While all epileptic seizures are caused by electrical disturbances in the brain, there are many different kinds of seizures. Some children have just one type, others a combination. Children's behavior, risk of injury, and treatment depend upon what kinds of seizures they have. Therefore, it is important to work together with your doctor identify your child's seizure types. Carefully observing what happens to your child during a seizure and keeping a written record can provide valuable information. 

Here are two charts that can help you do this:

The first lists the kind of information about a seizure that can help identify it, such as if and how a child is moving and what the child's eyes, mouth, and other parts of the body are doing. The other is a log where you can record important information about each seizure, such as how long it occurs for, what happens during it and how your child feels after. If your child is often with other caregivers or in school, you might want to give them these charts too. 

An online version to help you chart information about seizure activity is called My Epilepsy Diary. It lets you keep track of the child's history, seizures, medicines, triggers, appointments, and many more. You can also share the information with the child's doctor or nurse if agreed upon by all parties. 

The kind of seizure a child has depends on whether the whole brain is affected or just a certain part of it. The brain has billions of nerve cells that continually communicate with each other through tiny electrical signals. If too many of these cells fire together, the sudden burst of electrical energy can cause a seizure. There are two main kinds of seizures:

  • Generalized seizures affect the whole brain
  • Focal seizures affect only one part of the brain

Sometimes the electrical disturbance starts in one part of the brain and then spreads; this is called a focal to bilateral generalized seizure.

  • Generalized Tonic Clonic Seizures — Also known as a convulsion, this is the most common and easily recognized kind of generalized seizure. The child suddenly cries or screams, becomes stiff, falls, and then begins to move arms or legs in jerky, up-and-down or side-to-side movements. Skin may appear bluish, breathing can be shallow or stop briefly, and teeth are usually clenched tight. The child may wet or soil themselves due to a loss of bladder or bowel control. The seizure usually lasts a minute or two. Afterward, the child is often confused, may complain of sore muscles or a bitten tongue, and will typically fall into a deep sleep.
  • Absence Seizures — These seizures can easily be confused with daydreaming or not paying attention. However, the child is completely unconscious and cannot be alerted or woken up. It usually lasts only a few seconds, during which the child might stare blankly ahead, blink rapidly, or appear to be chewing. After it's over, the child will often seem completely normal.
  • Atonic and Tonic Seizures — Also called “drop attack” seizures, these seizures are when the child suddenly collapses and falls. It can be from the body stiffening or the opposite — a complete loss of muscle tone. These seizures can cause injuries, including head injuries, because of the force of the fall. Therefore, doctors often recommend that children who get these kinds of seizures wear helmets while playing, especially outdoors. After an atonic or tonic seizure is over, usually in less than a minute, the child regains consciousness and awareness.
  • Myoclonic Seizures — These are sudden, brief muscle jerks, usually affecting the child's neck, shoulders, and upper arms. They can be fairly mild or strong enough to make a child fall. These seizures are most common in the morning and often occur in clusters (more than one). They can be frustrating, causing children to drop what they are holding, spill drinks, etc.
  • Focal Aware Seizures — During these seizures, the child is aware of what is happening, but can't control it. The seizure can cause uncontrolled movement of part of the body, things to smell or taste strange to the child, stomach pain, or sudden fear or anger.
  • Focal Impaired Awareness Seizures — These seizures vary, depending upon where in the brain they occur. The child may stare, chew, make odd movements, mumble, run, scream, or even see things. These seizures sometimes occur when the child is sleeping. During a focal impaired awareness seizure, the child is unconscious and won't remember it after. Also called “automatisms,” they usually last one or two minutes, after which the child is often frightened or confused.
  • Focal to Bilateral Generalized Tonic-Clonic Seizures — These seizures may begin in one focal area on one side of the brain but then spread to become generalized tonic-clonic seizures (convulsive) that involve both sides of the brain. 

Most seizures last a few seconds to a few minutes. If seizures last longer than 5 minutes, or occur one after another, there is an increased risk of status epilepticus, which means a continuous state of seizure. The First Aid section of this site has information on what to do if your child experiences a seizure or status epilepticus.

Read more about different kinds of seizures.

Authored By:

Joseph I. Sirven MD | Patty Osborne Shafer RN, MN

on Sunday, February 09, 2014

Reviewed By:

Elaine Kiriakopoulos MD, MSc
Elaine Wirrell MD

on Wednesday, September 25, 2019

Resources

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