzy
  • Feeling depressed, sad, upset
  • Scared
  • Anxious
  • Frustrated, embarrassed, ashamed

Physical Changes:

  • May have injuries, such as bruising, cuts, broken bones or head injury if fell during seizure
  • May feel tired, exhausted or sleep for minutes or hours
  • Headache or other pain
  • Nausea or upset stomach
  • Thirsty
  • General weakness or weak in one part or side of the body
  • Urge to go to the bathroom or lose control of bowel or bladder

You are not alone.

If you or someone you know has seizures and any of the symptoms listed about, know that you are not alone.

Authored by: Steven C. Schachter, MD | Patricia O. Shafer, RN, MN | Joseph I. Sirven, MD
Reviewed by: Joseph I. Sirven, MD | Patricia O. Shafer, RN, MN on 3/2014
ADVERTISEMENT
Acute Causes of Seizures
  • Interruption of blood supply
  • High fever
  • Sleep deprivation
  • Lack of oxygen
  • Trauma
  • Infections of the brain
  • Poisons
ADVERTISEMENT